音频指导居家盆底肌锻炼对压力性尿失禁孕妇产后盆底康复的效果评价

The effects of pelvic floor muscle training based on audio guidance on postpartum pelvic floor rehabilitation in primiparas with stress urinary incontinence

目的探讨音频指导的居家盆底肌锻炼对压力性尿失禁孕妇产后盆底康复的效果。方法采用抽签法将108例合并压力性尿失禁的孕妇分为试验组(n=54)和对照组(n=54),试验组在对照组常规盆底肌锻炼的基础上采用音频指导锻炼,两组均锻炼至产后6个月,比较产后6~8周、3个月、6个月盆底肌肌电值、锻炼依从性及压力性尿失禁严重程度。结果产后6~8周、3个月、6个月,试验组盆底肌锻炼依从性均优于对照组(P<0.05);Ⅰ类肌纤维平均肌电值组间与时间存在交互效应(F=4.702,P=0.011),简单效应分析显示,产后6~8周、3个月、6个月,试验组Ⅰ类肌纤维平均肌电值均高于对照组(P<0.05);Ⅱ类肌纤维最大肌电值组间效应有统计学意义(F=13.881,P<0.001),时间效应有统计学意义(F=228.685,P<0.001),组间与时间无交互效应(F=0.664,P=0.517);耐力测试平均肌电值组间与时间存在交互效应(F=4.009,P=0.021),简单效应分析显示,产后6~8周、3个月、6个月,试验组耐力测试平均肌电值均高于对照组(P<0.05);两组尿失禁严重程度差异无统计学意义(P>0.05)。结论音频指导有利于提高孕产妇盆底肌锻炼的依从性,增强产后盆底肌力。

Objective To explore the effects of pelvic floor muscle training based on App-based audio guidance on postpartum pelvic floor rehabilitation in primiparas with stress urinary incontinence.Methods A total of 108 pregnant women with stress urinary incontinence were recruited and divided into the experimental group(n=54)and the control group(n=54)by lottery.Patients in the experimental group received audio guided exercises on the basis of routine care.Patients in both groups exercised to 6 months after childbirth.The pelvic floor muscle surface electromyography(sEMG),exercise compliance and the severity of stress urinary incontinence at 6~8 weeks,3 months,and 6 months after childbirth were compared between the two groups.Results At 6~8 weeks,3 months,and 6 months after childbirth,the compliance of the experimental group with pelvic floor muscle exercise was better than that of the control group(P<0.05).There was an interaction effect between groups and time in the average sEMG value of typeⅠfibers(F=4.702,P=0.011),and the simple effect analysis showed that the average sEMG value of typeⅠfibers in the experimental group were higher than those in the control group at different stages postpartum(P<0.05).The maximal sEMG value of typeⅡfibers was statistically significant between groups(F=13.881,P<0.001),and the time effects were statistically significant(F=228.685,P<0.001).The interaction between the invisible group and time was not statistically significant(F=0.664,P=0.517).There was an interaction effect between groups and time in the average sEMG values of endurance test(F=4.009,P=0.021).The simple effect analysis showed that at 6~8 weeks,3 months,and 6 months after childbirth,the average sEMG value of endurance test in the experimental group were higher than that in the control group(P<0.05).The severity of stress urinary incontinence in the two groups were relieved,however,the differences between the groups were not statistically significant(P>0.05).Conclusion Audio guidance is helpful to improve the compliance with the pelvic floor muscle training of pregnant women therefore improving postpartum pelvic floor muscle strength.