Turkish Journal of Physical Medicine and Rehabilitation 2002 , Vol 48 , Num 5

Stres Üriner İnkontinans Rehabilitasyonunda Biofeedback ve Pelvik Taban Kas Egzersizlerinin Kısa Dönem Etkinliği

Ayşe Karan 1 ,Nurten Eskiyurt 2 ,Önay Yalçın 3 ,Mete Işıkoğlu 3 ,Buket Aksaç 4 ,Semih Akı 5
1 İstanbul Üniversitesi İstanbul Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye
2 İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye
3 İstanbul Üniversitesi İstanbul Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, İstanbul
4 İstanbul Üniversitesi İstanbul Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbu
5 İstanbul Üniversitesi İstanbul Tıp Fakültesi, Fiziksel ve Rehabilitasyon Anabilim Dalı, İstanbul

We aimed to assess the effectiveness of pelvic floor muscle exercises (PFMEs) for the rehabilitation of genuine stress incontinence and results of the two methods of digital palpation and biofeedback for teach- ing the patients PFMEs was also compared in this study. The study was done on fifty patients with urodynamically verified diagnoses of genuine urinary incontinence. This randomized, controlled clinical study consisted of three groups. All of the patients in three groups were on hormone replacement therapy. The first group of 20 patients were taught PFMEs via digital palpation and instructed to continue the exercises as a home programme. These patients were controlled in the outpatient clinic weekly for a follow up period of 8 weeks. The second group of 20 patients underwent PFMEs via biofeedback session lasted 20 minutes, three times a week for 8 weeks. The third group of 10 patients did not have any exercise programme. Each group of patients were evaluated with the following parameters initially and 8 weeks later: pad test, perineometry, muscle strength assessment with digital palpation, incontinence frequency and Visual Analog Scale (VAS) for social activity index. All of the evaluation parameters revealed that the first two groups of patients were improved with respect to the pretreatment period. The results of these two groups were also significantly better than the third group of patients (p<0.001). The results of the first two groups were no better than each other except the value of perineometry (p>0.05). The values of perineometry in second group are better than those of first group (p<0.001). As a result, PFMEs which were taught by way of biofeedback and digital palpation resulted in significant improvement of the parameters of pad test, perineometry, digital palpation muscle strength, incontinence frequency and social activity index. Hence, PFMEs were effective for the treatment of genuine urinary incontinence in short term but improve-ment of perineometry value is better in the group of biofeedback.

Keywords : Stress urinary incontinence, pelvic floor muscle rehabilitation, biofeedback, perineometry