Predictors of Success for Physiotherapy Treatment in Women With Persistent Postpartum Stress Urinary Incontinence

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• 作者：Chantale Dumoulin ; PhD ; PT^a ; ^b ; ^{chantal.dumoulin@umontreal.ca" class="auth_mail" title="E-mail the corresponding author} ; Daniel Bourbonnais ; PhD ; OT^a ; ^c ; Mé ; lanie Morin ; PhD ; PT^d ; Denis Gravel ; PhD ; PT^a ; ^c ; Marie-Claude Lemieux ; MD ; FRCS(C)^e
• 关键词：Muscle strength ; Pelvic floor ; Postpartum period ; Rehabilitation ; Urinary incontinence ; stress
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2010
• 出版时间：July 2010
• 年：2010
• 卷：91
• 期：7
• 页码：1059-1063
• 全文大小：187 K

文摘

Dumoulin C, Bourbonnais D, Morin M, Gravel D, Lemieux M-C. Predictors of success for physiotherapy treatment in women with persistent postpartum stress urinary incontinence.

Objective

To identify predictors of success for physiotherapy treatment in women with persistent postpartum stress urinary incontinence (SUI).

Design

Secondary analysis of data from a single-blind randomized controlled trial comparing 2 physiotherapy intervention programs for persistent SUI in postpartum women.

Setting

Obstetric clinic of a mother and children's university hospital.

Participants

Women, ages 23 to 39 (N=57), were randomized to 1 of 2 pelvic floor muscle (PFM) training programs, 1 with and 1 without abdominal muscle training.

Intervention

Over 8 weeks, participants in each group followed a specific home exercise program once a day, 5 days a week. In addition, participants attended individual weekly physiotherapy sessions throughout the 8-week program.

Main Outcome Measures

Treatment success was defined as a pad weight gain of less than 2g on a 20-minute pad test with standardized bladder volume after 8 weeks' treatment. The relationship between potential predictive PFM function variables as measured by a PFM dynamometer and success of physiotherapy was studied using forward stepwise multivariate logistic regression analyses.

Results

Forty-two women (74%) were classified as treatment successes, and 15 (26%) were not. Treatment success was associated with lower pretreatment PFM passive force and greater PFM endurance pretreatment, but the latter association was barely statistically significant. This model explained between 23% (Cox and Snell R²) and 34% (Nagelkerke R²) of the outcome variability.

Conclusions

The results contribute new information on predictors of success for physiotherapy treatment in women with persistent postpartum SUI.