Feasibility of Telerehabilitation-Based Pelvic Floor Muscle Training for Urinary Incontinence in People With Multiple Sclerosis: A Randomized, Controlled, Assessor-Blinded Study.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neurologic Physical Therapy Pub Date : 2023-10-01 Epub Date: 2023-06-12 DOI:10.1097/NPT.0000000000000448

Ipek Yavas, Turhan Kahraman, Ozge Sagici, Asiye Tuba Ozdogar, Pinar Yigit, Cavid Baba, Serkan Ozakbas

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引用次数: 0

Abstract

Background and purpose: Urinary incontinence is a common symptom in people with multiple sclerosis. The primary aim was to investigate feasibility of telerehabilitation-based pelvic floor muscle training (Tele-PFMT) and compare its effects on leakage episodes and pad usage with home exercise-based pelvic floor muscle training (Home-PFMT) and control groups.

Methods: Forty-five people with multiple sclerosis with urinary incontinence were randomized into 3 groups. Tele-PFMT and Home-PFMT groups followed the same protocol for 8 weeks, but Tele-PFMT performed exercises 2 sessions/week under a physiotherapist's supervision. The control group did not receive any specific treatment. Assessments were made at baseline, weeks 4, 8, and 12. Primary outcome measures were feasibility (compliance to exercise, patient satisfaction, and number of participants included in the study), number of leakage episodes, and pad usage. Secondary outcomes included severity of urinary incontinence and overactive bladder symptoms, sexual function, quality of life, anxiety, and depression.

Results: Participant eligibility rate was 19%. Patient satisfaction and compliance to exercise were significantly higher in Tele-PFMT than in Home-PFMT ( P < 0.05). No significant differences in the change of leakage episodes and pad usage were found between Tele-PFMT and Home-PFMT. No significant differences in secondary outcomes were found between PFMT groups. Participants in both the Tele-PFMT and Home-PFMT groups had significantly better scores for some measures of urinary incontinence, and overactive bladder and quality of life in compared with the control group.

Discussion and conclusions: Tele-PFMT was feasible and acceptable in people with multiple sclerosis, and this mode of delivery was associated with greater exercise compliance and satisfaction compared with Home-PFMT. However, Tele-PFMT did not exhibit superiority in terms of leakage episodes and pad usage compared with Home-PFMT. A large trial comparing Home-PFMT and Tele-PFMT is warranted.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A440 ).

查看原文本刊更多论文

基于远程康复的盆底肌训练治疗多发性硬化症患者尿失禁的可行性：一项随机、对照、评估者盲法研究。

背景和目的：尿失禁是多发性硬化症患者的常见症状。主要目的是研究基于远程康复的盆底肌训练（远程PFMT）的可行性，并将其对渗漏事件和垫使用的影响与基于家庭锻炼的盆底肌肉训练（家庭PFMT）和对照组进行比较。方法：将45例多发性硬化伴尿失禁患者随机分为3组。远程PFMT和家庭PFMT组在8周内遵循相同的方案，但远程PFMT在理疗师的监督下每周进行2次锻炼。对照组未接受任何特殊治疗。在基线、第4、第8和第12周进行评估。主要的结果指标是可行性（运动依从性、患者满意度和研究参与者人数）、渗漏次数和护垫使用情况。次要结果包括尿失禁和膀胱过度活动症状的严重程度、性功能、生活质量、焦虑和抑郁。结果：参与者合格率为19%。远程PFMT的患者满意度和运动依从性显著高于家庭PFMT（P<0.05）。远程PFMT和家庭PFMT在渗漏事件和垫使用的变化方面没有发现显著差异。PFMT组之间的次要结果没有发现显著差异。与对照组相比，远程PFMT组和家庭PFMT组的参与者在某些尿失禁、膀胱过度活动和生活质量方面的得分均显著高于对照组。讨论和结论：远程PFMT在多发性硬化症患者中是可行和可接受的，与家庭PFMT相比，这种分娩方式与更高的运动依从性和满意度有关。然而，与家用PFMT相比，远程PFMT在泄漏事件和衬垫使用方面没有表现出优势。有必要进行一项比较家庭PFMT和远程PFMT的大型试验。视频摘要可从作者处获得更多见解（请参阅视频，补充数字内容，网址：http://links.lww.com/JNPT/A440）。

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来源期刊

Journal of Neurologic Physical Therapy CLINICAL NEUROLOGY-REHABILITATION

CiteScore

5.70

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Neurologic Physical Therapy (JNPT) is an indexed resource for dissemination of research-based evidence related to neurologic physical therapy intervention. High standards of quality are maintained through a rigorous, double-blinded, peer-review process and adherence to standards recommended by the International Committee of Medical Journal Editors. With an international editorial board made up of preeminent researchers and clinicians, JNPT publishes articles of global relevance for examination, evaluation, prognosis, intervention, and outcomes for individuals with movement deficits due to neurologic conditions. Through systematic reviews, research articles, case studies, and clinical perspectives, JNPT promotes the integration of evidence into theory, education, research, and practice of neurologic physical therapy, spanning the continuum from pathophysiology to societal participation.