远程保健骨盆-腹部力学训练康复计划对产褥期妇女盆底康复的有效性:一项随机对照研究。

IF 3.4 3区 医学 Q1 REHABILITATION
Ran Zhang, Yu Guo, Jiahua Zhang, Jing Zhang, Rui Zhuang, Chunli Liao, Haixin Bo
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引用次数: 0

摘要

背景:尽管盆底肌训练(PFMT)已成为产褥期妇女盆底功能障碍(PFD)的一线治疗方法,但其实施仍存在许多障碍。建立一个既有趣又方便的远程医疗盆底康复项目是必要的。目的:评价远程保健盆腹力学康复训练方案对产褥期妇女盆底康复的效果。设计:随机对照试验。设置:基于家庭的锻炼计划。人群:单胎,头侧初产妇。方法:将60名参与者随机分为干预组和对照组。干预组采用远程保健盆腹力学训练康复方案,为期6周,对照组维持常规护理。在产后1周(T1)和产后42天(T2)评估产褥期妇女PFD的痛苦程度。分别于产后2 d (T0)、t1、T2评估产妇对PFMT的知识、态度和自我效能感水平。在T0和T2时评估直间距(IRD)程度。T2时评估盆底肌力,包括改良牛津肌力(MOS)分级和动态阴道最大压力值。根据统计资料的类型选择统计分析方法,主要包括t检验和双因素重复测量方差分析。结果:所有受试者均未发生不良结局。干预6周后,干预组在T2时PFDI-20评分明显低于对照组,IRD程度较轻。在T1和T2时,实验组的单纯效果显著,干预组对PFMT的认知和态度高于对照组(F=4.427, P=0.040,偏η2=0.071; F=5.266, P=0.025,偏η2=0.083)。T2时,干预组单纯效果显著,干预组对PFMT的自我效能水平高于对照组(F=37.908, P2=0.395)。两组在T2时的牛津肌力分级、阴道动态最大压力值、I型和II型肌纤维强度比较,差异均无统计学意义。结论:远程保健盆腹力学训练康复方案可显著提高产褥期妇女的康复效果。临床康复影响:产褥期盆腹力学训练康复方案安全有效。远程医疗是一种非常推荐的手段盆底康复产褥期。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of telehealth pelvic-abdominal mechanics training rehabilitation program for pelvic floor rehabilitation in puerperal women: a randomized controlled study.

Background: There are still numerous barriers to the implementation of pelvic floor muscle training (PFMT), though it has been the first-line treatment for pelvic floor dysfunction (PFD) in puerperal women. The construction of telehealth pelvic floor rehabilitation program that is both fun and accessible is necessary.

Aim: To assess the efficacy of telehealth pelvic-abdominal mechanics rehabilitation training program for pelvic floor rehabilitation in puerperal women.

Design: A randomized controlled trial.

Setting: Home-based exercise program.

Population: Singleton, cephalic primiparous women.

Methods: The 60 participants recruited were randomly assigned to either the intervention or control group. The intervention group received a telehealth pelvic-abdominal mechanics training rehabilitation program for 6 weeks, while the control group remained on the routine care. The degree of distress of PFD in puerperal women was assessed at one week postpartum (T1) and 42 days postpartum (T2). The level of knowledge, attitudes and self-efficacy towards PFMT were assessed at 2 days postpartum (T0), T1and T2. The degree of inter-recti distance (IRD) was assessed at T0 and T2. Pelvic floor muscle strength was assessed at T2, including modified Oxford muscle strength (MOS) classification and dynamic maximal vaginal pressure values. Statistical analysis methods were chosen based on the type of statistical data, mainly including t-test and two-factor repeated measures ANOVA.

Results: No adverse outcomes occurred in all participants. After a 6-week intervention, the intervention group had a significantly lower PFDI-20 score than the control group at T2 and exhibited a lesser degree of IRD. At T1 and T2, the simple effect of group was significant, with the intervention group demonstrating higher levels of knowledge and attitude towards PFMT compared to the control group (F=4.427, P=0.040, partial η2=0.071; F=5.266, P=0.025, partial η2=0.083). At T2, the simple effect of group was significant, with the intervention group demonstrating higher level of self-efficacy towards PFMT compared to the control group (F=37.908, P<0.001, partial η2=0.395). There was no statistically significant difference between the two groups in terms of Oxford muscle strength classification, dynamic maximal vaginal pressure values, muscle fiber strength of type I and type II at T2.

Conclusions: This study provided evidence that telehealth pelvic-abdominal mechanics training rehabilitation program can significantly improve the rehabilitation effect of puerperal women.

Clinical rehabilitation impact: A pelvic-abdominal mechanics training rehabilitation program during the puerperium is safe and effective. Telemedicine is an extremely recommended means of pelvic floor rehabilitation during the puerperium.

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来源期刊
CiteScore
8.50
自引率
4.40%
发文量
162
审稿时长
6-12 weeks
期刊介绍: The European Journal of Physical and Rehabilitation Medicine publishes papers of clinical interest in physical and rehabilitation medicine.
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