Evidence for Benefit of Transversus Abdominis Training Alone or in Combination With Pelvic Floor Muscle Training to Treat Female Urinary Incontinence: A Systematic Review

被引:72
作者
Bo, Kari [1 ]
Morkved, Siv [2 ]
Frawley, Helena [3 ,4 ]
Sherburn, Margaret [3 ,4 ]
机构
[1] Norwegian Sch Sport Sci, Dept Sports med, N-0806 Oslo, Norway
[2] Norwegian Univ Sci & Technol, St Olavs Hosp, Clin Serv, Univ Trondheim Hosp,Dept Community Med & Gen Prac, N-7034 Trondheim, Norway
[3] Univ Melbourne, Sch Physiotherapy, Melbourne, Vic, Australia
[4] Royal Hosp Women, Melbourne, Vic, Australia
关键词
pelvic floor dysfunction; pelvic floor muscles; physiotherapy; transversus abdominis; urinary incontinence; INTRAVAGINAL PRESSURE; VAGINAL CONES; SINGLE-BLIND; STRESS; WOMEN; EXERCISE; HEALTHY; CONTRACTION; STRENGTH; COUGH;
D O I
10.1002/nau.20700
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Aims: Pelvic floor muscle training (PFMT) has Level A evidence to treat female urinary incontinence (UI). Recently, indirect training of the pelvic floor muscles (PFM) via the transversus abdominis muscle (TrA) has been suggested as a new method to treat UI. The aim of this article is to discuss whether there is evidence for a synergistic co-contraction between TrA and PFM in women with UI, whether TrA contraction is as effective, or more effective than PFMT in treating UI and whether there is evidence to recommend TrA training as an intervention strategy. Methods: A computerized search on PubMed, and hand searching in proceedings from the meetings of the World Confederation of Physical Therapy (1993-2007), International Continence Society and International Urogynecology Association (1990-2007) were performed. Results: While a co-contraction of the TrA normally occurs with PFM contraction, there is evidence that a co-contraction of the PFM with TrA contraction can be lost or altered in women with UI. No randomized controlled trials (RCTs) were found comparing TrA training with untreated controls or sham. Two RCTs have shown no additional effect of adding TrA training to PFMT in the treatment of UI. Conclusions: To date there is insufficient evidence for the use of TrA training instead of or in addition to PFMT for women with UI. Neurourol. Urodynam. 28:368-373, 2009. (C) 2009 Wiley-Liss, Inc.
引用
收藏
页码:368 / 373
页数:6
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