The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: a systematic literature review

Purpose

The purpose of this review was to assess the effectiveness of pelvic floor muscle training (PFMT) in the treatment of urinary incontinence (UI) in women, with a particular focus on the impact of this form of therapy on the patients' quality of life (QoL).

Methods

The following electronic databases were searched: PubMed, Embase, and Cochrane Library (articles only in English, 1990-2017). Search terms were as follows: urinary incontinence, pelvic floor muscle training, pelvic floor exercises, quality of life. Systematic review methods were based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement.

Results

The assessment of the impact of PFMT on the QoL of women with UI was conducted among 2,394 women in 24 selected studies. After the end of treatment, the majority of patients in the experimental groups noted a statistically significant improvement in QoL.

Conclusion

The results of this literature review demonstrate that PFMT is an effective treatment for UI in women. PFMT significantly improves the QoL of women with UI, which is an important determinant of their physical, mental, and social functioning.

The Impact Of Pelvic Floor Muscle Training On Urinary Incontinence In Men After Radical Prostatectomy (RP) - A Systematic Review

PURPOSE

The purpose of this study was to determine the efficacy of pelvic floor muscle training (PFMT) in the treatment of urinary incontinence (UI) in men after radical prostatectomy (RP).

METHODS

PubMed, ScienceDirect, and Cochrane Library databases were searched for studies published in years 2000-2019. We included randomized controlled trials in English which compare clinic-based vs home-based PFMT, preoperative and postoperative PFMT, supervised vs unsupervised PFMT, and PFMT alone vs no treatment at all.

RESULTS

Eight articles were included in the final review. There was a total of 1078 patients aged 45-75 in all study groups. The study participants received radical retropubic prostatectomy or radical prostatectomy. Included studies assessed the following interventions: preoperative and postoperative PFMT, supervised vs home-based PFMT, unsupervised PFMT vs no treatment at all, and PFMT combined with resistance and flexibility exercises vs PFMT alone.

CONCLUSION

PFMT is an effective treatment for urinary incontinence in men after radical prostatectomy. PFMT improves not only physical parameters but also the quality of life of men after RP.

The impact of pelvic floor muscle training on the myostatin concentration and severity of urinary incontinence in elderly women with stress urinary incontinence - a pilot study

Objective

The aim of the study was to assess the myostatin concentration and an improvement in the severity of urinary incontinence (UI) after pelvic floor muscle training (PFMT) in a group of elderly women with stress UI.

Methods

A total of 74 participants were included in the analysis: 40 participants in the experimental group (EG) and 34 participants in the control group (CG). The EG underwent PFMT, whereas no therapeutic intervention was applied to the CG. Myostatin concentration and UI severity (Revised Urinary Incontinence Scale [RUIS]) were assessed in all women before and after the treatment.

Results

By comparing the results before and after the treatment, we have been able to demonstrate a statistically significant decrease in myostatin concentration (P<0.0001) and an improvement in the severity of UI (RUIS) (P<0.0001) in the EG. No statistically significant differences in all measured variables were reported before and after the treatment in the CG. A lower myostatin concentration (P=0.0084) and an improvement in the severity of UI (RUIS) (P=0.0008) were observed after the treatment in the EG compared to that in the CG.

Conclusion

Effective PFMT causes downregulation of myostatin concentration and an improvement in the severity of UI in elderly women with stress UI. Further trials on a larger EG and an assessment of long-term treatment outcomes are required.

A randomized-controlled trial pilot study examining the effect of extracorporeal magnetic innervation in the treatment of stress urinary incontinence in women

Introduction

Peri- and postmenopausal women frequently suffer from urinary incontinence (UI). Generally, UI becomes more severe with age. It impacts physical, mental, and social functioning as well as the quality of life, often leading to depression. Extracorporeal magnetic innervation (ExMI) is a relatively new conservative treatment method for UI.

Objective

The aim of the study was to assess the effectiveness of ExMI in the treatment of stress UI in women.

Methods

A total of 52 women were included in the analysis: 28 participants were allocated to the experimental group (EG) and 24 to the control group (CG). The average age was 65.41 years (±SD 4.08). EG patients completed ExMI therapy. The treatment sessions lasted for 15 minutes, and occurred three times a week, for 4 weeks. No therapeutic intervention was applied to the CG. To objectify the treatment outcomes in both groups before and after the treatment, we measured myostatin concentration and performed the UI severity assessment (The Revised Urinary Incontinence Scale), perceived self-efficacy assessment (General Self-Efficacy Scale), and depression severity assessment (Beck Depression Inventory).

Results

The authors compared the EG results at the initial and final assessments and found a statistically significant improvement in severity of UI (P=0.001) and depression severity (P=0.006), and a decrease in myostatin concentration (P≤0.001). The authors did not find any statistically significant differences between all measured variables for the CG at the initial and final assessments. Furthermore, there were no statistically significant differences between all measured variables for the EG and the CG at the final assessment.

Conclusion

Further trials are needed to determine optimal treatment protocols for various UI types and to evaluate long-term outcomes of the ExMI treatment.

The Effects of Extracorporeal Magnetic Innervation in the Treatment of Women with Urinary Incontinence: A Systematic Review

PURPOSE

The aim of this study is to identify and critically evaluate literature regarding the clinical efficacy of extracorporeal magnetic innervation (ExMI) in the treatment of female patients with urinary incontinence (UI).

METHODS

An analysis was carried out using the following electronic databases: Medline, PubMed, ScienceDirect, and the Cochrane Library (data published between 2008 and 2023). Searches of the above databases were conducted in April 2023. Only randomized clinical studies (RCTs) in English studies were eligible for the study. Randomized controlled trials were included in the review and evaluated with the Downs and Black checklist.

RESULTS

Eleven studies met the inclusion criteria. Among these, two studies examined the use of ExMI and PMFT (pelvic floor muscle training) and three studies compared active ExMI versus sham ExMI. Four studies evaluated solely ExMI, and moreover, there was no control group in two of these studies. One study compared the effects of Kegel exercises with ExMI, while another study compared electrostimulation with ExMI. The reviewed studies exhibited significant differences in interventions, populations, and outcome measures.

CONCLUSIONS

Extracorporeal magnetic stimulation has shown promise as an effective treatment for female urinary incontinence. Whether used alone or as a component of combination therapy, ExMI has the potential to enhance patients' quality of life (QoL) without significant safety concerns.

A randomised-controlled trial pilot study examining the effect of pelvic floor muscle training on steroid hormone concentrations in elderly women with stress urinary incontinence

INTRODUCTION

In this study, we attempted to examine the effect of pelvic floor muscle training on testosterone and cortisol concentrations in elderly women with stress urinary incontinence.

MATERIAL AND METHODS

The number of participants included in the analysis was 59: 30 women in the experimental group (EG) and 29 women in the control group (CG). The EG underwent pelvic floor muscle training, whereas the CG did not receive any therapeutic intervention. In the present study the authors measured testosterone and cortisol concentrations as well as body mass index (BMI) in all study participants at the initial and final assessments.

RESULTS

The initial and final assessment results were compared and showed a statistically significant decrease in cortisol concentration and an increase in testosterone concentration in the EG. However, no statistically significant differences in the measured variables were observed in the CG at the initial and final assessments. The authors did not report any statistically significant correlations between testosterone and cortisol concentrations and the BMI score in the EG and CG. Also, statistically significant correlations between testosterone and cortisol concentrations in the EG were not apparent.

CONCLUSIONS

Determination of the concentration of testosterone and cortisol is a method that may help to objectify pelvic floor muscle training outcomes in elderly women with stress urinary incontinence.

Rehabilitation of infants after transtibial amputation due to thrombosis in the perinatal period. Case report

Congenital thrombosis and amputation in infancy is not common. Therefore, the existing literature lacks sufficient evidence regarding this subject. Available research primarily focuses on treatment and causes of thrombosis in children. The paper describes a case of preterm infant after transtibial amputation due to common iliac artery thrombosis during the perinatal period. The girl began neurodevelopmental therapy based on normal development patterns of infants, which was provided three times a week for 45 minutes. The rehabilitation process also included prosthesis and surgical interventions. The assessment of motor development of the child was carried out at the age of 6, 9, 12, 18 and 20 months, using the motor scale of the Albert Infants Motor Scale (AIMS). Case analysis allows to state that infant rehabilitation after transtibial amputation should be individualized, and focus on supporting normal motor development, based on the correct movement sequences of infants. Additionally, the AIMS scale can be used to assess the gross motor development in infants after amputation and is useful in formulating early therapeutic intervention. A prosthetist should perform prosthesis revisions as often as needed, i.e., in infants that is usually every 4 months. What is more, successful outcomes can be achieved by implementing proper surgical procedures regarding the appositional overgrowth of the residual limb in growing children.

Functional assessment of children with cerebral palsy –current reports

Many new definitions, classifications and ways of treating cerebral palsy (CP) have been identified within the last few years. Numerous tools determining the functional condition of children suffering from CP were developed, however, the ones which were approachable, were modified accordingly. Currently applied classifications take into account participation in a social life, activity ,as well as secondary alterations. The majority of results obtained from worldwide clinical research conducted in a group of children with CP are based on popular tests. The main aim of this paper is to show and analyse the crucial scales used for the functional assessment of children with the CP by taking into consideration the age and activity of patients and reliability of classifications.