基于三个提出的理论机制,盆底肌肉训练被推荐作为女性尿失禁的一线治疗方法:增强盆底肌肉力量,\'\'对时间的最大认识,\'和\'加强核心肌肉\'。这项范围审查的目的是系统地绘制支持和反对盆底肌肉训练干预措施减少女性尿失禁的理论机制的证据。
范围审查是基于对1990年至2020年在PubMed上发表的相关文献的全面搜索,CINAHL,PsycINFO,ClinialTrials.gov,来自评论文章的参考列表,以及该领域已知研究人员对文章的手工搜索。我们包括英语,如果盆底肌肉训练作为成年女性干预措施的同行评审文章为检验理论干预机制提供了经验证据。两名独立审稿人筛选了纳入的文章,并提取了描述每一项研究细节的数据(作者,Year,国家,设计,采样),盆底肌肉力量和尿失禁的措施,措施变化之间联系的统计分析,和盆底肌肉训练方案。总结了数据,以促进整合各种证据,以得出结论,支持或驳斥三种建议的控制女性尿失禁的理论机制。
在搜索确定的278篇文章中,13人(4.7%)符合纳入标准。盆底肌肉力量增强的机制缺乏证据,模棱两可地支持最大化的时机意识,也没有核心肌肉得到加强的证据.
这篇综述揭示了极其有限的数据,支持盆底肌肉训练计划管理女性尿失禁的理论机制。需要这样的证据来帮助女性和临床医生了解,为什么和当一个女人受益于盆底肌肉训练。未来的研究应该具体说明和报告统计分析,将理论机制与观察到的训练结果联系起来。
Pelvic floor muscle training is recommended as first line treatment for urinary incontinence in women based on three proposed theorized mechanisms: \'Enhanced Pelvic Floor Muscle Strength,\' \'Maximized Awareness of Timing,\' and \'Strengthened Core Muscles\'. The purpose of this scoping
review was to systematically map evidence for and against theorized mechanisms through which pelvic floor muscle training interventions work to reduce urinary incontinence in women.
The scoping
review is based upon a comprehensive search of relevant literature published from 1990 to 2020 in PubMed, CINAHL, PsycINFO, ClinialTrials.gov, reference lists from
review articles, and hand searches of articles by known researchers in the field. We included English-language, peer-reviewed articles on pelvic floor muscle training as an intervention for adult women if they provided empirical evidence to testing the theorized intervention mechanisms. Two independent reviewers screened articles for inclusion and extracted data to describe details of each study (author, year, country, design, sampling), measures of pelvic floor muscle strength and urinary incontinence, statistical analysis of linkage between changes in the measures, and pelvic floor muscle training regimens. Data were summarized to facilitate the integration of diverse evidence to draw conclusions on supporting or refuting the three proposed theorized mechanisms for managing urinary incontinence in women.
Of the 278 articles identified with the search, 13 (4.7%) met inclusion criteria. There was weak to no evidence for the mechanism of enhanced pelvic floor muscle strength, equivocal support for maximized awareness of timing, and no evidence for strengthened core muscles.
This
review revealed extremely limited data supporting the proposed theorized mechanisms underlying pelvic floor muscle training programs to manage urinary incontinence in women. Such evidence is needed to help women and clinicians understand how, why and when a woman benefits from pelvic floor muscle training. Future studies should specifically state and report statistical analysis that relates the theorized mechanisms to the training outcomes observed.