Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 9-10, Pages: 638-644
https://doi.org/10.2298/SARH1110638P
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Physical therapy in the treatment of stress urinary incontinence
Parezanović-Ilić Katarina (Centar za fizikalnu medicinu i rehabilitaciju, Klinički centar, Kragujevac)
Jeremić Branislav (Centar za terotehnologiju i tribologiju, Mašinski fakultet, Kragujevac)
Mladenović-Segedi Ljiljana (Klinika za akušerstvo i ginekologiju, Klinički centar Vojvodine, Novi Sad)
Arsenijević Slobodan (Ginekološko-akušerska klinika, Klinički centar, Kragujevac)
Jevtić Milorad (Centar za fizikalnu medicinu i rehabilitaciju, Klinički centar, Kragujevac)
Introduction. Stress urinary incontinence (SUI) is an involuntary release of
urine through the urethra during the increase of abdominal pressure in the
absence of m. detrusor contraction. The exercise of pelvic floor muscles is
recommended as the first line of cure. It is the least invasive and the only
method without any undesirable side effects, which leads to either
improvement or complete cure of SUI in 80-85% of cases. Objective. The aim of
this study was to establish whether the strengthening of pelvic floor muscles
using proprioceptive neural facilitation (PNF) spiral dynamic technique was
more efficient in comparison to classical Kegel exercise. Methods. The
research was carried out at the Centre for Physical Medicine and
Rehabilitation, Clinical Centre Kragujevac. Sixty-six female patients with
the symptoms of SUI were monitored in the period of two years. Thirty-four
patients did pelvic floor muscle exercises twice a day, in the morning and in
the evening, with 15-20 contractions. Thirty-two patients used PNF spiral
dynamic technique for strengthening pelvic floor muscles. The patients who
used the spiral dynamic technique also did some exercises from the program;
they exercised twice a day, in the morning and in the evening, following the
prescribed schedule. Treatment outcome was assessed by measuring the pelvic
floor muscles by a vaginal dynamometer. Results. The values of the pelvic
floor muscle force that were measured using the vaginal dynamometer in both
examined groups (PNF spiral dynamic technique or Kegel exercise) were
statistically significantly higher after the implemented exercise program
(t-test; p=0.000). No statistically significant difference in pelvic floor
muscle values was found between the patients who applied PNF spiral dynamic
technique and those who did Kegel exercise either before or after the
exercise (two-factor analysis of variance with repeated measurements, factor
of exercise type; p=0.899). Conclusion. Strengthening of pelvic floor muscles
by exercises results in a significant increase of pelvic floor muscle
strength and reduction of SUI symptoms, regardless of the used exercise
program, PNF spiral dynamic technique or Kegel exercise program.
Keywords: urinary incontinence, proprioceptive neural facilitation, spiral dynamic technique, Kegel exercise
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