Fizioterapevtski postopki pri konzervativni obravnavi stresne urinske inkontinence pri starejših ženskah : diplomsko delo

Strle, Nika Aleša (author), Jakovljević, Miroljub (mentor)

Uvod: Stresna urinska inkontinenca pomeni nehoteno uhajanje urina ob aktivnostih, ki povečajo pritisk v trebušni votlini. Je posledica šibkosti mišic medeničnega dna ali oslabljene podpore sečnega mehurja. Najpogosteje se pojavi pri ženskah okrog menopavze in predstavlja pomemben zdravstveni, higienski in psihološki oziroma socialni problem. Primarna obravnava je konzervativno zdravljenje, ki vključuje fizioterapevtske postopke, kot so vadba mišic medeničnega dna, električna ali magnetna stimulacija, pa tudi ukrepe za zdrav življenjski slog in uporabo higienskih izdelkov. Namen: V diplomskem delu smo želeli preko pregleda literature predstaviti učinkovitost fizioterapevtskih postopkov pri konzervativni obravnavi starejših žensk s stresno urinsko inkontinenco. Metode dela: Znanstvene prispevke smo iskali v podatkovnih zbirkah PEDro, PubMed, MEDLINE, CINAHL, Wiley Online Library in Science Direct. Iskanje smo omejili na časovno obdobje 2008–2018. Raziskave smo ocenili s PEDro lestvico in vključili le tiste z oceno 5 ali več. Rezultati: Na podlagi kriterijev je bilo v pregled literature vključenih 6 raziskav – tri randomizirane kontrolirane raziskave, dve pilotni raziskavi in ena študija primera. Omenjene so še štiri raziskave, ki kriterijem le minimalno niso zadostile, vendar so bile za diplomsko delo relevantne. V vseh raziskavah je bil preučevan vpliv različnih fizioterapevtskih postopkov za zdravljenje stresne urinske inkontinence. Predstavljene so vadba mišic medeničnega dna, električna stimulacija, magnetna stimulacija in terapevtska masaža trebuha, večinoma pa so del obravnave tudi nasveti za zdrav življenjski slog. Razprava in zaključek: V raziskavah so bile uporabljene različne oblike fizioterapije, zato rezultatov ne moremo ustrezno primerjati med seboj, je pa pri vseh obravnavah prišlo do izboljšanja stanja v primerjavi z začetnim stanjem oziroma s primerjalno skupino. Na podlagi pregledane literature je težko določiti, katera vrsta intervencije je najučinkovitejša, saj je bilo pri vseh opaženo zmanjšanje simptomov in izboljšanje kakovosti življenja; relativizirani rezultati pa kot najučinkovitejšo intervencijo nakazujejo visokointenziven program vadbe mišic medeničnega dna. Lahko zaključimo, da so fizioterapevtski postopki pri obravnavi starejših žensk s stresno urinsko inkontinenco učinkoviti, za točno določanje razlik med učinkovitostjo posameznih postopkov pa je potrebno nadaljnje raziskovanje.

• Language: Slovenian
• Keywords: stresna urinska inkontinenca, starejše ženske, konzervativna obravnava, fizioterapevtski postopki
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-103042
• COBISS.SI-ID: 5484651
• Publication date in RUL: 13.09.2018

Secondary language

• Language: English
• Title: Physiotherapy as a part of conservative treatment of stress urinary incontinence in older women : diploma work

Abstract

Introduction: Stress urinary incontinence is defined as involuntary loss of urine during activities that increase abdominal pressure. It is caused by pelvic floor muscle weakness or loss of bladder support. It is most prevalent in menopausal women and regarded as an important health, hygienic, psychological, and social problem. Primary treatment is conservative management, including physiotherapeutic treatments such as pelvic floor muscle training, electrical or magnetic stimulation, together with healthy life style modification, and hygienic products. Purpose: The aim of this paper is to review relevant literature and present the effectiveness of different physiotherapeutic interventions in conservative treatment of older women with stress urinary incontinence. Methods: Literature search was conducted in electronic databases PEDro, PubMed, MEDLINE, CINAHL, Wiley Online Library, and Science Direct. The search was limited to articles published from 2008 to 2018. Where possible, methodology of the studies was assessed using PEDro scale; only studies graded 5 or more were included in this paper. Results: Based on set criteria we included six studies in this systematic literature review – three randomized controlled trials, two pilot studies, and one case report. There are four more studies mentioned which almost met the criteria and present relevant information. All included studies researched the effectiveness of different physiotherapeutic treatments for stress urinary incontinence; pelvic floor muscle training, electrical stimulation, magnetic stimulation, and therapeutic abdominal massage are presented, with healthy life style modification often also being a part of the treatment. Discussion and conclusion: As different treatments were used in different studies, it is hard to compare their results; however, each study showed an improvement of the condition in comparison to the baseline values or control group results. Based on the reviewed literature it is difficult to define the most effective treatment option, as all treatments resulted in alleviation of the symptoms and improvement of quality of life; nevertheless, relativised results point to the intensive exercise program for pelvic floor muscles as the most effective therapy. It can be concluded that physiotherapy is effective in conservative treatment of older women with stress urinary incontinence, however further research is necessary to distinguish the effectiveness of different kinds of therapy.

• Keywords: stress urinary incontinence, older women, conservative treatment, physiotherapy