Article

OBJECTIVE: To identify predictors of success for physiotherapy treatment in women
with persistent postpartum stress urinary incontinence (SUI). DESIGN: Secondary
analysis of data from a single-blind randomized controlled trial comparing 2
physiotherapy intervention programs for persistent SUI in postpartum women.
SETTING: Obstetric clinic of a mother and children's university hospital.
PARTICIPANTS: Women, ages 23 to 39 (N=57), were randomized to 1 of 2 pelvic floor
muscle (PFM) training programs, 1 with and 1 without abdominal muscle training.
INTERVENTION: Over 8 weeks, participants in each group followed a specific home
exercise program once a day, 5 days a week. In addition, participants attended
individual weekly physiotherapy sessions throughout the 8-week program. MAIN
OUTCOME MEASURES: Treatment success was defined as a pad weight gain of less than
2 g on a 20-minute pad test with standardized bladder volume after 8 weeks'
treatment. The relationship between potential predictive PFM function variables
as measured by a PFM dynamometer and success of physiotherapy was studied using
forward stepwise multivariate logistic regression analyses. RESULTS: Forty-two
women (74%) were classified as treatment successes, and 15 (26%) were not.
Treatment success was associated with lower pretreatment PFM passive force and
greater PFM endurance pretreatment, but the latter association was barely
statistically significant. This model explained between 23% (Cox and Snell R(2))
and 34% (Nagelkerke R(2)) of the outcome variability. CONCLUSIONS: The results
contribute new information on predictors of success for physiotherapy treatment
in women with persistent postpartum SUI.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS