PELVIC FLOOR MUSCLE TRAINING VERSUS NO TREATMENT FOR URINARY INCONTINENCE IN WOMEN

European Scientific Journal February 2015 /SPECIAL/ edition vol.2 ISSN: 1857 - 7881 (Print) e PELVIC FLOOR MUSCLE TRAINING VERSUS NO TREATMENT FOR URINARY INCONTINENCE IN WOMEN Vjollca Ndreu 0 Student Fatjona Kamberi 0 Student Enkeleda Sinaj 0 Student 0 0 Faculty of Technical Medical Sciences, University of Medicine, Tirana, Albania Anila Sula, General Nurse "Queen Geraldine" Maternity , Tirana , Albania Pelvic floor muscle training is the most commonly used physical therapy treatment for women with urinary incontinence (UI). According to the World Health Organization bladder problems affect more than 200milion people worldwide. Urinary incontinence is a disorder that affects women far more frequently than men; 85% of people suffering from urinary incontinence are women. According to existing studies and literature few women go to consult a therapist who specializes in urinary incontinence in our country. Talking about UI, it is a taboo for most women, especially for women living in small cities or rural area. The purpose of the study was to determine the effects of pelvic floor muscle training for women with urinary incontinence in comparison to no treatment. This is a randomized control trial and to gather information was used a questionnaire( ICIQ-SF), and personal contact with patients. The patients were randomly allocated into two groups, the control group and the experimental group. The experimental group practiced PFME at home, the control group didn't practice PFME at home. The study indicates that physiotherapy has a key role in the conservative treatment of UI and is less costly than other methods of treatment. PFME gives good results in controlling involuntary loss of urine. This treatment isn't very recognized in Albania. One of the best ways to introduce this method will be from the family doctors and from maternity staff who treats the most effected patients, future mothers. Urinary Incontinence; Pelvic Floor Muscle Exercise; Pelvic floor; Physiotherapi - Introduction Pelvic floor muscle training is the most commonly used physical therapy treatment for women with urinary incontinence (UI). According to the World Health Organization bladder problems affect more than 200milion people worldwide. Urinary incontinence is a disorder that affects women far more frequently than men; 85% of people suffering from urinary incontinence are women.Women experience UI twice as often as men. Various factors may affect the development of UI. The most well known are, pregnancy and childbirth, menopause, overweight and obesity, hormonal disorders, and muscle weakness of pelvic diaphragm. According to existing studies and literature few women go to consult a therapist who specializes in urinary incontinence in our country. Talking about this kind of problems it is a taboo for most women, especially for women living in small cities or rural area. For them it is difficult to even consider a therapist for such personal problems. Most of the cases women blame their selfs for these problems. Urinary Incontinence has a large impact on the quality of their lives, they are obliged to restrict their outings outside of their houses. UI limits them in their daily activities as in the professional, social and family aspects. Incontinence creates psychological disorders such as anxiety and depression. Limits their physical activities such as walking, running, exercising or swimming. One of the ways to come to the aid of people with such condition as urinary incontinence it is conservative treatment whose main elements are lifestyle modifications (physical activity, dietary habits, and weight loss), bladder control exercises, and pelvic floor muscle training (PFMT). This treatment it is not very popular or recognized too much in Albania. Inclusion criteria Were included in this study women aged over 18years old who have given birth at least once. Exclusion criteria Were excluded from the study women under 18 years of age and those who had not giving birth. Data collection instrument Participants were briefed on the purpose of the study and their inclusion in the study was made with their written consent. Ethical approval was granted by the ethics committee of University of Medicine of Tirana and all patients were fully informed of the plan and goals of treatment.The participants were also informed that they could withdraw from the study at any time without suffering any ill effects whatsoever. They were evaluated before application musculatures pelvic exercises and again after 12 weeks of application of these exercises. To gather information a questionnaire was used by International Consultation on Incontinence Questionnaire (ICIQ-SF), and personal contact with patients. T-student Test was used to detect the effects of application of PFME exercises and to compare the change of the situation between the two groups before and after application of pelvic floor exercises. The value of p <0.05 was considered significant value. Women were randomly divided into two groups; Group A (experimental group), n=19 served as intervention and received a 3 month intensive pelvic floor exercise protocol while Group B (control group) , n=21 served as control and received no therapy Therapy procedure All women in group A were instructed about pelvic floor anatomy and how to control pelvic muscles voluntarily. Kegel's pelvic floor muscle therapy (PFMT) protocol was used for 3 consecutive months. The exercise comprised of 10 repetitions of 8 contractions each; with contraction held for six seconds and two minutes rest in between each contraction. At the end of each session, three to four fast 'flicker' contractions were added. At 12 weeks, the number of contractions per repetition had been increased to twelve. Women in group A regularly attended physiotherapy clinic for three months (36 sessions) with additional follow up pelvic floor exercises at home daily. Some women who missed their sessions were requested for compliance in future. The effectiveness of biofeedback assisted PFMT was assessed pre and post training in group A and this was statistically compared with group B (at 1st week and after 3 months). After 3 months of treatment we have an noticeable improvement of the IU situation on group A (Tab2). After applying the PFME of this group have decreased the frequency, quantity of urine and number of used protectors, p ** <0.001. Variables Beginsntiundgyof the After 12 weeks In group B we dont have any significantly improvements of the incontinences situation because the "p" value is not significant in the number of used protectors p = 0.267; in the frequency of urination at night = 0.056; and the quantity of urination p=0,005 (tab3) at the beginning of the study and after a period of 3 months. After 12 weeks How much do you usually leak? With regard to the comparison of two groups at the beginning of the study and 12 weeks after application of pelvic musculatures exercises it (...truncated)