The effect of rehabilitation exercises combined with direct vagina low voltage low frequency electric stimulation on pelvic nerve electrophysiology and tissue function in primiparous women: A randomised controlled trial

Yang, Sumian; Sang, Wenshu; Jing, Feng; Zhao, Haifeng; Li, Xian; Li, Ping; Fan, Hongfang; Tang, Zengjun; Gao, Lina

doi:10.1111/jocn.13790

Cited by 34 publications

(51 citation statements)

References 20 publications

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“…The two phases of life have been proved to be associated with increased incidence of PFDs. Pregnancy and childbirth, especially vaginal childbirth, are two independent factors causing PFDs [ 8 , 9 ]. Although severe morbidity of women from PFDs is rare, PFDs do seriously affect the quality of women’s life.…”

Section: Discussionmentioning

confidence: 99%

Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara

Zhao¹,

Zou

Xiao³

et al. 2018

BMC Pregnancy Childbirth

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BackgroundTo investigate the effect of different delivery modes and related obstetric factors on the short-term strength of the pelvic floor muscle after delivery in Chinese primipara.MethodsA total of 4769 healthy Chinese primiparas at postpartum 6–8 weeks were interviewed. According to the difference of delivery mode, the selected primiparas were divided into 2 groups, including cesarean delivery group containing 2020 and vaginal delivery group containing 2749. All the vaginal deliveries were further divided into 3 groups, including episiotomy group containing 2279, perineal laceration group containing 398, and forceps assisted group containing72. The scales of their pelvic floor muscle (PFM) strengths were examined by specially trained personnel using digital palpation (Modified Oxford scale:0–5 grade). According to participants’ willingness, if the PFM strength was weak (0 or 1 grade), at-home PFM training would be recommended and an electrical stimulation combined with biofeedback therapy would be conducted for them in hospital. Twelve weeks after delivery, the PFM strength would be measured again. For statistical analysis, t-test, one-way variance analysis, Chi-square analysis, Kruskal-Wallis test H, Mann-Whitney U test and Wilcoxon test were carried out.ResultsThe PFM strength in cesarean delivery group was higher than in vaginal delivery group (p < 0.05). Among 3 vaginal delivery groups, the PFM strength in perineal laceration group was the highest (p < 0.05); however, there was no difference in PFM strength between episiotomy group and forceps assisted group (p>0.05). After accepting PFM training at home and therapy in hospital, 305 women showed increased PFM strength (p < 0.05).ConclusionsVaginal delivery is an independent risk factor causing the damage of PFM, and episiotomy may cause injury of PFM. Through PFM training at home and therapy in hospital, those damage will resume as soon as possible in the short-time period after delivery.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1918-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara

Zhao¹,

Zou

Xiao³

et al. 2018

BMC Pregnancy Childbirth

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“…Additionally, no significant difference was observed between the study groups. The POP prevalence in the intervention group had also significantly declined in the study by Yang et al (39).…”

Section: Physiotherapy and Pfmes For Pop Prevention And Treatmentmentioning

confidence: 79%

“…A total of 4 articles selected in this review had explored the effects of physiotherapy and PFMEs on POP prevention and treatment during pregnancy and at postpartum period (16,17,39). In this respect, therapeutic interventions in two studies were PFMEs (3,17).…”

Section: Physiotherapy and Pfmes For Pop Prevention And Treatmentmentioning

confidence: 99%

“…PFMEs in one group and PFMEs along with hypopressive abdominal exercises (HAEs) in the other group. In the study by Yang et al (39), both groups had received interventions including Kegel exercises and pelvic movements in one group, as well as PFMEs and electrostimulation in the other one. In both articles (3,17), no significant difference was observed between the groups in terms of POP severity or prevalence.…”

Section: Physiotherapy and Pfmes For Pop Prevention And Treatmentmentioning

confidence: 99%

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Physiotherapy and Pelvic Floor Muscle Exercises for the Prevention and Treatment of Pregnancy-Related Pelvic Floor Dysfunctions: A Systematic Review and Meta-analysis

Khorasani

Ghaderi

Sarbakhsh

et al. 2019

International Journal of Women’s Health and Reproduction Scienc

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Objectives: The present systematic review focused on the prevention or treatment of three main types of pelvic floor dysfunctions (PFDs) specifically pelvic organ prolapse (POP), urinary incontinence (UI), and fecal incontinence (FI) using physiotherapy and pelvic floor muscle exercises (PFMEs). With regard to the breadth of the problem, there is not much evidence grounded on the best management. The main purpose of this systematic review was to evaluate the effects of physiotherapy and PFMEs on the prevention and treatment of pregnancy-related PFDs; namely, POP, FI, and UI. Therefore, this review incorporated studies comparing the use of physiotherapy and PFMEs with every other existing interventions. Methods: This systematic review and meta-analysis was conducted on randomized-controlled-trial (RCT) articles and quasi-RCT designs through a search in the studies published with no time limits until December 2017 in the databases of PubMed (Medline), Web of Science, Scopus, Embase, Cochrane Library, and ProQuest. The meta-analysis was also applied for data synthesis. Moreover, heterogeneity was assessed using Cochran’s Q test and I2 index. Results: A total number of 26 RCTs were examined in this review in which the outcome variables were related to POP, UI, and FI prevalence; POP, UI, and FI severity, as well as pelvic floor muscle (PFM) strength and endurance. In most articles, UI prevalence or severity in intervention groups had significantly improved compared with those in controls. The number of studies examining POP and FI was also relatively low. In two studies, FI severity or prevalence in intervention groups had significantly enhanced in comparison with those in control groups; however, FI prevalence in two articles had been reported lower in intervention groups than that in control groups although no significant difference had been observed. There was also no significant improvement in intervention groups in two other studies in this respect. Besides, three articles had not reported traces of improvement in POP, as well as a significant difference between intervention and control groups. Nevertheless, two studies had found a significant improvement in POP in this regard. Based on meta-analysis results for the variable of PFM strength, Cochran’s Q test (P<0.001) and I2 index (90.02) indicated heterogeneity between studies; so, a random-effect meta-analysis was applied to estimate overall effect sizes. The overall mean differences following intervention between the study groups were also equal to 6.94, with a 95% CI (1.36 to 12.52). Conclusions: It was concluded that physiotherapy and PFMEs might have effects on pregnancy-related UI, but they had not consistently reduced FI severity or prevalence and failed to constantly improve POP.

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“…[ 18 ] Some researchers have utilized ES to stimulate the pelvic floor muscles and nerves by transmitting different current intensities, to improve the ability of controlling urine in the pelvic floor rehabilitation programme for primiparous women. [ 19 ] BT focuses on increasing the bladder capacity by lengthening the interval time between bathroom trips, to improve the detrusor stability during urine storage period. [ 20 ] A RCT trial emphasized the value of BT for controlling urinary incontinence in postpartum period either alone or with PFMT.…”

Section: Introductionmentioning

confidence: 99%

A network meta-analysis protocol of conservative interventions for urinary incontinence in postpartum women

Wang

et al. 2020

Medicine

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Background: Postpartum urinary incontinence (PPUI) is a common urological condition in women after childbirth. Due to the side effects of surgical and pharmacological therapies, the patients and physicians alike express a strong preference for conservative approaches on PPUI, such as pelvic floor muscle training, biofeedback, electrical stimulation, bladder training, vaginal cones and acupuncture. Application of these conservative approaches should be guided by high quality evidence, yet their comparative effectiveness has not been well documented. Therefore, the network meta-analysis aims to compare, rank and summarize all available studies to determine which conservative intervention is more effective for PPUI. Methods: In this present study, qualified English and Chinese studies will be searched in PubMed, Scopus, EMBASE, The Cochrane Library, Web of Science, VIP Database, Wanfang Database, Chinese Biomedical Literature Database and China National Knowledge Infrastructure. All eligible randomized controlled trails (RCTs) of conservative interventions for PPUI will be included. R software 3.61 (R Foundation for Statistical Computing, Vienna, Austria) will be applied to synthesize data and conduct network meta-analysis. I 2 statistic and Z test will be used to assess heterogeneity and inconsistency, respectively. Results: Ethical approval is not required for this existed literature based meta-analysis. The findings of this research will be disseminated through a recognized journal. Conclusion: The findings of this study will provide ranking evidence for clinicians and patients to choose a more appropriate conservative therapy on PPUI. Trial registration number: PROSPERO CRD42020168042

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The effect of rehabilitation exercises combined with direct vagina low voltage low frequency electric stimulation on pelvic nerve electrophysiology and tissue function in primiparous women: A randomised controlled trial

Abstract: These conclusions justify that rehabilitation exercise combined with DES can better relieve uncomfortable symptoms postpartum and improve the women's quality of life.

Cited by 34 publications

References 20 publications

Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara

Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara

Physiotherapy and Pelvic Floor Muscle Exercises for the Prevention and Treatment of Pregnancy-Related Pelvic Floor Dysfunctions: A Systematic Review and Meta-analysis

A network meta-analysis protocol of conservative interventions for urinary incontinence in postpartum women

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