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婦女尿失禁的物理治療

Physical Therapy for Urinary Incontinent Women

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摘要


婦女健康議題有關之物理治療雖已在世界各國蓬勃發展,但在國內仍屬起步階段。本文旨在介紹女性尿失禁之種類、治療原則與療效。本文屬於敘述性回顧(narrative review)文章,作者依據臨床經驗,與回顧婦女尿失禁物理治療之相關教科書,並查詢MEDLINE資料庫之相關文獻,綜合整理而得。尿失禁種類與成因與尿失禁的物理治療方法,如骨盆底肌肉運動、生物回饋、電刺激治療、膀胱訓練等的方法與療效。此外,本文對於膀恍訓練的方法與療效亦略有介紹。物理治療對於輕中度尿失禁患者可達到50到70%的治癒或進步率。

並列摘要


The National Conference on Physical Therapy in Education held earlier this year (2000) recommended the inclusion of the topic of women's health in the undergraduate physical therapy curriculum. ll1e purpose of this article was to review methods of the physical therapy intervention and their efficacy for women with urinary incontinence﹒MEDLINE database and relevant textbooks were systemically searched. The classifications and etiologies of urinary incontinence were also reviewed. The evaluation of urinary incontinence generally includes history taking, urodynamic study, void109 diary, pad weighting test and pelvis floor muscle assessment. The methods of physical therapy intervention commonly employed were the pelvic floor exercise (Kegel exercise), vaginal pressure biofeedback, vaginal cones, electrical stimulation (functional electric stimulation, transcutaneous electrical stimulation, interferential current). The improvement due to various methods of physical therapy intervention varies from 50-70% of the patients. The lack of double blind randomized experimental studies was noted.

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