骨盆底肌訓練對患有妊娠相關骨盆帶疼痛產後婦女之效應：前實驗研究

Effects of Pelvic Floor Muscles Training in Postpartum Women With Pregnancy-Related Pelvic Girdle Pain: A Pre-Experimental Study

郭怡良(Yi-Liang Kuo) ； 吳紀萱(Chi-Hsuan Wu) ； 吳孟興(Meng-Hsing Wu) ； 林冠吟(Kuan-Yin Lin) ； 蔡一如(Yi-Ju Tsai)

《物理治療》 46卷4期 (2021/12) Pp. 239-249

https://doi.org/10.6215/FJPT.202112_46(4).0002

摘要

背景與目的：產後妊娠相關骨盆帶疼痛比例甚高，且身心健康受嚴重影響。懷孕與生產皆會使骨盆底肌功能受損，然而至今骨盆底肌訓練對妊娠相關骨盆帶疼痛的研究甚少。因此，本研究目的為探討以骨盆底肌訓練為主之骨盆穩定運動，對於產後妊娠相關骨盆帶疼痛之效應與可行性。方法：共14位產後3個月後仍存有妊娠相關骨盆帶疼痛之婦女完成為期8週之骨盆穩定運動介入。婦女在介入前後皆接受所有評估項目，包含疼痛程度、失能狀況、生活品質，以及超音波影像之腹肌與骨盆肌肉的肌肉厚度或收縮情形。結果：在8週骨盆穩定運動介入後，婦女的疼痛失能及生活品質皆獲得顯著的改善，達中度至高度效應值。雖然腹部肌肉厚度或骨盆底肌收縮未有顯著差異。結論：本研究初步證據顯示以骨盆底肌訓練為主之8週骨盆穩定運動介入，對於產後患有妊娠相關骨盆帶疼痛的婦女有減緩疼痛、改善失能、與提升生活品質的效果。然而，未來仍需更多隨機分配試驗證明骨盆底肌訓練對改善妊娠相關骨盆帶疼痛的真實效益。

關鍵字

妊娠相關骨盆帶疼痛 ； 產後婦女 ； 骨盆穩定運動 ； 骨盆底肌

並列摘要

Background and Purpose: Pregnancy-related pelvic girdle pain (PPGP) is a common complaint in women after delivery. Postpartum women with PPGP often have pain, disability, and lower quality of life, as well as emotional problems. However, studies of pelvic floor muscles (PFM) exercise intervention on postpartum women with PPGP are scarce and current evidence is still controversial. The main purposes of this study are to investigate the effects of PFM training on pain, disability, muscle functions, and quality of life in postpartum women with PPGP. Methods: A total of 14 women suffering from postpartum PPGP completed an 8-week PFM training program. All participants received the same outcome assessment before and after intervention including pain intensity (numeric rating scale), disability level (pelvic girdle questionnaire and Oswestry disability index), quality of life (short form-36), and the sonographic measures of abdominal muscle thickness and control of PFM. Results: After an 8-week intervention, the pain, disability, and quality of life were significantly improved with medium to large effect sizes. Although no changes in the abdominal muscle thickness and PFM contraction were found. Conclusion: The 8-week PFM training program in the current study may improve pain, disability, quality of life in the postpartum women with PPGP. A randomized controlled trial study is still required in the future to prove the clinical effectiveness of the PFM training in postpartum women with PPGP.

並列關鍵字

Pregnancy-related pelvic girdle pain ； Postpartum women ； Pelvic stabilization exercise ； Pelvic floor muscles