生物反馈电刺激联合盆底肌肉训练对产妇盆底康复影响

目的 探讨生物反馈电刺激联合盆底肌肉训练对产妇盆底康复的影响.方法 分别将北部战区总医院2020年3—12月收治的102例初产妇纳入初产妇组,101例经产妇纳入经产妇组.将初产妇随机分入初产妇A组(n=49)和初产妇B组(n=53),将经产妇随机分入经产妇A组(n=50)和经产妇B组(n=51).初产妇A组和经产妇A组...     

盆底生物反馈电刺激对女性产后性功能影响

目的 探讨盆底生物反馈电刺激对女性产后性功能的影响.方法 选取北部战区总医院自2019年6月至2021年4月收治的508例产后女性为研究对象.将研究对象随机分入A组(n=253)和B组(n=255).A组接受盆底肌肉锻炼(凯格尔运动),B组接受盆底肌康复训练(盆底生物反馈电刺激).比较两组治疗前后的女性性功能指数量表评...     

四维盆底超声在电刺激联合生物反馈结合盆底肌锻炼治疗压力性尿失禁疗效评估中的价值

目的:探讨四维盆底超声在电刺激联合生物反馈盆底肌锻炼治疗压力性尿失禁(SUI)疗效评估中的价值.方法:选择60例SUI患者,电刺激联合生物反馈盆底肌锻炼3个月后分析治疗效果;并于治疗前后采用经会阴四维盆底超声记录患者肛提肌裂孔面积、裂孔左右径、肛提肌厚度、膀胱颈移动度、膀胱尿道后角及尿道内口漏斗形成率.结果:治疗后,肛...     

生物反馈电刺激盆底肌肉训练慢性盆腔疼痛综合征

目的;探讨生物反馈电刺激盆底肌肉训练联合哈乐治疗慢性盆腔疼痛综合征的效果。方法;60例慢性盆腔疼痛综合征患者,治疗前后常规行前列腺液常规(EPS)、慢性前列腺炎症状评分(NIH-CPSI)和尿流率检查,使用生物反馈治疗仪进行盆底肌肉电刺激,每次20min,10次为一疗程,治疗两个疗程评价其治疗效果,并追踪随访6月。结果;60例慢性盆底疼痛综合症患者治疗后的最大尿流率(MFR)均上升(P<0.05),最大尿道闭合压(MUCP)均下降(P<0.05);治疗后NIH-CP-SI评分降低(P<0.05);EPS中白细胞计数降低(P<0.05);治疗后疼痛消失33例,占55.00%;疼痛缓解14例,占23.33%;无效13例,占21.77%。60例患者中有55例获得半年追踪,无一例复发。结论;生物反馈电刺激盆底肌肉训练治疗慢性盆底疼痛综合征是一种有效的、治愈率较高的治疗方法。     

电刺激训练前后肌肉力量交叉迁移效果的实验观察

采用T90 - 1型电刺激肌肉力量训练仪对 10名 19～ 2 1岁男性二级运动员左腿股前肌群进行电刺激训练 ,测定等长状态时伸膝与屈膝肌肉力量。结果 :受试者左腿股前肌群 (主动肌群 )伸膝力量提高 4 7± 3 5kg(P <0 0 1) ,对抗肌群 (股后肌群 )屈膝力量提高 2 1± 2 8kg(P <0 0 1)。右腿股前肌群 (主动肌群 )伸膝力量提高 2 6± 0 5 5kg(P <0 0 1) ,对抗肌群 (股后肌群 )屈膝力量提高 1 0± 0 71kg(P <0 0 5 )。表明电刺激左腿股前肌群明显提高股后肌群的力量的同时 ,亦可有效地提高右腿股前、股后肌群的力量。     

脑循环电刺激联合语言训练在语言发育迟缓患儿中的应用

目的 探讨脑循环电刺激联合语言训练在语言发育迟缓患儿中的应用效果.方法 收集2018年11月-2019年11月收治的82例语言发育迟缓患儿临床资料,将采用语言训练的42例患儿纳入A组,将采用脑循环电刺激联合语言训练的40例患儿纳入B组.训练3个月后,比较两组临床效果,比较两组训练前、3个月后语言发育商及生长激素水平.结...     

神经肌肉电刺激联合躯干控制训练促进脑卒中急性期偏瘫患者康复研究

目的 探讨神经肌肉电刺激(NMES)联合躯干控制训练促进脑卒中急性期偏瘫患者康复的效果.方法 收集2019年12月-2020年3月采用NMES联合躯干控制训练的30例脑卒中急性期偏瘫患者资料纳入观察组,收集2019年6月-2019年11月采用NMES的30例脑卒中急性期偏瘫患者资料纳入对照组,两组连续干预1个月.比较两组患者躯干功能障碍量表(TIS)、Fugl-meyer评定量表(FMA)和日常生活活动能力量表(BI指数).结果 干预1个月,两组患者的TIS、FMA和BI评分均高于干预前,观察组高于对照组,差异有统计学意义(P＜0.05).结论 脑卒中急性期偏瘫患者采取NMES联合躯干控制训练能改善患者的躯干和肢体功能,提高患者的日常生活活动能力.     

经会阴超声评估肌电刺激盆底治疗压力性尿失禁的疗效

目的:采用经会阴超声评价肌电刺激盆底治疗的疗效,为产后压力性尿失禁的康复提供指导.方法:选择进行产后SUI盆底康复的40例产妇作为病例组,同时选择30例产后非SUI和非妊娠年轻女性作为对照组,研究组进行盆底肌电治疗,并于治疗前、治疗5次后及治疗10次后,采用经会阴超声于安静状态及压力状态下(Valsalva动作时)分别测量患者的盆膈裂孔面积(Sr、Ss),耻骨直肠肌厚度(dr、ds),膀胱颈至耻骨联合下缘的距离(Lr、Ls)、膀胱颈角度(θr、θs)、膀胱颈旋转角度(θ),并进行组间比较.结果:SUI组治疗前Sr、Ss、dr、ds和θr、θs及θ均大于产后非USI组和未孕组(P＜0.05);Lr及Is均小于对照组(P＜0.05);SUI组经盆底肌电激治疗5次后及10次后,与治疗前相比,Sr、Ss、dr、ds和θr、θs及θ均逐渐缩小,而Lr、Is逐渐增大(P＜0.05),并逐渐接近产后非USI组;产后非USI组Sr、Ss、dr、ds和θr、θs及θ均大于未孕组(P＜0.05);Lr及Ls均小于未孕组(P＜0.05).结论:经会阴超声检查能对骨盆功能损伤和康复提供客观准确评价指标.     

盆底三维超声判断压力性尿失禁患者盆底功能损伤和疗效的价值

目的 探讨盆底三维超声在压力性尿失禁患者盆底功能损伤和疗效判断中的应用价值.方法 选取40例产后压力性尿失禁患者纳入本次实验作为观察组,另选择同期产后40例正常产妇纳入本次实验作为对照组,观察组产后接受盆底康复治疗,2组均接受盆底三维超声检查,统计并比较2组盆底功能(盆底裂孔面积、膀胱尿道后角以及膀胱颈至耻骨联合下缘的...     

女性盆底功能障碍性便秘病人耻骨直肠肌功能的盆底超声研究进展

女性盆底功能障碍（FPFD）所致便秘与耻骨直肠肌功能不全密切相关。盆底超声不仅可以通过多种成像技术精准评估耻骨直肠肌的局部运动和组织硬度,还可以动态观察其与周围组织结构的毗邻关系,发现盆底各脏器、肌肉、血管的异常改变,对FPFD相关性便秘有较大应用价值。就盆底超声对FPFD所致便秘病人耻骨直肠肌功能的诊断价值及研究进展进行综述。     

Adherence to pelvic floor muscle exercise and long-term effect on stress urinary incontinence A five-year follow-up study

The purpose of this investigation was to study adherence to exercise, pelvic floor muscle (PFM) function and strength and patient satisfaction 5 years after cessation of organized PFM exercise for stress urinary incontinence. All 23 women who had taken part in an "intensive exercise group" in a randomized trial 5 years ago participated in the follow-up study. Structured interview, vaginal palpation and vaginal squeeze pressure were used to assess the condition, PFM function and muscle strength, respectively. Seventy percent of the women were exercising the PFM once a week or more often. Two women were not able to correctly contract the PFM. Mean PFM strength was 18.1 cm H₂O. Three had undergone surgery since the initial study. Sixty-one percent were satisfied with their condition.     

无盆底功能障碍女性肛提肌动态磁共振成像观察

目的：探讨无盆底功能障碍女性肛提肌功能和形态变化特征。方法对20名无盆底功能障碍性疾病志愿者行盆腔动态磁共振成像（MRI）检查,测量在静息位及最大腹压时肛提肌裂隙面积、双侧耻骨直肠肌厚度、肛提肌板角度及其变化值。结果肛提肌裂隙面积：静息位（9257±1234）mm2,最大腹压（10380±1395） mm2,差异有统计学意义（P＜0．05）。耻骨直肠肌厚度：静息位（5．9±0．8）mm,最大腹压（4．7±0．6）mm,差异有统计学意义（P＜0．05）;左、右侧耻骨直肠肌厚度不对称：静息位分别为（6．0±0．8）mm、（5．8±0．7）mm,最大腹压分别为（4．8±0．7）mm、（4．6±0．6）mm,差异有统计学意义（P＜0．05）。肛提肌板角度：静息位（40±4）°,最大腹压（46±4）°,差异有统计学意义（P＜0．05）,其变化值为（6．0±1．6）°。结论动态MRI检查可以直观地观察肛提肌的形态,评价肛提肌的功能。     

Electromyographic evaluation of synergist muscles of the pelvic floor muscle depending on the pelvis setting in menopausal women: A prospective observational study

BackgroundPelvic floor muscle (PFM) training is recommended to increase their strength and endurance. Muscles which act synergistically with PFM are taken into consideration in the therapeutic management of weakened PFM.Research questionhow does electromyography activity of the synergists muscle to PFM change concerning pelvis position and does the greater bioelectric activity of synergist muscles affect PFM function?MethodsA prospective, observational study evaluating the surface electromyography (sEMG) activity of selected synergist muscles of the PFM depending on the orientation of the pelvis. One hundred thirty-one menopausal women registered for the study were screened for inclusion and exclusion criteria, and by the results, eighty-two participants were enrolled for measurements. The comparisons of results between the values obtained in different positions of the pelvis (anterior pelvic tilt – P1, posterior pelvic tilt – P2 and neutral pelvic tilt – P3) were performed using Kruskal–Wallis test. A multivariate linear regression analysis was used to assess relationships between the bioelectrical activity of PFM and activity of all tested muscles – rectus abdominis (RA), gluteus maximus (GM), and adductor magnus (AM).ResultsHigher RA, GM, AM bioelectrical activity was observed in the P2 as compared to P3 (during resting and functional PFM activity)(p < 0.05). Multivariate linear regression did not find the association between the bioelectrical activity of PFM and the activity of all synergist muscles in each position.SignificancesEMG activity of selected muscles acting synergistically with PFM differ depending on the pelvis position and is the highest in the posterior pelvic tilt. Greater activity of the synergists, resulting from the pelvic position, does not affect the myoelectric activity of PFM. It seems that muscles that act synergistically with PFM may not play such a significant role in the therapeutic management of PFM.     

Effects of sit-to-stand training combined with transcutaneous electrical stimulation on spasticity,muscle strength and balance ability in patients with stroke: A randomized controlled study

Sit-to-stand is a fundamental movement of human being for performing mobility and independent activity. However, Stroke people symptoms experience difficulty in conducting the sit-to-stand due to paralysis and especially ankle spasticity. Recently, transcutaneouselectrical- stimulation (TENS) is used to reduce pain but also to manage spasticity. The purpose of this study was to determine (1) whether TENS would lead to ankle spasticity reduction and (2) whether sit-to-stand training combined with TENS would improve spasticity, muscle strength and balance ability in stroke patients. Forty-stroke patients were recruited and were randomly divided into two groups: TENS group (n = 20) and sham group (n = 20). All participants underwent 30-sessions of sit-to-stand training (for 15-min, five-times per week for 6-weeks). Prior to each training session, 30-min of TENS over the peroneal nerve was given in TENS group, whereas sham group received non-electrically stimulated TENS for the same amount of time. Composite-Spasticity-Score was used to assess spasticity level of ankle plantar-flexors. Isometric strength in the extensor of hip, knee and ankle were measured by handheld dynamometer. Postural-sway distance was measured using a force platform. The spasticity score in the TENS group (2.6 ± 0.8) improved significantly greater than the sham group (0.7 ± 0.8, p < 0.05). The muscle strength of hip extensor in the TENS group (2.7 ± 1.1 kg) was significantly higher than the sham group (1.0 ± 0.8 kg, p < 0.05). Significant improvement in postural-sway was observed in the TENS group compared to the sham group (p < 0.05). Thus, sit-to-stand training combined with TENS may be used to improve the spasticity, balance function and muscle strength in stroke patients.     

静、动态MRI用于盆底功能障碍肛提肌评价的研究进展

盆底功能障碍是由于盆底支持结构薄弱所引起的包括盆腔器官脱垂、排尿及排便功能障碍等一系列症状的疾病。肛提肌是支持盆底的主要结构,静态MRI具有较高的软组织分辨力,能客观地评价肛提肌的形态及结构,动态MRI能实时反映肛提肌的运动及功能,为其全面评估提供客观依据。就静、动态MRI在盆底功能障碍中对肛提肌评价的应用及研究进展予以综述。     

糖尿病对盆腔器官脱垂患者行网片盆底重建术影响

目的探讨糖尿病对盆腔器官脱垂(POP)患者行应用网片的盆底重建术的短期疗效及生活质量的影响。方法收集2014年6月至2015年6月中国医科大学附属盛京医院妇产科应用网片行盆底重建术的糖尿病POP患者30例(糖尿病组)与非糖尿病POP患者30例(非糖尿病组)。分别记录两组患者基本情况,围术期相关的临床指标,术前盆腔器官脱垂定量(POP-Q)分度,术前及术后3、6个月盆底功能障碍影响问卷-短表20(PFDI-20)评分及盆底功能影响问卷简要版-7(PFIQ-7)评分。结果两组患者术后排尿异常、新发尿失禁或既往尿失禁加重、盆腔感觉异常、排便感觉异常、网片裸露、复发等并发症例数分别比较,差异无统计学意义(P>0.05);糖尿病组患者术后并发症总例数(43例)明显多于非糖尿病组(24例)(P<0.05)。两组患者术前PFDI-20、PFIQ-7评分比较,差异无统计学意义(P>0.05);术后3、6个月PFDI-20、PFIQ-7评分均明显低于术前(P<0.05);糖尿病组术后3、6个月PFDI-20、PFIQ-7评分高于非糖尿病组(P<0.05)。结论与非糖尿病POP患者比较,合并糖尿病的POP患者行应用网片的盆底重建术同样能达到理想的客观治愈率及明显的生活质量改善。但糖尿病患者盆腔、泌尿系统并发症较多,术后短期生活质量改善程度不及非糖尿病患者。