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Authors' Reports Dalia Kamel describes for SIIC the most significant aspects of his article de scribe para SIIC los aspe ctos re le vante s de su artículo Abdominal and pelvic floor muscles in treating stress urinary incontinence
EXERCISE TRAINING FOR MILD STRESS URINARY INCONTINENCE IN FEMALES This study showe d that 12 we e k s of spe cific abdom inale x e rcise s re sulte d in m ore im prove m e nt in vaginal pre ssure and le ak point pre ssure ove r pe lvic floor e x e rcise s. The article was published by El artículo fue publicado por Hong Kong Physiotherapy Journal Volum e / Volum e n: 31 Num be r / Núm e ro: 1 First and last page s / Páginas inicial-final: 12-18 Ye ar / Año: 2013 Month / Me s: 6
This journal, which is covered by SIIC Data Bases, is part of the bibliographic colle ctions of the Bibliote ca Biom é dica (BB) SIIC . Esta re vista, clasificada por SIIC Data Bases, inte gra e l ace rvo bibliográfico de la Bibliote ca Biom é dica (BB) SIIC .
Principal institution where the research took place Institución principal de la inve stigación De partm e nt of Physical The rapy for O bste trics and Gyne cology, Faculty of Physical The rapy, C airo Unive rsity,C airo, Egypt, Al Dok k i, Giza, Egypt
Research description / Descripción de la investigación Manama, Bahrein (especial para SIIC) Stre ss urinary incontine nce (SUI) is the involuntary loss of urine which occurs following a sudde n rise in the intraabdom inal pre ssure cause d by coughing, sne e zing, straining, laughing or othe r physical activitie s [1, 2]. O f course it is a m e dical, social and hygie nic proble m [3]. It has a profound psychosocial im pact not only on patie nts but also, on the ir fam ilie s and care give rs, re sulting in loss of se lf ste m , se x ual dysfunction, withdrawal from social as we ll as physical and fitne ss activitie s, which m ay thre at wom e n’s ge ne ral he alth, we llbe ing and de cre ase he r ability to m aintain an inde pe nde nt life style [4]. SUI is the m ost com m on type of urinary incontine nce in wom e n. Many factors are involve d in the e tiology of SUI including pre gnancy, childbirth, and surgical proce dure s that dam age ne rve s le ading to pe lvic floor m uscle s [5]. Additional factors are chronic coughing from sm ok ing or pulm onary dise ase , pe rsiste nt urinary tract infe ctions, and obe sity [6]. The first line of tre atm e nt for SUI is the pe lvic floor e x e rcise s (PME's) to stre ngth we ak pe rine al and pe lvic floor m uscle s. Approx im ate ly 30% of wom e n are unable to pe rform an isolate d pe lvic floor m uscle s contraction following writte n or ve rbal instruction [7, 8]. So, the first ste p in (PME's) is to e stablish be tte r aware ne ss of pe lvic floor m uscle function [9]. (PME's) are indicate d whe n the incontine nce is m ild, the patie nt is m e dically unfit for surge ry or doe s not wish to unde rgo an ope ration, or in wom e n who have not ye t com ple te d the ir fam ilie s. The y m ay also be use ful prior to surge ry whe n the patie nt is on a long waiting list [10]. The actual e ffe cts of (PME's) on the bladde r and pe lvic m uscle s are not com ple te ly unde rstood but the re m ay be a re lationship be twe e n change s in various m e asure s of pe lvic floor stre ngth, such as anal or re ctal sphincte r stre ngth or incre ase d ure thral closure pre ssure , all of which pre ve nt urine le ak age [11]. Pubococcyge us is the principle m uscle re quiring atte ntion whe n applying PME's, but be fore stre ngthe ning, the patie nt m ust have an aware ne ss of what she is doing, as visual cue s are ge ne rally lim ite d [12]. Ge ne rally the succe ss rate of PME's in the tre atm e nt of urinary incontine nce , se e m s to de pe nd on type and grade of incontine nce , appropriate instruction and flow-up, e nthusiasm of the the rapist, type of training program m e , the tim e to follow-up e x am ination and patie nt com pliance is of outm ost im portance [13]. Many patie nts have the ide a that PME's involve e ithe r pulling in the abdom inal m uscle s or be aring down with abdom inal pre ssure . Be aring down is lik e ly to worse n stre ss incontine nce while pulling in the abdom inal m uscle s is probably be ne ficial! [14, 15]. The pe lvic floor m uscle s are not an isolate d unite , but part of the abdom inal capsule surrounding the abdom inal and pe lvic organs. The structure s com prising this capsule are the lum bar ve rte brae and m ultifidus m uscle s, the diaphragm (which has both postural and re spiratory role s), the transve rsus abdom inis and the pe lvic floor m uscle s
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www.siicsalud.com/des/croincompleto.php/137533 diaphragm (which has both postural and re spiratory role s), the transve rsus abdom inis and the pe lvic floor m uscle s com ple x . The se m uscle s contribute to the m ainte nance of the trunk posture in an upright position and act syne rgistically. So, it se e m s that, pe lvic floor m uscle s act as part of an inte grate d abdom ino-pe lvic unite [16]. Many studie s inve stigate d the re lationship be twe e n the abdom inal and pe lvic floor m uscle s. Abdom inal m uscle activity is a norm al re sponse to a pe lvic floor m uscle contraction and the position of the lum bar spine , e ithe r fle x ion, e x te nsion or ne utral, varie s the EMG re sponse in e ach abdom inal m uscle . In fle x ion subje cts pe rce ive d a dim inishe d ability to pe rform a m ax im al pe lvic floor m uscle contraction and the palpate d pubococcyge us m uscle contraction was le ss pronounce d. W he n spe cific isom e tric abdom inal contraction was pe rform e d in lying, pubococcyge us and e x te rnal anal sphincte r EMG activity incre ase d. This provide s pre lim inary e vide nce that spe cific abdom inal e x e rcise s activate the pe lvic floor m uscle s [17]. The pre vious re se arche s approve d that the re is a re lation and autom atic re sponse be twe e n spe cific abdom inal m uscle s and pe lvic floor m uscle s. So, in the curre nt study our aim was to com pare the re sponse to abdom inal m uscle training with pe lvic floor m uscle training for the tre atm e nt of m ild SUI in obe se . Thirty fe m ale obe se patie nts with m ild SUI we re involve d in this study. The se participants we re random ly assigne d into two e qual groups. Inte rve ntion was Abdom inal e x e rcise s (Abd. e x 's) group (n=15) re ce ive d spe cific e x e rcise s for transve rsus abdom inis and inte rnal obliqus m uscle s. W he re as, pe lvic floor e x e rcise s (PF e x 's) group (n=15) re ce ive d pe lvic floor e x e rcise s. R e garding the pe lvic floor e x e rcise s we re divide d into thre e ste ps for the pubovaginalis, pubore ctalis and the pubococcyge us as a whole . In addition to die tary m odification in the form of an intak e of 1200 k cal/d divide d into thre e m ain m e als and two snack s. The actual tre atm e nt was te rm inate d at 12 we e k s. The patie nts in both groups we re e ncourage d to continue the ir own program m e plus die tary m odifications until the y we re re asse sse d at we e k 24. The participants we re e valuate d for vaginal pre ssure , le ak point pre ssure (LPP) and waist/hip ratio (W HR ) be fore , im m e diate ly afte r and at a 12-we e k follow-up afte r the te rm ination of tre atm e nt. The ABD group showe d a significant incre ase in vaginal pre ssure im m e diate ly afte r the inte rve ntion and at follow-up (p< 0.001), while the PF group showe d no significant change in this variable . The ABD group also showe d a significant incre ase in LPP afte r 12 we e k s of tre atm e nt (p=0.008), while the PF group de m onstrate d no significant change in the sam e variable (p = 0.030). At 24 we e k s, the LPP re m aine d significantly diffe re nt from the base line only for the ABD group (p= 0.005). The re sults showe d that the 12-we e k abdom inal m uscle stre ngth training program m e
Bibliographic references R e fe re ncias bibliográficas Be rghm ans L, He ndrick s H, Bo K. C onse rvative tre atm e nt of stre ss urinary incontine nce in wom e n: A syste m atic re vie w of random ize d clinical trials. Br J Urol 82:181-191, 1998. Be rnie r F, Sim s T. Manage m e nt of clie nts with urinary disorde rs. In: Black JM, Hawk s JH (Eds.), Me dical- surgical nursing: C linical m anage m e nt for positive outcom e s (8th Ed.), St Louis, MO , Else vie r Saunde rs; 2009. Pp. 727-778. Be rnstie n I. The pe lvic floor m uscle thick ne ss in he althy and urinary incontine nt wom e n m e asure d by re fe re nce to the e ffe ct of pe lvic floor training. J Ne urourol Urodyn 16:237-275, 1997. Bo K, Hage n R , Kwarste in B, Larse n S. Pe lvic floor m uscle e x e rcise s for tre atm e nt of fe m ale stre ss urinary incontine nce . Effe ct of two diffe re nt de gre e s of pe lvic floor m uscle e x e rcise s. Ne urourol Urodyn 9:489-502, 1990. C am m u H, Block e e l C , Am y J. W ho will be ne fit from pe lvic floor m uscle training for stre ss urinary incontine nce ? Am J O bste t Gynae col 191(4):1152-1157, 2004. Doughty D. Prom oting contine nce : sim ple strate gie s with m ajor im pact. O stom y W ound Manage 49:46-52, 2003. Knight S, Layvock J, Naylor D. Evaluation of ne urom uscular e le cte rical stim ulation in the tre atm e nt of ge nuine stre ss incontine nce . Physiothe r 84(2):61-70, 1998. Kohli, N. Urogyne cology. In: David B, Philip S, Douglas A. The physiologic basis of gyne cology and obste trics, 1st e d., Lippincott W illiam s & W ik ins, Philade lphia; 2001. Pp. 317-319. Mark we ll S, Sapsford R . Physiothe rapy m anage m e nt of pe lvic floor dysfunction. In: Sapsford R , Bullock J, Mark we ll S. W om e n's he alth: A te x t book for physiothe rapist, 1st e d., W B Saunde rs C om pany, London; 1998. Pp. 383-407. Patty K. C onse rvative tre atm e nt of urinary stre ss incontine nce . J. Physician and Sport Me d 96:335-345, 1996. R e illy E, Fre e m an R , W ate rfie ld M. Pre ve ntion of postpartum stre ss incontine nce in prim igravidae with incre ase d bladde r ne ck m obility. BJO G 109(1):68-76, 2002. R ichardson C , Jull G, Hodge s P, Hide s J. The rape utic e x e rcise for spinal se gm e ntal stabilization in low back pain, 1st e d., C hurchill Livingstone , Edinburgh; 1999. Pp. 75-84. R ose M, Sm ith J, Ne wm an D. Be havioral m anage m e nt of urinary incontine nce in hom e bound olde r adult. Hom e He althcare Nurse 8:1015, 1990. Sapsford R , Hodge s P, R ichardson C , C oope r D, Mark we ll S, Jull G. C o-activation of the abdom inal and pe lvic floor m uscle s during voluntary e x e rcise s. Ne urourol Urodyn 20:31-42, 2001. Sym onds I, Bak e r P, Ke an L. Proble m orie ntate d obste trics and gyne cology. London: Hodde r Arnold; 2002. p. 257. Tapp A, C ardozo L, Hills B, Branick C . W ho be ne fits from physiothe rapy? Ne urourol Urodyn 7:259-261, 1988. W ong S, Fung Y, Fung M, Tang H. Biofe e dback of pe lvic floor m uscle s in the m anage m e nt of ge nuine stre ss incontine nce in C hine se wom e n. Physiothe r 87(12):644-648, 2001. Other articles written by the author Dalia Kamel O tros artículos de Dalia Kam e l Hanan S. El-Me k awy, PT.D., Dalia M. Kam e l, PT.D., Magda S. Moursi, PT.D. and Ahm e d M. El-Halwagy, M.D. Effe ct of Balance Training on Postural Balance in O be se Post m e nopausal W om e n, Bulle tin of Faculty of Physical The rapy- C airo Unive rsity, July, (2007).
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* Effe ct of Ae robic Ex e rcise s on Mood Swings in Pe rim e nopausal W om e n, Bulle tin of Faculty of Physical The rapy- C airo Unive rsity, January, (2008). * Saye d A. Tantawy*, Dalia M. Kam e l, Ne ve e n A. Abd El-R aoof and Moham e d A. R ham an. Effe ct of Low Le ve l Lase r The rapy in the Tre atm e nt of C he m othe rapy Induce d O ral Mucositis in Postm e nopausal Bre ast C ance r, Bulle tin of Faculty of Physical The rapy- C airo Unive rsity, January, (2008). * Hoda M. Zak aria, Saye d A. Tantawy, Dalia M. Kam e l, Sahar M. Ade l, Khalid A. Kasse m . Fe cal Incontine nce R e sponse s to Poste rior Tibial Ne rve Stim ulation in Partial Spinal C ord Injure d Patie nts, Bulle tin of Faculty of Physical The rapy- C airo Unive rsity, Vol. 14, No. 1, (2009). * Dalia M. Kam e l*, Ne ve e n A. Abd El -R aoof , Saye d A. Tantawy , Ade l F. El-Be gawy, Nihal Y. Abosaif. Doe s Ae robic Ex e rcise Training with W e ight Loss Affe ct Se rum C -R e active Prote in in Asym ptom atic O be se Pe ri-Me nopausal W om e n? The Me dical Journal of C airo Unive rsityC airo Unive rsity, Vol. 78, No. 2, De ce m be r (2010). Dalia M. Kam e l*, Hala M. Hanfy, Ahm e d El-Halwagy ,Am al Abde l W ahab. Effe ct of Ae robic Ex e rcise s on Mood Swings in Pe rim e nopausal W om e n, Bulle tin of Faculty of Physical The rapy- C airo Unive rsity, January, (2008). Adly H Sabour, Ali A Thabe t, Dalia M Kam e l, Saye d A Tantawy. C om parison of Transvaginal ve rsus Poste rior Tibial Ne rve Ele ctrical Stim ulation on Urodynam ic m e asure m e nts in Egyptian W om e n with De trusor Instability. The He alth 2012; 3(4): 90-93 Saye d A Tantawy, Dalia M Kam e l. Efficacy of Ultrasound on Bone Mine ral De nsity and Q uality of Life in Fe m ale s Post m aste ctom y Patie nts: Pre - Post Inte rve ntion Study. Indian Journal of Physiothe rapy and O ccupational The rapy - Ye ar : 2012, Volum e : 6, Issue : 4.
SIIC System of Assisted Editing (SSEA) / Sistema SIIC de Edición Asistida (SSEA) Dalia Kamel was invited by SIIC on
The author's report was accepted on
Dalia Kam e l fue invitado por SIIC e l 2013, july 16
La crónica de l autor fue aprobada e l 2013, august 16 Published in siicsalud Publicado e n siicsalud 0000, 0
The article is strictly related to the following sections of siicsalud El artículo se re laciona e strictam e nte con las siguie nte s se ccione s de siicsalud
Gynaecology and Obstetrics
Urology
/ O bste tricia y Gine cología
/ Urología
and secondarily related to the following sections y se cundariam e nte con las siguie nte s se ccione s
R e productive Me dicine Me dicina R e productiva
O ste oporosis and Bone Disorde rs O ste oporosis y O ste opatías Mé dicas
Information about the full text Acerca del trabajo completo EXERCISE TRA INING FOR MILD STRESS URINA RY INCONTINENCE IN FEMA LES
A uthor / Autor Dalia Kam e l1 1 Dr., De partm e nt O f Physical The rapy For O bste trics And Gyne cology, Faculty O f Physical The rapy, C airo Unive rsity,cairo, Egypt, Manam a,
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1 Dr., De partm e nt O f Physical The rapy For O bste trics And Gyne cology, Faculty O f Physical The rapy, C airo Unive rsity,cairo, Egypt, Manam a, Bahre in, Associate Profe ssor
Acce ss to the original source Hong Kong Physiotherapy Journal
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