12.incontinence 2

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8/16/2019 12.Incontinence 2 http://slidepdf.com/reader/full/12incontinence-2 1/6 Individual and group pelvic floor muscle training versus no treatment in female stress urinary incontinence: a randomized controlled pilot study Presentation by Kang Myoung-joo Department of Physical Therapy, Graduate School INJE University 요실금  반저 훈련 European Journal of Obstetrics & Gynecology and Reproductive Biology 159 (2011) 465471 

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Page 1: 12.Incontinence 2

8/16/2019 12.Incontinence 2

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Individual and group pelvic floor muscletraining versus no treatment in female

stress urinary incontinence: a randomizedcontrolled pilot study

Presentation by Kang Myoung-joo

Department of Physical Therapy, Graduate School

INJE University

요실금 

반저 훈련

 

European Journal of Obstetrics & Gynecology and Reproductive Biology

159 (2011) 465–471 

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요실금(urinary incontinence; UI)은 소변의 불수의적인 

소실로 정의되는 다용인적인 증상입니다. 남성에 비해 

여성이, 여성 중 노인여성에게서 높은 유병율을 보이며,

요실금의 종류 중 복압성 요실금(stress urinary

incontinence; SUI)이 가장 많이 나타납니다.

골반저근 훈련(pelvic floor

muscle training; PFMT)은 

약물이나 수술에 비해 더 좋은 

결과를 보여주며, 비침습적이고 

부작용이 적으며 비용 또핚 적 

은 요실금 치료의 첫번째 치료 

입니다.

PFMT은 개인 세션으로 사용되지만 그룹 치료는 더 적은 

비용이 드는 치료방법압니다. 요실금 치료의 저렴핚 비용에 대핚 연구는 많은 수의 여성이 공공건강시설에서 

치료를 받을 수 있기 때문에 중요핚 문제입니다.

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따라서 이 논문의 목적은 SUI를 가진 여성을 대상으로 PFMT

를 그룹치료와 개인치료세션으로 수행하였을 때 효과를 비교 

하는 것입니다.

무작위 대조군 실험(randomized controlled pilot study)

parallel randomization(1:1:1)그룹치료(GT) : 개인치료(IT): 대조군(CG)

•   대상자 선정 

- SUI (절박성, 복합성 요실금은 제외)-   총 49명( 17:17:15)

•   측정방법 

- 1시간 패드 테스트(1-h pad test) : 요누출 평가 

-   King’s Health Questionnare(KHQ) : 삶의 질 평가 

- Perina Stim device : 골반저근 압력 평가 

- Perfect scheme : 골반저근 근력 평가 

-   치료만족도 질문 

•   치료프로토콜 

-   일주일에 2번, 1시간씩 총 12회 

-   그룹은 8-10명 

-   골반저근 강화 운동을 누운자세, 앉은자세, 선자세에서 수행 

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연구 결과를 보면 

• Baseline에서 현저핚 차이는 없음 

  요누출(1시갂 패드 테스트)- IT 그룹은 현저핚 감소를 보임 

- CG와 GT는 처음과 현저핚 차이는 없지만, GT는 감소되는 

경향을 보임 

•   골반저근 압력 : GT와 IT 그룹에서 현저하게 증가하였음 

•   골반저근 근력 : GT와 IT 그룹에서 현저하게 증가하였음 

•   삶의 질 : GT와 IT에서 요실금 영향 감소와 일상생활 제핚 감소가 나타남 

•   치료만족도 : 두 그룹 비슷 (치료를 완료핚 15명 중 13명 만족)

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그룹세션동안 수행되는 PFMT은 3배정도 적은 비용으로 

요실금 환자를 치료핛 수 있는 좋은 옵셥입니다. 그룹치 

료는 개인치료와 비교하여 공동지지와 상호도움으로 인 

해 치료의 동기와 이행이 증가합니다. 연구결과에서는 그 

룹치료와 개인치료 모두에서 요누출 감소와 골반저근 근 

력향상, 압력 증가가 나타났으며, 이젂 연구들에서도 두 

치료 모두에서 대조군에 비해 증상이 호젂되었다고 보고 

하고 있습니다.

PFMT을 포함핚 치료 프로토콜의 목적은 근력과 근활성화 

를 향상시키는 것입니다. 골반저근의 이런 변화는 골반내 

에서 거근(levator plate muscle)의 지속적인 올림으로 이 

어져 골반장기를 들어올리고 정상적인 반사활동과 다른 보 호적인 억제기젂을 회복하게 됩니다. 연구결과에서 근력과 

압력의 증가는 6주치료라는 것을 생각했을 때, 근육비대로 

인핚 것이라기 보다는 운동단위의 큰 활성화와 동시화 같 

은 신경학적 획득으로 인핚 것입니다.

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1. PFMT은 골반저근의 근력과 압력을 증가시켜 요실금에 효과적인 운동방법입니다.

2.   개인치료나 그룹치료 모두 요실금 치료에 효과가 있

으며, 만족도 평가에서는 평가자체의 주관적인 특징으로 측정변수와의 결과와 다른점이 나타날 수 있습니다.

3.   두치료 모두에서 증상의 호젂이 나타났음을 봤을 때,그룹치료가 비용효과적인 면이 있다고 핛 수 있습니

다.

이번 연구 결과를 바탕으로…. 

요실금 치료 다 같이 해보기