Résumé
Contexte : L’incontinence urinaire d’effort (IUE) touche de25 à 45 % des femmes adultes. Plusieurs traitements non invasifs sont recommandés pour diminuer les symptômes mais leurs effets à long terme restent limités. Cependant le plancher pelvien fait partie de la cavité abdominale qui,régie par un processus complexe, permet d’assurer la stabilisation du tronc, la continence, la respiration ainsi que les fonctions gastro-intestinales.
Objectif : L’objectif de cette revue est d’évaluer l’intérêt des exercices de stabilisation abdo-lombo-pelvienne associés ou non à une prise en charge standard chez les femmes atteintes d’IUE.
Méthode : Les recherches ont été menées dans PubMed, CINHAL, PEDro, Cochrane et Embase. Les études évaluant une technique de stabilisation abdo-lombo-pelvienne associée ou non à une autre prise en charge dans le but de traiter l’IUE ont été sélectionnées. Les critères d’évaluations sont l’intensité des symptômes, la qualité de vie ainsi que la force musculaire du plancher pelvien.
Résultats : Sur 967 articles, 9 études ont été sélectionnées sur la base du PICOS. On observe une diminution de l’intensité des symptômes (Urinary Distress Index (UDI) p = 0.002 ;nombre de fuites urinaires p = 0.01). Aucun résultat statistiquement significatif n’a été trouvé en faveur de la qualité de vie et de la force musculaire du plancher pelvien.
Conclusion : Les résultats démontrent qu’une prise en charge globale de la ceinture abdo-lombo-pelvienne obtient de meilleurs résultats en termes de diminution de symptôme d’IUE (nombres de fuite par jour, quantité), d’efficacité de traitement et de maintien sur le long terme qu’avec un traitement uniquement basé sur un renforcement des muscles du plancher pelvien.
Background: Stress urinary incontinence (SUI) affects25–45% of adult women. Several non-invasive treatments are recommended to reduce symptoms of SUI, but their long-term effects are limited. The pelvic floor is part of the abdominal cavity, which governs complex processes to ensure trunk stabilization, continence, breathing, and gastrointestinal functions. Objective: The aim of this review is to assess the effectiveness of abdominal-lumbo-pelvic stabilization exercises with or without standard management in women with SUI.Method: Literature search was conducted in the databases PubMed, CINAHL, PEDro, Cochrane, and Embase. Studies evaluating an abdominal-lumbo-pelvic stabilization technique with or without other management for the treatment of SUI were included. The evaluation criteria were symptom severity, quality of life, and pelvic floor functionality. Results: Of 967 articles, nine were selected on the basis of the PICOS criteria for qualitative and quantitative analysis.A decrease in symptom severity was observed (Urinary Distress Index (UDI), p=0.002; number of urinary leakage episodes, p=0.01). No statistically significant results were found for improvement in the quality of life and pelvic floor muscle strength. Conclusion: The results show that comprehensive management of the abdominal lumbo-pelvic region achieves better results in terms of reduction in SUI symptoms severity(number of leaks per day and quantity), treatment effectiveness,and long-term maintenance than treatments based solely on pelvic floor muscle strengthening.
Background: Stress urinary incontinence (SUI) affects25–45% of adult women. Several non-invasive treatments are recommended to reduce symptoms of SUI, but their long-term effects are limited. The pelvic floor is part of the abdominal cavity, which governs complex processes to ensure trunk stabilization, continence, breathing, and gastrointestinal functions. Objective: The aim of this review is to assess the effectiveness of abdominal-lumbo-pelvic stabilization exercises with or without standard management in women with SUI.Method: Literature search was conducted in the databases PubMed, CINAHL, PEDro, Cochrane, and Embase. Studies evaluating an abdominal-lumbo-pelvic stabilization technique with or without other management for the treatment of SUI were included. The evaluation criteria were symptom severity, quality of life, and pelvic floor functionality. Results: Of 967 articles, nine were selected on the basis of the PICOS criteria for qualitative and quantitative analysis.A decrease in symptom severity was observed (Urinary Distress Index (UDI), p=0.002; number of urinary leakage episodes, p=0.01). No statistically significant results were found for improvement in the quality of life and pelvic floor muscle strength. Conclusion: The results show that comprehensive management of the abdominal lumbo-pelvic region achieves better results in terms of reduction in SUI symptoms severity(number of leaks per day and quantity), treatment effectiveness,and long-term maintenance than treatments based solely on pelvic floor muscle strengthening.