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Can Pelvic Floor Muscle Training Reduce my Prolapse

2016年2月2日 更新者:Copenhagen University Hospital at Herlev

Can Pelvic Floor Muscle Training Reduce my Prolapse? A Randomised Controlled Trial Comparing the Effect of Pelvic Floor Muscle Training and Lifestyle Advice on Pelvic Organ Prolapse

Purpose The aim of this study is to examine if a structured pelvic floor muscle training combined with lifestyle advice with can improve pelvic organ prolapse (POP) symptoms more than structured lifestyle advice programme alone.

Background Pelvic organ prolapse (POP) is a common condition among adult women and almost one in ten women experience symptoms caused by POP. The key symptom of POP is seeing or feeling a bulge in the vaginal opening but POP often gives other symptoms, such as pain, difficulty emptying the bladder or the bowel, incontinence and sexual problems such as dyspareunia.

A majority of women with POP will be offered reconstructive surgery but the risk of reoperations is substantial and surgery may cause new symptoms. In one out of four women surgery does not relieve symptoms and the women have been exposed to unnecessary risk of complications.

It is therefore important to evaluate the effect of conservative treatments for POP. New studies have shown that pelvic floor muscle training offered in combination with lifestyle advice has a significant on POP symptoms and objective measures of POP compared to a lifestyle advice leaflet alone.

No studies have compared the effect of a combined pelvic floor muscle training and lifestyle advice programme with a structured programme of lifestyle advice and hypothetically the structured lifestyle advice programme could have a substantial effect on its own. Our hypothesis is that the pelvic floor muscle training is a vital component of a conservative treatment for POP.

Methods In this single-blind randomised controlled study women with POP will randomised to either a programme of structured pelvic floor muscle training combined with lifestyle advice or a structured lifestyle advice programme alone. Both groups will receive the same lifestyle advices through six (separate) lectures within 12 weeks. The training group will be examined and individually instructed in pelvic floor muscle training before the intervention starts and they will, in continuation with their lifestyle lectures, perform pelvic floor muscle training as group training

調査の概要

研究の種類

介入

入学 (実際)

108

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

      • Copenhagen、デンマーク、DK - 2730
        • Copenhagen University Hospital at Herlev

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年歳以上 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

女性

説明

Inclusion Criteria:

  • ≥18 years of age female reporting bothersome symptoms of any type of POP
  • Newly referred to the hospital clinic
  • Prolapse ≥II POP-Q
  • Understand and write Danish

Exclusion Criteria:

  • Instruction in pelvic floor muscle training within the last two years
  • Dementia
  • Pregnancy or less than one year postnatal
  • Disorders that can affect ability to participate in the intervention such as neurological or psychiatric disorders

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:独身

武器と介入

参加者グループ / アーム
介入・治療
実験的:Group 1
Group 1 will be individually examined and instructed in pelvic floor muscle training before the intervention starts by specialized physiotherapists. The examination includes a vaginal or an anal examination. The women attend six group sessions within 12 weeks containing structured information about POP and the possible affection of POP on quality of life, exercising and sexual relationship. The lifestyle advice contains information about life style changes that could improve POP symptoms, such as bladder and bowel habits, coughing, heavy lifting, eating habits and weight loss. The women will perform pelvic floor muscle training in the group and they will perform pelvic floor muscle training at home. The training will be individually planned according to the findings of the pelvic floor physiotherapist. The women in the intervention group fill in an exercise diary and also describe on a Visual Analog Scale if the training causes any bother.
Group 1 will be individually examined and instructed in pelvic floor muscle training before the intervention starts by specialized physiotherapists. The examination includes a vaginal or an anal examination. The women attend six group sessions within 12 weeks containing structured information about POP and the possible affection of POP on quality of life, exercising and sexual relationship and information that could improve POP symptoms, such as bladder and bowel habits, coughing, heavy lifting, eating habits and weight loss. The women will perform pelvic floor muscle training in the group and perform pelvic floor muscle training at home. The training will be individually planned according to the findings of the pelvic floor physiotherapist. The women in the intervention group fill in an exercise diary and also describe on a Visual Analog Scale if the training causes any bother.
アクティブコンパレータ:Group 2
Group 2 attend six group sessions within 12 weeks containing structured information about POP and the possible affection of POP on quality of life, exercising and sexual relationship. The lifestyle advice contains information about life style changes that could improve POP symptoms, such as bladder and bowel habits, coughing, heavy lifting, eating habits and weight loss
Group 2 attend six group sessions within 12 weeks containing structured information about POP and the possible affection of POP on quality of life, exercising and sexual relationship. The lifestyle advice contains information about life style changes that could improve POP symptoms, such as bladder and bowel habits, coughing, heavy lifting, eating habits and weight loss

この研究は何を測定していますか?

主要な結果の測定

結果測定
時間枠
Patient Global Index of Improvement scale (PGI-I)
時間枠:three months after ended intervention
three months after ended intervention

二次結果の測定

結果測定
メジャーの説明
時間枠
Objective pelvic organ prolapse measured with the pelvic organ prolapse Quantification system (POP-Q)
時間枠:before, right after, three and 12 months after the intervention has ended
before, right after, three and 12 months after the intervention has ended
Pelvic Floor Distress Inventory - short form 20 (PFDI-20)
時間枠:right after, three months and 12 months after ended intervention
Validated condition-specific questionnaire
right after, three months and 12 months after ended intervention
Pelvic Floor Impact Questionnaire - short form 7 (PFIQ-7)
時間枠:right after, three months and 12 months after ended intervention
Validated condition-specific questionnaire
right after, three months and 12 months after ended intervention
Background variables
時間枠:At time of inclusion
age, parity, BMI, working status as predictors of effect of the intervention
At time of inclusion
Size of levator hiatus and presence of levator ani avulsions examined through transperineal ultrasound
時間枠:At time of inclusion
as predictors of effect of the intervention
At time of inclusion
Cost-effectiveness
時間枠:12 months after ended intervention
Need for further treatment and calculation of economic costs for both interventions compared to number of surgeries avoided will be evaluated
12 months after ended intervention
Patient Global Index of Improvement scale (PGI-I)
時間枠:Right after ended intervention and 12 months after ended intervention
Right after ended intervention and 12 months after ended intervention

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2012年8月1日

一次修了 (実際)

2015年4月1日

研究の完了 (実際)

2015年4月1日

試験登録日

最初に提出

2012年6月4日

QC基準を満たした最初の提出物

2012年6月5日

最初の投稿 (見積もり)

2012年6月6日

学習記録の更新

投稿された最後の更新 (見積もり)

2016年2月3日

QC基準を満たした最後の更新が送信されました

2016年2月2日

最終確認日

2014年7月1日

詳しくは

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