PELVIC-FLOOR REHABILITATION .2. PELVIC-FLOOR REEDUCATION WITH INTERFERENTIAL CURRENTS AND EXERCISE IN THE TREATMENT OF GENUINE STRESS-INCONTINENCE IN POSTPARTUM WOMEN - A COHORT STUDY

Background and Purpose. This descriptive cohort study investigated a p hysical therapy program of pelvic-floor neuromuscular electrostimulati on (NMES) combined with exercises, with the aim of developing, a simpl e, inexpensive, and conservative treatment for postpartum genuine stre ss incontinence (GSI). Subjects. Eight female subjects with urodynamic ally established GSI persisting more than 3 months after delivery part icipated in the study. The subjects ranged in age from 24 to 37 years ((X) over bar 32, SD = 4.2). Methods. This was a descriptive multiple- subject cohort study. Each subject received a total of nine treatment sessions during 3 consecutive weeks, consisting of two 15-minute sessi ons of NMES followed by a 15-minute pelvic-floor muscle exercise progr am. Patients also practiced daily pelvic-floor exercises during the 3- week treatment period. The treatment intervention was measured using t hree separate variables. Maximum muscle contractions (pretraining, dur ing training, and post-training) were measured indirectly as pressure, using perineometry. Urine loss Pretraining and posttraining was measu red by means of a Pad test. Self-reported frequency of incontinence wa s recorded daily throughout the period of the study, using a diary. Da ta were analyzed using a one-way repeated measures analysis of varianc e (ANOVA): a Wilcoxon signed-ranks test, and a Friedman two-way ANOVA by ranks. Results. The results indicated that maximum pressure generat ed by pelvic-floor contractions was greater and both the quantity of u rine loss and the frequency of incontinence were lower following the i mplementation of the physical therapy program. Five subjects became co ntinent, and three others improved. A follow-up survey 1 year Inter co nfirmed the consistency of these results. Conclusion and Discussion. T he results suggest that the proposed physical therapy program may infl uence postpartum GSI. Further studies are needed to validate this simp le, inexpensive, and conservative physical therapy protocol.