مطالعه مرورنظام مند بررسی تاثیر فیزیوتراپی و تمرینات کف لگن در پیشگیری و درمان اختلالات کف لگن مرتبط با بارداری

مجریان: فریبا قادری

خلاصه روش اجرا: Physiotherapy and pelvic floor muscle exercises (PFMEs) are recommended by so many articles(1) and they are also included in current guidelines for pregnant women. Pregnancy and childbirth are predisposing factors for pelvic floor disorders such as urinary incontinence (UI), fecal incontinence (FI), pelvic organ prolapse (POP), sexual dysfunction and pelvic pain syndrome(2). Different reviews were done to investigate the effects of physiotherapy and PFMEs on pregnancy related pelvic floor disorders in pre and postnatal period and most of them supports the effects of PFMEs in primary and secondary prevention and treatment (3, 4). But a clear and definite treatment method is not recommended so there are many physiotherapy methods and exercise protocols in different trials (5-8) and it is difficult to make a decision on treatment method. Also the previous systematic reviews, included only one or two pelvic floor dysfunctions prevention or treatment (1, 9) but the present study includes all three main pelvic floor dysfunctions including UI, FI and POP prevention or treatment. As well as this study includes both physiotherapy and PFMEs while most of the previous studies included only PFMEs (10-12). The aims of the present systematic review are to answer these questions:  What are the effects of different physiotherapy and PFMEs methods in prevention and treatment of pregnancy related pelvic floor disorders including FI, UI and POP?  Are there any differences between physiotherapy and PFMEs methods in prevention and treatment results of different pregnancy related pelvic floor disorders including FI or UI or POP? The review included all of the published studies with the following criteria: a) Randomized or quasi- randomized controlled trial design b) Pregnant women with or without UI, FI or/and POP c) Postpartum women with or without UI, FI, POP d) Postpartum women with vaginal or cesarean section e) Different types of physiotherapy intervention methods f) Control group with or without any treatment g) Outcome variables related to prevalence of UI, FI and POP, severity of UI, FI and POP, FFM strength and endurance g) Articles published in the English language h) Articles published until December 2019. Articles with non-RCT or non-quasi-RCT design and articles with non-English language were excluded.