Issue №6-20, 2021

Original article

https://doi.org/10.38025/2078-1962-2021-20-6-48-57

Nordic Walking in Rehabilitation of Women with Stress Urinary Incontinence after Sling Operations

View article (Download PDF file)



Download XML file

1 ORCIDAlexey A. Bazhenov, 2 ORCIDJulia М. Borzunova, 2,3 ORCIDАlexander В. Zyryanov

1 Ivdel Сentral District Hospital, Ivdel, Sverdlovsk region, Russian Federation
2 Ural State Medical University, Yekaterinburg, Russian Federation
3 Sverdlovsk Regional Clinical Hospital №1, Yekaterinburg, Russian Federation


ABSTRACT

It is known that urinary incontinence remains one of the most common diseases in women, representing a serious medical and social problem. Practice shows that sling operations without subsequent rehabilitation measures, especially in the long term, do not solve the problem. In urogynecology, the use of physical exercises and physiotherapeutic methods is aimed at restoring impaired urinary functions. A relatively new approach to the rehabilitation of women after sling operations is the inclusion of Nordic walking (NW) into the rehabilitation program. Certain experience in this field has been accumulated in Sverdlovsk Regional Clinical Hospital № 1 (Yekaterinburg).

AIM. To improve the efficiency of treatment of female stress urinary incontinence using the technique of NW in rehabilitation programs after sling operations.

MATERIAL AND METHODS. In Sverdlovsk Regional Clinical Hospital № 1 in Yekaterinburg, NW is included in rehabilitation programs for women with stress urinary incontinence after sling operations. Experience in planning and conducting a four-week course of NW under the physiotherapist guidance has been accumulated. Patients after sling operations (n= 85) were randomized into two groups. Rehabilitation program of patients of the first group (n = 37) included a 4-week course of NW on the background of basic therapy (antibacterial therapy, antispasmodics, anticoagulants), while in the second group (n = 48) only basic therapy was realized. The dynamics of clinical manifestations of stress urinary incontinence was studied, uroflowmetry parameters, PAD-test data, cough test were evaluated; the answers of the patients to the questions of the international questionnaires PFDI-20, PFIQ-7 were analyzed.

RESULTS AND DISCUSSION. The variability of the currently used methods of rehabilitation of patients with stress urinary incontinence requires objectification of the results. The study showed that Nordic walking (NW) is a pathogenetically justified and clinically effective method for rehabilitation of women with stress urinary incontinence after sling operations. The analysis of the rehabilitation activities data based on the dynamics of leading clinical symptoms, PAD test, cough test, uroflowmetry parameters revealed significant differences (p<0.05) between two groups at all follow-up periods: a month, three and nine months. Postoperative objective evaluation of the treatment results correlate with patients’ subjective data: women who completed a course of NW rated their quality of life significantly higher than patients of the control group under the rehabilitation program without inclusion of therapeutic physical factors. The structure of NW classes is based on the understanding that the body response to the physical factors impact is provided by various organs and systems. The inclusion of NW in rehabilitation programs requires adherence to the basic principles of achieving training status.

CONCLUSION. The expediency of NW including in the complex treatment of patients with stress urinary incontinence is due to the regression of main clinical symptoms, reliably significant dynamics of instrumental parameters and test results in comparison with the group that received only basic therapy. The implementation of the therapeutic effect is based on the principle of unity of syndromicpathogenetic and clinical-functional approaches. Clinical-functional approaches is the basis for the implementation of the therapeutic effect.


KEYWORDS: urinary incontinence under stress, sling operation, therapeutic physical factors, Nordic walking, rehabilitation program

Acknowledgments: The study had no sponsorship.

Conflict of interest:: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

For citation: Bazhenov A.A., Borzunova J.М., Zyryanov А.В. Nordic Walking in Rehabilitation of Women with Stress Urinary Incontinence after Sling Operations. Bulletin of Rehabilitation Medicine. 2021; 20 (6): 48-57. https://doi.org/10.38025/2078-1962-2021-20-6-48-57

For correspondence: Julia М. Borzunova, e-mail: jmborzunova@e1.ru



References:

  1. Milsom I., Gyhagen M. The prevalence of urinary incontinence. Climacteric: the Journal of the International Menopause Society. 2019. https://doi.org/10.1080/13697137.2018.1543263
  2. Shim K.H., Choo S.H., Park S.G., Yoo H.J., Choi J.B. Survey on disease insight and prevalence of urinary incontinence in women. Investigative and Clinical Urology. 2021; 62(5): 577-583. https://doi.org/10.4111/icu.20210019
  3. Apolikhina I.A., Dikke G.B., Kochev D.M. Sovremennaya lechebno-profilakticheskaya taktika pri opushchenii i vypadenii polovykh organov u zhensh- chin. Znaniya i prakticheskiye navyki vrachey [Modern therapeutic and prophylactic tactics for prolapse and prolapse of the genitals in women. Knowl- edge and practical skills of doctors]. Obstetrics and Gynecology. 2014; (10): 4-5 (In Russ.).
  4. Popov A.A. Sovremennyye aspekty diagnostiki. kvalifikatsii i khirurgicheskogo lecheniya opushcheniya i vypadeniya zhenskikh polovykh organov. Dokt. Diss. [Modern aspects of diagnostics. qualification and surgical treatment of prolapse and prolapse of female genital organs. Doct. Diss.]. M. 2001: 178 p. (In Russ.).
  5. LuKacz E.S., Santiago-Lastra Y., Albo M.V., Brubaker L. Urinary incontinence in women: A Review. Journal of the American Medical Association. 2017; 318(16): 1592-1604. https://doi.org/10.1001/jama.2017.12137
  6. Chapple C., Dmochowski R. Particulate Versus Non-Particulate Bulking Agents in the Treatment of Stress Urinary Incontinence. Research and Reports in Urology. 2019; (11): 299-310. https://doi.org/10.2147/RRU.S220216
  7. Pivazyan L., Kasyan G., Grigoryan B., Pushkar D. Effectiveness and safety of bulking agents versus surgical methods in women with stress urinary incon- tinence: a systematic review and meta-analysis. International Urogynecology Journal. 2021. https://doi.org/10.1007/s00192-021-04937-1
  8. Ponomarenko G.N. Fizicheskaya i reabilitatsionnaya meditsina: fundamentalnyye osnovy i klinicheskaya praktika. Fizioterapiya. balneologiya i reabili- tatsiya [Physical and Rehabilitation Medicine: Fundamentals and Clinical Practice]. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2016; 15(6): 284-289. https://doi.org/10.18821/1641-3456-2016-15-6-284-289 (In Russ.).
  9. Epifanov A.V., Achkasov E.E., Epifanov V.A. Meditsinskaya reabilitatsiya [Medical Rehibilitation]. M. GEOTAR-Media. 2015: 672 p. (In Russ.).
  10. Ponomarenko G.N. Dialektika poznaniya i metafizika svoevoliya v fizioterapii. Voprosy` kurortologii, fizioterapii i lechebnoj fizkul`tury [Dialectic cogni- tion and metaphysics in physiotherapy]. Problems of Balneology, Physiotherapy and Exercise Therapy. 2005; (3): 38-44 (In Russ.).
  11. Ulashhik V.S. Fizioterapiya. Universal`naya medicinskaya e`nciklopediya [Physiotherapy. Universal medical encyclopedia]. M. Knizhny`j Dom. 2008: 640 p. (In Russ.).
  12. Akulenko L.V., Kasyan G.R., Kozlova Yu.O., Tupikina N.V., Vishnevskij D.A., Pushkar` D.Yu. Disfunkciya tazovogo dna u zhenshhin v aspekte geneticheskix issledovani [Pelvic floor dysfunction in women in the aspect of genetic research]. Urologiia. 2017; (1): 76-81. https://doi.org/10.18565/urol.2017.1.76-81 (In Russ.).
  13. Suhanov A.A., Dikke G.B., Kukarskaya I.I. Epidemiologiya i etiopatogenez disfunkcii tazovogo dna [Epidemiology and etiopathogenesis of pelvic floor dysfunction]. Doktor.Ru. 2018; 10(154): 27-31. https://doi.org/10.31550/1727-2378-2018-154-10-27-31 (In Russ.).
  14. Lowder J.L., Frankman E.A., Ghetti C., Burrows L.J., Krohn M.A., Moalli P., Zyczynski H. Lower urinary tract symptoms in women with pelvic organ pro- lapse. International Uronecology Journal. 2010; 21(6): 665-672. https://doi.org/10.1007/s00192-009-1088-2
  15. Orazov M.R., Silant’eva E.S., Soldatskaya R.A., Belkovskaya M.E. Effektivnost’ fizioterapii v lechenii nedostatochnosti myshc tazovogo dna u zhenshchin reproduktivnogo vozrasta [The effectiveness of physiotherapy in the treatment of pelvic floor muscle insufficiency in women of reproductive age]. Doktor.Ru. 2020; 19(8): 71-76. https://doi.org/10.31550/1727-2378-2020-19-8-71-76 (In Russ.).
  16. Gadzhieva Z.K. Funkcional`noe sostoyanie nizhnix mochevy`x putej i medikamentoznaya korrekciya narushenij mocheispuskaniya u zhenshhin v kli- makterii. Kand. Diss. [The functional state of the lower urinary tract and drug correction of urinary disorders in women in menopause. Cand. Diss.]. M. 2001. (In Russ.).
  17. Pereverzev A.S., Shhukin D.V., Yakubovskij V.N. Ul`trazvukovaya i magnito-rezonansnaya xarakteristiki tazovy`x narushenij pri stressovom nederzhanii mo- cha [Ultrasound and magnetic resonance characteristics of pelvic disorders in stress urinary incontinence]. Plenum of the Board of the Russian Society of Urologists: Materials. M. 2001: 135-136 (In Russ.).
  18. Asklund I., Samuelsson E., Hamberg K., Umefjord G., Sjöström M. User Experience of an App-Based Treatment for Stress Urinary Incontinence: Qualita- tive Interview Study. Journal of Medical Internet Resources. 2019; 21(3): e11296. https://doi.org/10.2196/11296
  19. Rygh P., Asklund I., Samuelsson E. Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study. British Medical Journal Open. 2021; 11(1): e040819 p. https://doi.org/10.1136/bmjopen-2020-040819
  20. Schreiweis B., Pobiruchin M., Strotbaum V., Suleder J., Wiesner M., Bergh B. Barriers and facilitators to the implementation of ehealth services: systematic literature analysis. Journal of Medical Internet Resources. 2019; 21(11): e14197 p. https://doi.org/10.2196/14197
  21. Barieva Yu.B., Botvineva L.A., Kajsinova A.S., Samsonova N.A. Rol’ fizicheskih nagruzok i pit’evyh mineral’nyh vod v profilaktike i lechenii abdominal’nogo ozhireniya – osnovy metabolicheskogo sindroma [Role of physical loads and drinking mineral water in prevention and treatment of obesity – basis of metabolic syndrome]. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2017; 16(5): 228-233. https://doi.org/10.18821/1681-3456-2017-16-5-228-233 (In Russ.).
  22. Volodina K.A., Linchak R.M., Achkasov E.E., Alaeva E.N., Runenko S.D., Kurbakova E.V. Istoriya kardioreabilitacii: ot strogogo 2-mesyachnogo postel’nogo rezhima do skandinavskoj hod’by [The history of cardiorehabilitation: from a strict 2-month bed rest to Ccandinavian Walking]. Cardiovascular Therapy and Prevention. 2017; 16(4): 100-105. https://doi.org/10.15829/1728-8800-2017-4-100-105 (In Russ.).
  23. Epifanov V.A. Vosstanovitel`naya medicina: uchebnik [Restorative medicine: textbook]. 2013: 304 p. (In Russ.).
  24. Schwanbeck K. The ultimate Nordic pole walking book. 3rd revised edition. Auckland: Meyer & Meyer Sport. 2014: 243 p.
  25. Tschentscher M., Niederseer D., Niebauer J. Health benefits of Nordic walking: A systematic review. American Journal of Preventive Medicine. 2013; 44(1): 76-84.
  26. Oranskij I.E. Specifichnost` v dejstvii fizioterapevticheskix faktorov, mif ili real`nost`? [Specificity in the action of physiotherapeutic factors, myth or real- ity?]. Problems of Balneology, Physiotherapy and Exercise Therapy. 2009; (2): 52-53 (In Russ.).



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.

Aссоциация НАЭСКЛ