Unwillkürliches reflektorisches Training der Beckenbodenmuskulatur bei Belastungsinkontinenz

Willkürliches Training der Beckenbodenmuskeln (BBM) ist bei deren Insuffizienz und bei Belastungsinkontinenz (BI) effizient. Allerdings werden in Situationen, die BI provozieren, schnelle, unwillkürliche, reflektorische BBM-Kontraktionen verlangt, um die Kontinenz zu gewährleisten. In der Physiotherapie stellt sich deshalb die Frage, ob und wie reflektorische BBM-Kontraktionen trainiert werden können.

• Literatur

• 1 Bernards AT, Berghmans BC, Slieker-Ten Hove MC. et al. Dutch guidelines for physiotherapy in patients with stress urinary incontinence: an update. Int Urogynecol J. 2014; 25 (02) : 171-179
• 2 Bhend J, Born E, Krause K. et al. Whole Body Vibration and Pelvic Floor - Cross-Section Study on Muscular Activation. Physioscience 2007; 3 (04) : 177-180 , DOI: 10.1055/s-2007-963365.
• 3 Bø K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength. Phys Ther 2005; 85 (03) : 269-282
• 4 Bø K. . Urinary Incontinence, Pelvic Floor Dysfunction, Exercise and Sport. Sports Med 2004; 34 (07) : 451-464
• 5 Culbertson S, Davis AM. Nonsurgical Management of Urinary Incontinence in Women. JAMA 2017; 317 (01) : 79-80
• 6 Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women [Review]. Cochrane Database of Systematic Reviews 2018 , Issue 10. Art. No.: CD005654
• 7 Dumoulin C, Glazener C, Jenkinson D. Determining the optimal pelvic floor muscle training regimen for women with stress urinary incontinence [Review]. Neurourol Urodyn 2011; 30 : 746-753
• 8 Guellich A, Schmidtbleicher D. Struktur der Kraftfähigkeiten und ihrer Trainingsmethoden. Deutsche Zeitschrift für Sportmedizin 1999; 50 : 223-234
• 9 Gupta JK, Lin CH, Chen Q. Flow dynamics and characterization of a cough. Indoor Air 2009; 19 (06) : 517-525
• 10 Haylen BT, de Ridder D, Freeman RM. et al. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 2010; 29 (01) : 4-20
• 11 Hay-Smith J, Herderschee R, Dumoulin C. et al. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women: An abridged Cochrane systematic review [Meta-Analysis Review]. Eur J Phys Rehabil Med 2012; 48 : 689-705
• 12 Kraus WE, Powell KE, Haskell WL. et al.; 2018 PHYSICAL ACTIVITY GUIDELINES ADVISORY COMMITTEE. Physical Activity, All-Cause and Cardiovascular Mortality, and Cardiovascular Disease. Med Sci Sports Exerc . 2019; 51 (06) : 1270-1281
• 13 Lauper M, Kuhn A, Gerber R. et al. Pelvic Floor Stimulation: What Are The Good Vibrations?. Neurourol Urodyn 2009; 28 (05) : 405-410
• 14 Leitner M, Moser H, Eichelberger P. et al. Pelvic floor muscle activity during fast voluntary contractions in continent and incontinent women. Neurourol Urodyn 2019; 38 (02) : 625-631
• 15 Leitner M, Moser H, Eichelberger P. et al. Evaluation of pelvic floor muscle activity during running in continent and incontinent women: An exploratory study. Neurourol Urodyn 2017; 36 (06) : 1570-1576
• 16 Luginbuehl H, Lehmann C, Baeyens JP. et al. Involuntary reflexive pelvic floor muscle training in addition to standard training versus standard training alone for women with stress urinary incontinence: study protocol for a randomized controlled trial. Trials 2015; 16 : 524
• 17 Luginbuehl H, Lehmann C, Gerber R. et al. Continuous versus intermittent stochastic resonance whole body vibration and its effect on pelvic floor muscle activity. Neurourol Urodyn 2012; 31 (05) : 683-687
• 18 Luginbuehl H, Naeff R, Zahnd A. et al. Pelvic floor muscle electromyography during different running speeds: an exploratory and reliability study. Arch Gynecol Obstet . 2016; 293 (01) : 117-124
• 19 Luginbuehl H, Baeyens JP, Kuhn A. et al. Pelvic floor muscle reflex activity during coughing – an exploratory and reliability study. Ann Phys Rehabil Med 2016; 59 (5-6): 302-307
• 20 Markland AD, Richter HE, Fwu CW. Prevalence and Trends of Urinary Incontinence in Adults in the United States, 2001 to 2008. J Urol 2011; 186 (02) : 589-593
• 21 Miller J, Kasper C, Sampselle C. Review of muscle physiology with application to pelvic muscle exercise. Urol Nurs 1994; 14 (03) : 92-97
• 22 Minassian VA, Stewart WF, Wood GC. Urinary incontinence in women: variation in prevalence estimates and risk factors. Obstet Gynecol 2008; 111 (02) Pt 1): 324-331
• 23 Morin M, Bourbonnais D, Gravel D. et al. Pelvic Floor Muscle Function in Continent and Stress Urinary IncontinentWomen Using Dynamometric Measurements. Neurourol Urodyn 2004; 23 (07) : 668-674
• 24 Moser H, Leitner M, Eichelberger P. et al. Pelvic floor muscle activity during jumps in continent and incontinent women: an exploratory study. Arch Gynecol Obstet 2018; 297 (06) : 1455-1463
• 25 Nygaard IE, Shaw JM. Physical activity and the pelvic floor. Am J Obstet Gynecol 2016; 214 (02) : 164-171
• 26 Ortega DR, Rodríguez Bíes EC, Berral de la Rosa FJ. . Analysis of the vertical ground reaction forces and temporal factors in the landing phase of a countermovement jump. J Sports Sci Med 2010; 9 (02) : 282-287
• 27 Peng Q, Jones R, Shishido K. Spatial distribution of vaginal closure pressures of continent and stress urinary incontinent women. Physiol Meas 2007; 28 (11) : 1429-1450
• 28 Pomian A, Lisik W, Kosieradzki M. et al. Obesity and Pelvic Floor Disorders: A Review of the Literature. Med Sci Monit 2016; 22 : 1880-1886
• 29 Qaseem A, Dallas P, Forciea MA. et al. Clinical Guidelines Committee of the American College of Physicians. Nonsurgical management of urinary incontinence in women: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2014; 161 (06) : 429-440
• 30 Radlinger L, Bachmann W, Homburg J. et al. Rehabilitatives Krafttraining. Stuttgart: Thieme; 1998
• 31 Riemsma R, Hagen S, Kirschner-Hermanns R. et al. Can incontinence be cured? A systematic review of cure rates. BMC Med 2017; 15 (01) : 63
• 32 Saeuberli PW, Schraknepper A, Eichelberger P. et al. Reflex activity of pelvic floor muscles during drop landings and mini-trampolining-exploratory study. Int Urogynecol J 2018; 29 (12) : 1833-1840
• 33 Shishido K, Peng Q, Jones R. et al. Influence of Pelvic Floor Muscle Contraction on the Profile of Vaginal Closure Pressure in Continent and Stress Urinary Incontinent Women. J Urol 2008; 179 (05) : 1917-1922
• 34 Syan R, Brucker BM. Guideline of guidelines: urinary incontinence. BJU Int 2016; 117 (01) : 20-33
• 35 Tähtinen RM, Cartwright R, Tsui JF. et al. Long-term Impact of Mode of Delivery on Stress Urinary Incontinence and Urgency Urinary Incontinence: A Systematic Review and Meta-analysis. Eur Urol 2016; 70 (01) : 148-158
• 36 Tennstedt SL, Link CL, Steers WD, McKinlay JB. Prevalence of and risk factors for urine leakage in a racially and ethnically diverse population of adults the Boston Area Community Health (BACH) survey. Am J Epidemiol 2008; 167 (04) : 390-399
• 37 Tomori Z, Widdicombe JG. Muscular, bronchomotor and cardiovascular reflexes elicited by mechanical stimulation of the respiratory tract. J Physiol 1969; 200 (01) : 25-49
• 38 Verelst M. Leivseth G. Force and Stiffness of the Pelvic Floor as Function of Muscle Length: A Comparison Between Women With and Without Stress Urinary Incontinence. Neurourol Urodyn 2007; 26 (06) : 852-857
• 39 Zadpoor AA, Nikooyan AA. The relationship between lower-extremity stress fractures and the ground reaction force: a systematic review. Clin Biomech 2011; 26 (01) : 23-28