LairaRamos
Introduction: Urinary incontinence is a chronic and
limiting disease that affects both men and women but
is more common in women. A conservative treatment is
prescribed as a first therapeutic option for this illness,
but we do not know what the appropriate dosage for the
exercises is, nor is there a consensus on whether individual
sessions are more effective than group sessions, or
whether other additional techniques should be used in
conjunction with the exercises. Objective: To evaluate the
Active Perineal Rehabilitation (APR) protocol in the treatment
of stress urinary incontinence. Methods: Sixty-one
women between the ages of 35 and 78 with complaints of
urinary incontinence were selected and underwent one
of two treatments: The APR protocol, carried out in individual
sessions with a combination of kinesiotherapy
with biofeedback, electrical stimulation, vaginal cones
and home exercises, over a period of three months; or
group exercises (GE), carried out in groups of three to five
participants, over a period of six months. The volunteers
were divided into three groups according to the pelvic
floor muscle (PFM) force and the treatment undertaken:
APRa (n=14) patients with force 0 or 1, and treated with
APR protocol; APRb (n=21) patients with force between
2 and 5, and treated with APR protocol; and GE (n=26)
patients with force between 2 and 5, and treat with group
exercises. Results: All patients in the three groups had
a significant improvement in the number and quantity
of urine loss, with no statistical difference between the
groups. At the end of the treatment, 33.3% of the APRa
group, 70.6% of the APRb group and 68.8% of the GE
group said that they had seen an improvement. In the follow-
up six months after the last session these percentages
were 57.6%, 75%, and 53.8%, respectively. Conclusions:
The APR protocol is as effective as group exercises in the
treatment of stress urinary incontinence. A great APR differential
is that it can be indicated to patients with PFM
force 0 or 1, still then physical therapy was not considered
adequate to treat these patients.
