Efectividad del entrenamiento de los músculos del suelo pélvico en la incontinencia urinaria: revisión sistemática

Resumen

Objetivos

Determinar el mejor modo de entrenamiento de los músculos del suelo pélvico (PFMT) y evaluar su eficacia preventiva contra la incontinencia urinaria durante el embarazo, así como sus efectos a medio/largo plazo.

Métodos

Se ha llevado a cabo una revisión sistemática en las bases de datos Pubmed, PEDro, ISI Web of Knowledge y CINAHL, incluyéndose aquellos estudios que solo aplican PFMT (pelvic floor muscle training).

Resultados

Se obtuvieron un total de 133 estudios en las 4 bases de datos que, tras aplicar los criterios de inclusión y exclusión, se redujeron a 21.

Conclusiones

Es más eficaz bajo supervisión del fisioterapeuta, no hay diferencias en realizarlo individualmente o en grupo, no hay consenso en cuanto a si previene la incontinencia urinaria realizándolo durante el embarazo, aunque sí tras el parto, y a medio/largo plazo no tiene tan buenos resultados, como a corto plazo, debido a la baja adhesión al entrenamiento años después.

Abstract

Objectives

To determine the best way to perform pelvic floor muscle training (PFMT), to review the effectiveness of this training method in women with urinary incontinence (UI) during pregnancy, as well as its middle to long-term effects.

Methods

A systematic review of randomised controlled trials was performed using the databases: Pubmed, PEDro, ISI Web of Knowledge and CINAHL and searching up to September 2011. Trials were included if they assessed the effects of PFMT.

Results

A total of 133 studies were found. After inclusion/exclusion criteria were applied, only 21 were included in this review.

Conclusions

PFMT is more effective when it was performed under supervision. Individual treatment and group PFMT are equally effective. There was no consensus about its capacity to prevent UI when performed during pregnancy, but it was found to be effective after puerperium. Due to the low rate of patient adherence to training, better short-term effects have been found than in the long-term.