功能性盆底肌训练对女性压力性尿失禁患者的效果

doi:10.3969/j.issn.1006-9771.2026.06.007

Abstract

Abstract:

Objective To observe the effect of functional pelvic floor muscle training on pelvic floor muscle function, incontinence symptoms and quality of life in female patients with stress urinary incontinence(SUI).
Methods From February, 2024 to July, 2025, 40 female patients with SUI were recruited from Beijing Bo'ai Hospital and advertisements. They were randomly divided into control group(n=20)and experimental group(n=20). The control group received conventional pelvic floor muscle contraction and relaxation training, and the experimental group received functional pelvic floor muscle contraction and relaxation training, for eight weeks. The data of pelvic floor muscle strength, pelvic floor muscle surface electromyography(sEMG), 1-hour urine pad test and Incontinence Quality of Life questionnaire(I-QOL)were collected before and after training. The compliance rate was counted after training.
Results One case dropped down in the control group and three cases dropped down in the experimental group. After treatment, the pelvic floor muscle strength increased in both groups(|Z|>3.317, P<0.01), the pre-resting average value, sustained contraction average value and durable contraction average value of sEMG improved in the control group(|t|>2.731, P<0.05), the mass of 1-hour urine pad significantly reduced(t>9.215, P<0.001)and the I-QOL score significantly increased(|t|>13.229, P<0.001)in both groups; compared with the control group, the pelvic floor muscle strength significantly increased(Z=-2.281, P=0.023), the mass of 1-hour urine pad significantly reduced(t=4.215, P<0.001), the I-QOL score significantly increased(t=-4.501, P<0.001), and the compliance rate significantly increased(Z=-2.798, P<0.01)in the experimental group.
Conclusion Functional pelvic floor muscle training can significantly improve pelvic floor muscle strength, incontinence symptoms and quality of life in female patients with SUI.

Key words: stress urinary incontinence, pelvic floor function, functional activities, functional pelvic floor muscle training

CLC Number:

R694

LI Ya'nan, YE Miao, WU Juan, CHEN Cong, WAN Lingfang, YU Lili, GAO Linlin, QIN Yi, JING Huafang. Effect of functional pelvic floor muscle training on stress urinary incontinence in women[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(6): 690-698.

Figures/Tables 6

Table 1

Table 2

Table 3

Table 4

Table 5

Table 6

References 40

[1]	LUGO T, LESLIE S W, MIKES B A, et al. Stress urinary incontinence[M]. Treasure Island, FL: StatPearls Publishing, 2025.
[2]	中国研究型医院协会妇产科学专业委员会. 北京大学女性压力性尿失禁诊断与治疗专家共识[J]. 中国妇产科临床杂志, 2025, 26(4): 370-378.
[3]	CARLSON K, ANDREWS M, BASCOM A, et al. 2024 Canadian Urological Association guideline: female stress urinary incontinence[J]. Can Urol Assoc J, 2024, 18(4): 83-102. doi: 10.5489/cuaj.8751
[4]	YOUNT-TAVENER S M, FAY R A. Maintaining a long-term practice of daily pelvic floor muscle exercises: What do childbearing women think[J]. J Midwifery Women Health, 2024, 69(4): 567-576. doi: 10.1111/jmwh.v69.4
[5]	ZHU J, PANG H, WANG P, et al. Female urinary incontinence in China after 15 years' efforts: results from large-scale nationwide surveys[J]. Sci Bull(Beijing), 2024, 69(20): 3272-3282.
[6]	TALASZ H, KREMSER C, KOFLER M, et al. Phase-locked parallel movement of diaphragm and pelvic floor during breathing and coughing: a dynamic MRI investigation in healthy females[J]. Int Urogynecol J, 2011, 22(1): 61-68. doi: 10.1007/s00192-010-1240-z
[7]	TOPRAK N, SEN S, VARHAN B. The role of diaphragmatic breathing exercise on urinary incontinence treatment: a pilot study[J]. J Bodyw Mov Ther, 2022, 9: 146-153.
[8]	MOLNÁR T, DOMJÁN A, SZŰCS M, et al. Utilizing synergism between the transverse abdominal and pelvic floor muscles at different postures in nulliparous women: a randomized case-control study[J]. Urol Int, 2022, 106(3): 274-281. doi: 10.1159/000519590
[9]	TAJIRI K, HUO M, MARUYAMA H. Effects of co-contraction of both transverse abdominal muscle and pelvic floor muscle exercises for stress urinary incontinence: a randomized controlled trial[J]. J Phys Ther Sci, 2014, 26(8): 1161-1163. doi: 10.1589/jpts.26.1161 pmid: 25202173
[10]	SIFF L N, HILL A J, WALTERS S J, et al. The effect of commonly performed exercises on the levator hiatus area and the length and strength of pelvic floor muscles in postpartum women[J]. Female Pelvic Med Reconstr Surg, 2020, 26(1): 61-66. doi: 10.1097/SPV.0000000000000590
[11]	郑佳雨, 徐萌艳, 吴映瑛, 等. 产褥期核心肌群稳定性训练对自然分娩初产妇盆底康复的影响研究[J]. 护理与康复, 2022, 21(11): 17-21.
	ZHENG J Y, XU M Y, WU Y Y, et al. Study on effect of core muscle stability exercise during puerperium on pelvic floor rehabilitation of pri-mipara after natural delivery[J]. J Nurs Rehabil, 2022, 21(11): 17-21.
[12]	OJUKWU C P, OJUKWU C S, OKEMUO A J, et al. Comparative effects of selected abdominal and lower limb exercises in the recruitment of the pelvic floor muscles: determining adjuncts to Kegel's exercises[J]. J Bodyw Mov Ther, 2022, 29: 180-186. doi: 10.1016/j.jbmt.2021.09.009 pmid: 35248269
[13]	BØ K, FRAWLEY H, HAYLEN B T, et al. An International Urogynecological Association(IUGA)/International Continence Society(ICS)joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction[J]. Int Urogynecol J, 2017, 28(2): 191-213. doi: 10.1007/s00192-016-3123-4
[14]	HAY-SMITH E J C, STARZEC-PROSERPIO M, MOLLER B, et al. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women[J]. Cochrane Database Syst Rev, 2024, 12(12): CD009508.
[15]	中华医学会妇产科学分会妇科盆底学组. 女性压力性尿失禁诊断和治疗指南(2017)[J]. 中华妇产科杂志, 2017, 52(5): 289-293.
	Urogynocology Subgroup, Chinese Society of Obstetrics and Gynocology, Chinese Medical Association. Update of guideline on the diagnosis and treatment of female stress urinary incontinence(2017)[J]. Chin J Obstet Gynecol, 2017, 52(5): 289-293.
[16]	WANG Y, LIU L, CHEN Q, et al. Modified lumbo-pelvic exercise to alleviate mild stress urinary incontinence in middle-aged females[J]. Sci Rep, 2023, 13(1): 7142-7152. doi: 10.1038/s41598-023-34417-z pmid: 37130891
[17]	YOSHIDA M, MURAYAMA R, HOTTA K, et al. Differences in motor learning of pelvic floor muscle contraction between women with and without stress urinary incontinence: evaluation by transabdominal ultrasonography[J]. Neurourol Urodyn, 2017, 36(1): 98-103. doi: 10.1002/nau.v36.1
[18]	陈娟, 任远, 朱兰. 改良牛津肌力分级和盆底表面肌电评估女性压力性尿失禁患者盆底肌功能的相关性[J]. 中华医学杂志, 2020, 100(37): 2908-2912.
	CHEN J, REN Y, ZHU L. Correlation between modified Oxford grading scale and pelvic floor surface electromyography in assessment of pelvic floor muscle function in female patients with stress urinary incontinence[J]. Natl Med J Chin, 2020, 100(37): 2908-2912.
[19]	OLEKSY Ł, WOJCIECHOWSKA M, MIKA A, et al. Normative values for glazer protocol in the evaluation of pelvic floor muscle bioelectrical activity[J]. Medicine(Baltimore), 2020, 99(5): e19060.
[20]	MEDEIROS ARAUJO C, DE MORAIS N R, SACOMORI C, et al. Pad test for urinary incontinence diagnosis in adults: systematic review of diagnostic test accuracy[J]. Neurourol Urodyn, 2022, 41(3): 696-709. doi: 10.1002/nau.v41.3
[21]	GÜLER SÖNMEZ T, UĞRAŞ E, GÜL ŞAHIN E, et al. The prevalence of incontinence and its impact on quality of life[J]. Medicine(Baltimore), 2024, 103(52): e41108.
[22]	王建宁, 吴丽萍. 盆底功能障碍性疾病患者盆底肌训练依从性评估的研究进展[J]. 护理学杂志, 2023, 38(21): 16-20.
	WANG J N, WU L P. Research progress on assessment of pelvic floor muscle training adherence in patients with pelvic floor dysfunction[J]. J Nurs Sci, 2023, 38(21): 16-20.
[23]	PRUDENCIO C, BARBOSA A, DERÓBIO A L, et al. Comparison of three physiotherapy methods for treatment of stress urinary incontinence: impact in quality of life and muscle function[C]. Rio de Janeiro, Brazil:44th Annual Meeting of the International Continence Society(ICS), 2014: 20-24.
[24]	BØ K. Mechanisms for pelvic floor muscle training: morphological changes and associations between changes in pelvic floor muscle variables and symptoms of female stress urinary incontinence and pelvic organ prolapse: a narrative review[J]. Neurourol Urodyn, 2024, 43(8): 1977-1996. doi: 10.1002/nau.v43.8
[25]	BØ K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work?[J]. Int Urogynecol J, 2004, 15: 76-84. doi: 10.1007/s00192-004-1125-0
[26]	TIM S, MAZUR-BIALY A I. The most common functional disorders and factors affecting female pelvic floor[J]. Life(Basel), 2021, 11(12): 1397-1415.
[27]	LOSAVIO R, CONTEMORI S, BARTOLI S, et al. Electromyographic and stabilometric analysis of the static and dynamic "standing bird dog" exercise[J]. Sports(Basel), 2023, 11(6): 119.
[28]	PARK H, HAN D. The effect of the correlation between the contraction of the pelvic floor muscles and diaphragmatic motion during breathing[J]. J Phys Ther Sci, 2015, 27: 2113-2115. doi: 10.1589/jpts.27.2113 pmid: 26311935
[29]	DIMLI B O, MUTLU E K, ALTAC D S, et al. Comparison of the effects of pelvic floor muscle training and modified pilates exercises in elderly women with stress urinary incontinence: a randomized clinical trial[J]. Eur J Obstet Gynecol Reprod Biol, 2024, 300: 327-336. doi: 10.1016/j.ejogrb.2024.07.033 pmid: 39084033
[30]	王瑞元, 孙彪. 运动生理学[M]. 北京: 人民体育出版社, 2023.
[31]	OLEKSY Ł, MIKA A, SULOWSKA-DASZYK I, et al. The reliability of pelvic floor muscle bioelectrical activity(sEMG)assessment using a multi-activity measurement protocol in young women[J]. Int J Environ Res Public Health, 2021, 18(2): 765-778. doi: 10.3390/ijerph18020765
[32]	HOFF BRÆKKEN I, MAJIDA M, ENGH M E, et al. Morphological changes after pelvic floor muscle training measured by 3-dimensional ultrasonography: a randomized controlled trial[J]. Obstet Gynecol, 2010, 115(2 Pt 1): 317-324. doi: 10.1097/AOG.0b013e3181cbd35f pmid: 20093905
[33]	CACCIARI L P, MORIN M, MAYRAND M H, et al. Pelvic floor morphometrical and functional changes immediately after pelvic floor muscle training and at 1-year follow up, in older incontinent women[J]. Neurourol Urodyn, 2021, 40(1): 245-255. doi: 10.1002/nau.v40.1
[34]	MARQUES S A A, SILVEIRA S R B D, PÁSSARO A C, et al. Effect of pelvic floor and hip muscle strengthening in the treatment of stress urinary incontinence: a randomized clinical trial[J]. J Manipulative Physiol Ther, 2020, 43(3): 247-256. doi: 10.1016/j.jmpt.2019.01.007
[35]	SAPSFORD R R, CLARKE B, HODGES P W. The effect of abdominal and pelvic floor muscle activation patterns on urethral pressure[J]. World J Urol, 2013, 31(3): 639-644. doi: 10.1007/s00345-012-0995-x pmid: 23192396
[36]	SAPSFORD R R, HODGES P W. Contraction of the pelvic floor muscles during abdominal maneuvers[J]. Arch Phys Med Rehabil, 2001, 82(8): 1081-1088. doi: 10.1053/apmr.2001.24297
[37]	FANI M, CHITSAZ N, GOHARPEY S, et al. The effect of trunk-stabilizing muscle training in women with stress urinary incontinence: a randomized controlled trial[J]. PM R, 2024, 16(5): 485-495. doi: 10.1002/pmrj.v16.5
[38]	KONSTANTINIDOU E, SAKALIS V, KALAITZI M, et al. The role of abdominal muscle training in combination with pelvic floor muscle training to treat female urinary incontinence: a pilot 12-week study[J]. Cent Eur J Urol, 2024, 77(2): 218-224.
[39]	CHIEN C H, HUANG X Y, HSU S P, et al. Self-efficacy and positive thinking as predictors of health-related quality of life in women with stress urinary incontinence[J]. BMC Womens Health, 2022, 22(1): 444-453. doi: 10.1186/s12905-022-02025-0 pmid: 36368983
[40]	YAZDANY T, JAKUS-WALDMAN S, JEPPSON P C, et al. American Urogynecologic Society systematic review: the impact of weight loss intervention on lower urinary tract symptoms and urinary incontinence in overweight and obese women[J]. Female Pelvic Med Reconstr Surg, 2020, 26(1):16-29. doi: 10.1097/SPV.0000000000000802

组别	n	年龄/岁	身高/cm	体质量/kg	BMI/(kg·m^-2)	分娩次数/n
对照组	19	41.52±8.49	162.84±3.86	62.89±5.39	24.11±3.08	1.00(1.00,2.00)
试验组	17	40.41±9.09	162.42±6.48	59.04±6.83	22.36±1.91	1.00(1.00,2.00)
t/Z值		0.380	0.245	1.885	2.009	0.112
P值		0.706	0.808	0.068	0.053	0.911

组别	n	测试	M(Q_L, Q_U)	Z值	P值
对照组	19	前测	2.00(2.00, 3.00)	-3.317	0.001
		后测	3.00(3.00, 3.00)
试验组	17	前测	2.00(2.00, 3.00)	-3.666	<0.001
		后测	3.00(3.00, 4.00)
训练前两组比较				-1.076	0.282
训练后两组比较				-2.281	0.023

组别	n	测试	$\stackrel{-}{\mathit{x}}$±s	t值	P值
对照组	19	前测	72.33±6.26	-1.363	0.190
		后测	74.92±11.26
		训练前后差值	-2.59±8.27
试验组	17	前测	66.70±12.68	-1.382	0.186
		后测	68.69±13.55
		训练前后差值	-1.99±5.95
训练前两组均值差			5.64±3.28	1.720	0.095
训练后两组均值差			6.23±4.14	1.506	0.141

肌电指标	组别	n	测试	$\stackrel{-}{\mathit{x}}\pm \mathit{s}$	t值	P值
前静息平均值	对照组	19	前测	4.48±3.27	3.128	0.006
			后测	2.68±2.07
			训练前后差值	1.79±2.50
	试验组	17	前测	4.56±2.92	0.799	0.436
			后测	4.26±3.07
			训练前后差值	0.30±1.57
	训练前两组均值差			-0.08±1.04	-0.080	0.937
	训练后两组均值差			-1.57±0.86	-1.819	0.078
快速收缩最大值	对照组	19	前测	36.75±13.25	-1.299	0.210
			后测	39.95±15.09
			训练前后差值	-3.20±10.73
	试验组	17	前测	32.73±16.20	-0.028	0.978
			后测	32.80±13.29
			训练前后差值	-0.06±9.31
	训练前两组均值差			4.01±4.91	0.817	0.419
	训练后两组均值差			7.15±4.76	1.501	0.143
持续收缩平均值	对照组	19	前测	25.19±8.09	-2.731	0.014
			后测	30.44±12.15
			训练前后差值	-5.25±8.38
	试验组	17	前测	21.33±10.36	-1.443	0.168
			后测	23.36±11.15
			训练前后差值	-2.03±5.79
	训练前两组均值差			3.85±3.08	1.251	0.220
	训练后两组均值差			7.08±3.90	1.814	0.079
耐久收缩平均值	对照组	19	前测	21.19±6.53	-2.954	0.008
			后测	26.99±10.55
			训练前后差值	-5.80±8.56
	试验组	17	前测	18.38±7.84	-1.441	0.169
			后测	23.49±18.87
			训练前后差值	-5.10±14.60
	训练前两组均值差			2.81±2.40	1.171	0.250
	训练后两组均值差			3.50±5.02	0.697	0.491
后静息平均值	对照组	19	前测	4.96±3.83	0.236	0.816
			后测	4.85±2.89
			训练前后差值	0.12±2.13
	试验组	17	前测	5.12±3.20	0.565	0.580
			后测	4.83±3.67
			训练前后差值	0.29±2.09
	训练前两组均值差			-0.16±1.18	-0.132	0.896
	训练后两组均值差			0.01±1.09	0.013	0.990

组别	n	测试	$\stackrel{-}{\mathit{x}}\pm \mathit{s}$	t值	P值
对照组	19	前测	6.49±1.23	12.978	<0.001
		后测	3.99±1.16
		训练前后差值	2.50±0.84
试验组	17	前测	6.44±2.16	9.215	<0.001
		后测	2.50±0.93
		训练前后差值	3.94±1.76
训练前两组均值差			0.05±0.58	0.082	0.935
训练后两组均值差			1.49±0.35	4.215	<0.001

Effect of functional pelvic floor muscle training on stress urinary incontinence in women

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 6

References 40

Related Articles 14

Metrics

Comments

Recommended 0

组别	n	测试	$\stackrel{-}{\mathit{x}}\pm \mathit{s}$	t值	P值
对照组	19	前测	61.47±8.75	-13.229	<0.001
		后测	70.74±10.77
		训练前后差值	-9.26±3.05
试验组	17	前测	66.47±12.33	-21.476	<0.001
		后测	85.76±9.05
		训练前后差值	-19.29±3.70
训练前两组均值差			-5.00±3.53	-1.414	0.167
训练后两组均值差			-15.02±3.34	-4.501	<0.001

[1]	JIANG Ren-jian, LI Hang, ZHOU Jie, WANG Mei-yuan. Effects of Sling Exercise Therapy on Muscle Strength of Pelvic Floor for Patients with Postpartum Stress Urinary Incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(9): 1103-1106.
[2]	ZHAO Xiang-hu, MA Ming, XU Liang, LIN Ping, SUN Wu-dong, ZHANG Rong, LI Ling, LU Jie. Application of Breathing Training in Postpartum Stress Urinary Incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(6): 720-725.
[3]	PI Zhou-kai, ZHANG Pan-de, ZHOU Hui-chang, CHEN Hui-qiong, XU Kun-yu, FENG Shun-yan. Effect of Vaginal Pressure Feedback Combined with Pelvic Floor Muscle Resistant Training on Stress Urinary Incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2016, 22(2): 194-197.
[4]	GAO Li-xia;PENG Jin-liang;LIU Qi.. Effect of Simple Pelvic Floor Vibration Therapy on Stress Urinary Incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2013, 19(2): 177-179.
[5]	LI Xue-feng;YANG Hong-wei. Effect of Intravaginal Electronic Stimulation on Postpartum Stress Urinary Incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2012, 18(7): 676-677.
[6]	HAN Hong;LI Ming.. Effect of Acupuncture on Postpartum Stress Urinary Incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2011, 17(7): 671-672.
[7]	ZHANG Qiong;GUAN Yu-tao;ZHENG Wei;et al.. Effect of Biofeedback Combined with Pelvic Floor Muscle Training on Female Stress Urinary Incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2011, 17(2): 173-175.
[8]	CHEN Tian-xiao;LIU Yuan-biao;YANG Dan-dan;et al.. Effect of Faradization Combined with Pelvic Floor Muscle Exercise on Female Stress Urinary Incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2011, 17(11): 1078-1080.
[9]	WEI Tao.. Rehabilitation of Perimenopausal Women with Stress Urinary Incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2010, 16(6): 584-586.
[10]	WANG Biao;YANG Yong;WU Zhi-jin. Application of Suprapubic Arc Sling for Stress Urinary Incontinence in Female:30 Cases Report [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2008, 14(09): 870-872.
[11]	WANG Biao;YANG Yong;WUZhi-jin. Follow-up of Transobturator Ttension-free Vaginal Tape-obturator Procedure on Stress Urinary Incontinence in Female:Report of 112 Cases [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2008, 14(08): 778-780.
[12]	LUO Guang-cheng;FANG Qiang;LI Long-kun;et al. Urodynamic Characteristics of Stress Urinary Incontinence Occurred in Premenopausal and Postmenopausal Adult Women [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2006, 12(06): 523-524.
[13]	LUO Guang-cheng;FANG Qiang;LI Long-kun;et al. Correlation between urodynamic parameters and vaginal deliveries in women with genuine stress urinary incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2005, 11(11): 894-895.
[14]	ZHAI Jian-jun;ZHANG Yi. Effect of tension-free vaginal tape procedure on stress urinary incontinence [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2004, 10(07): 432-433.