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Osteopathic treatment of women suffering from urinary incontinence following an injury to the perineum during delivery: A randomized controlled trial

Journal: International Journal of Osteopathic Medicine Date: 2008/12, 11(4):Pages: 158. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.sciencedirect.com/science/article/pii/S1746068908001053)

Keywords:

[7550]

Abstract:

Objective: The main objective of this study is to evaluate whether an osteopathic treatment in addition to the current standard therapy (“pelvic floor muscle training”) can improve the overall quality of life of women suffering from urinary incontinence following an injury to the perineum during delivery. Design: Evaluator-blind randomized controlled trial.
Materials and methods: Sixty women (average age 37.5 years) diagnosed by their gynecologists as suffering from urinary incontinence took part in the study. By means of external randomisation 30 women were assigned to the intervention group, 30 women to the control group. The intervention group received four osteopathic treatments in intervals of three weeks. Both groups received usual instructions on how to do pelvic floor muscle training at home, and were advised to perform those exercises on a regular basis for the entire time of participation in the trial (12 weeks). Osteopathic dysfunctions in the visceral, parietal and cranio-sacral systems were recorded on the day of treatment in accordance with the individual diagnoses of the patients and were treated based on osteopathic principles. Primary outcome parameter was a condition-specific outcome instrument, the King's Health Questionnaire (KHQ). Results: The total score of the KHQ could only be measured for about 40 patients because of some missing values of the other 20 patients. In the intervention group the symptom-specific quality of life had significantly improved by the end of treatment from 34 to 19 points on the KHQ (95% CI=8.6 to 21.4, p< 0.0005). The improvement in the control group was less pronounced (31 to 22 points, 95% CI=2.6% to 16.6%, p=0.011). The direct comparison of both groups, however did not reveal a statistically significant superiority of the additional intervention (Inter-group difference of longitudinal changes 5.5 points, 95%CI=-3.7% to 14.6%, p=0.24). To allow evaluation of the total number of 60 patients two secondary analyses were carried out, with missing values replaced either by the average value or the worst value of the group. In both of these exploratory analyses the total score of the KHQ revealed statistically significant superiority of the addition of an osteopathic treatment. Conclusion: Four osteopathic treatments in intervals of three weeks in addition to pelvic floor muscle training had a statistically significant influence on the symptom-specific quality of life of women with urinary incontinence following an injury of the perineum, suggesting superiority of an additional osteopathic therapy as opposed to the standard therapy of “pelvic floor muscle training” alone. An osteopathic treatment series seems to be a suitable therapeutic method in the treatment of women with urinary incontinence following perineal injury.


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