농촌지역 요실금 여성의 골반저 근육강화 방법에

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Comparison of the Effects of Pelvic Floor Muscle Strengthening Therapies for Urinary Incontinence among Women
in a Rural Community

Park, Kwang-he
Advisor Kang, Myung-geun, MD, PhD
Department of Public Health,
Graduate School of Chosun University

The purpose of this study was to compare the effects of 3 pelvic floor muscles strengthening therapies for women with urinary incontinence(UI) in a rural community setting of Gwangju city, Korea by quasi-experimental study design.
The study subjects were 61 women consisted of 3 experimental groups applied combined therapy of biofeedback and extracorporeal magnetic innervation(group A, 20 subjects), therapy of extracorporeal magnetic innervation alone(group B, 25subjects) and therapy of collective behavioral training alone(group C, 16 subjects) over 6 weeks, from whom have received the documented informed consents. The outcome measures to compare the effects of 3 groups of therapies were the subjective indices such as UI situation score(USS), self-efficacy towards UI self-control(SEUI), UI-related quality of life(QoLUI), degree of improvement in symptoms, maintenance of strengthening exercise trained at 3 months after completion and the objective indices such as maximum and mean pressure on vaginal contraction(cmH2O; VPmax, VPmean), maintaining time of vaginal contraction(sec.; VCT). As the methods of statistical analyses, paired t-test for the change from pre- to post-experimental values of 3 groups respectively, ANCOVA for comparing mean differences between pre- and post-experimental outcome values among 3 groups after adjusting the covariates with non-equivalent baseline values, repeated measure ANOVA for analysing individual changes of USS were used.
The major findings of this study were as follows;
1) USS decreased significantly after interventions in all 3 groups(p<0.001, respectively). But regarding the mean difference in USS, there was no significant difference among 3 groups(p=0.681).
2) VPmax increased in all 3 groups(p<0.001, respectively). VPmean increased in both group A and B(p<0.001), but in the case of group C, increased partially(p=0.081). VCT increased in group A, B(p<0.001), and group C(p=0.004). Regarding the mean difference in VPmax(p=0.169), VPmean(p=0.133), and VCT(p=0.833), there were no significant difference among 3 groups.
3) SEUI increased significantly after interventions in all 3 groups (p<0.001, respectively). But regarding the mean difference in SEUI, there was no significant difference among 3 groups(p=0.150). As a result of post hoc test(LSD), group B showed somewhat more increase than group C.
4) QoLUI increased in group A, B(p<0.001, respectively), and group C(p=0.003). Regarding the mean difference in QoLUI , there was a partial difference among 3 groups(p=0.059). As a result of post hoc test(LSD), group A showed more increase than group B and group C.
5) The symptoms of UI improved in all 3 groups(proportion of subjects with feeling of improvement=86.9%).
6) There was signigicant difference in degree of improvement in symptoms among 3 groups(p=0.001). Especially, in the case of group B, 68.0% of subjects said that they might be cured 'completely'. As a result of follow-up telephone survey at the time of 3 months after completion of each programs, 3 groups showed no significant difference in the maintenance of strengthening exercise trained(p=0.925). USS at 3 months after completion was not different from that at immediately after completion in all 3 groups.
In conclusion, as the results of assessment of the effectiveness through both subjective and objective outcome measures, the 3 pelvic floor muscle strengthening therapies had similar effectiveness to strengthen pelvic floor muscles. Therefore, we suggested that behavioral training therapy be requested to women with UI in rural community-setting, in that this therapeutic modality was less invasive and more expensive than other 2 modalities and was similar to them in effectiveness.
Key words : urinary incontinence, behavioral training, extracorporeal magnetic innervation, strengthening pelvic floor muscles, rural women
Alternative Author(s)
Park Kwang-he
조선대학교 대학원 보건학과
보건대학원 보건학과
Awarded Date
Table Of Contents
표 목 차 ii
그림목차 iii
영문초록 iv

I. 서론 1
A. 연구의 필요성 1
B. 연구목적 4
C. 연구가설 5

II. 이론적 배경 6
A. 여성의 요실금 6
B. 골반저근육강화방법 10

III. 연구방법 24
A. 연구설계 24
B. 연구대상 24
C. 실험방법 26
D. 자료수집방법 및 측정도구 33
E. 자료분석방법 38

IV. 연구결과 39
A. 연구대상자의 특성분포 및 동질성 검정 39
B. 가설검정결과 48

V. 고찰 57

VI. 요약 및 결론 61

참고문헌 63
부록 77
조선대학교 대학원
박광희. (2007). 농촌지역 요실금 여성의 골반저 근육강화 방법에.
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