Ocena skuteczności nowoczesnych urządzeń i metod rehabilitacji w terapii dysfunkcji mięśni dna miednicy
DOI:
https://doi.org/10.15611/nit.2025.41.06Słowa kluczowe:
pelvic floor muscles, dysfunction, rehabilitation, biofeedback, electrical stimulationAbstrakt
Cel: Celem pracy jest ocena skuteczności nowoczesnych urządzeń i metod rehabilitacji stosowanych w terapii dysfunkcji mięśni dna miednicy. Szczególną uwagę poświęcono takim technikom, jak biofeedback, elektrostymulacja oraz inteligentne trenażery wspomagające terapię.
Metodyka: W pracy dokonano przeglądu literatury naukowej dotyczącej mechanizmów zaburzeń dna miednicy, ich diagnostyki oraz możliwości terapeutycznych. Analizie poddano również skuteczność różnych metod rehabilitacyjnych, ze szczególnym uwzględnieniem ich zastosowania w praktyce fizjoterapeutycznej.
Wyniki: Przegląd badań wskazuje, że nowoczesne metody rehabilitacji, w tym biofeedback i elektrostymulacja, są skutecznymi narzędziami w terapii pacjentów z dysfunkcjami mięśni dna miednicy. Poprawiają one siłę mięśniową, kontrolę nad czynnościami fizjologicznymi oraz jakość życia pacjentów. Integracja terapii z technologiami mobilnymi dodatkowo zwiększa efektywność leczenia.
Implikacje i rekomendacje: Nowoczesne metody rehabilitacji powinny być szerzej stosowane w leczeniu dysfunkcji dna miednicy. Kluczowe znaczenie ma indywidualizacja terapii oraz edukacja pacjentów w zakresie profilaktyki i odpowiedniego stosowania technik terapeutycznych. Konieczne są dalsze badania nad optymalizacją protokołów terapeutycznych oraz długoterminowymi efektami leczenia.
Oryginalność/wartość: Praca dostarcza kompleksowego przeglądu aktualnych metod rehabilitacji mięśni dna miednicy, podkreślając ich znaczenie kliniczne i potencjalne kierunki dalszego rozwoju. Stanowi istotne źródło wiedzy dla specjalistów z zakresu wykorzystania możliwości, jakie dają trenażery i urządzenia stosowane w terapii dysfunkcji mięśni dna miednicy.
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Bibliografia
Adamiak-Godlewska, A., & Rechberger, T. (2012). Nowoczesne techniki oceny anatomii i funkcji dna miednicy u kobiet [Evaluation of Pelvic Floor Muscle Anatomy and Function in Women: Modern Techniques]. Przegląd Menopauzalny, 11(4), 259-263.
Arif, T., Ali, S., Bhojwani, K., Sadiq, M., Siddiqui, A., Ur-Rahman, A., Khan, M., Hasan, F., & Shahzil, M. (2025). Global Prevalence and Risk Factors of Irritable Bowel Syndrome from 2006 to 2024 Using the Rome III and IV Criteria: A Meta-Analysis. European Journal of Gastroenterology & Hepatology, 37(12), 1314-1325.
Babazadeh-Zavieh, S. S., Bashardoust Tajali, S., Haeri, S. M. J., & Shamsi, A. (2023). Effects of Transcutaneous Electrical Nerve Stimulation on Chronic Pelvic Pain in Women: A Systematic Review and Meta-Analysis. Complementary Medicine Research, 30(2), 161-173.
Batmani, S., Jalali, R., Mohammadi, M., & Bokaee, S. (2021). Prevalence and Factors Related to Urinary Incontinence in Older Adults Women Worldwide: A Comprehensive Systematic Review and Meta-Analysis of Observational Studies. BMC Geriatrics, 21(1).
Bø, K., Berghmans, B., Mørkved, S., & Van Kampen, M. (Eds.). (2015). Evidence-Based Physical Therapy for the Pelvic Floor: Bridging Science and Clinical Practice. Churchill Livingstone.
Brækken, I., Villumstad, T., & Evensen, N. (2024). Randomised Controlled Pilot Trial to Assess Effect of Electrical Stimulation of Weak Pelvic Floor Muscles. Archives of Gynecology and Obstetrics, 309(6), 2921-2929.
Cavalcante, J., De Souza Ribeiro, V., De Cássia Marqueti, R., Paz, I., Bastos, J., Vaz, M., Babault, N., & Durigan, J. (2024). Effect of Muscle Length on Maximum Evoked Torque, Discomfort, Contraction Fatigue, and Strength Adaptations during Electrical Stimulation in Adult Populations: A Systematic Review. PLOS ONE, 19(6).
Chen, M., Lai, P., & Ding, D. (2023). The Beneficial Effects of Conservative Treatment with Biofeedback and Electrostimulation on Pelvic Floor Disorders. Tzu-Chi Medical Journal, 36(3), 291-297.
Chêne, G., Mansoor, A., Jacquetin, B., Mellier, G., Douvier, S., Sergent, F., Aubard, Y., & Seffert, P. (2013). Female Urinary Incontinence and Intravaginal Electrical Stimulation: An Observational Prospective Study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 170(1), 275-280.
Chiang, C., Jiang, Y., & Kuo, H. (2021). Therapeutic Efficacy of Biofeedback Pelvic Floor Muscle Exercise in Women with Dysfunctional Voiding. Scientific Reports, 11.
Da Silva, J., De Godoi Fernandes, J., Caracciolo, B., Zanello, S., De Oliveira Sato, T., & Driusso, P. (2021). Reliability of the PERFECT Scheme Assessed by Unidigital and Bidigital Vaginal Palpation. International Urogynecology Journal, 32(12), 3199-3207.
De Araújo, C., Brito, L., Marques, A., & Juliato, C. (2024). Use of a Mobile Application for Pelvic Floor Muscle Training in Women with Urinary Incontinence: A Randomized Control Trial. International Urogynecology Journal, 35(3), 589-598.
De Souza Duarte, N., De Azevedo, Y., Furtado, E., De Araújo, L., Bendelack, R., Rodrigues, C., Araújo, N., Neves, P., Soares, A., Barros, R., Santos, T., Nunes, É., Ferreira, E., Callegari, B., & De Melo-Neto, J. (2024). Electromyographic Activity of Pelvic Floor Muscles in Different Positions during the Use of an Innovative Vaginal Educator: Cross-Sectional Study. PLOS ONE, 19(3).
Díaz-Mohedo, E., Odriozola Aguirre, I., Molina García, E., Infantes-Rosales, M. A., & Hita-Contreras, F. (2023). Functional Exercise Versus Specific Pelvic Floor Exercise: Observational Pilot Study in Female University Students. Healthcare, 11(4), 561.
Duelund-Jakobsen, J., Buntzen, S., Lundby, L., Laurberg, S., Sørensen, M., & Rydningen, M. (2024). One‐Stage Implant in Sacral Neuromodulation for Faecal Incontinence – Short‐Term Outcome from a Prospective Study. Colorectal Disease, 26(5), 968-973.
Dufour, S., Fedorkow, D., Kun, J., Deng, S., & Fang, Q. (2019). Exploring the Impact of a Mobile Health Solution for Postpartum Pelvic Floor Muscle Training: Pilot Randomized Controlled Feasibility Study. JMIR mHealth and uHealth, 7(7).
Fernandes, A., Jorge, C., Weatherall, M., Ribeiro, I., Wallace, S., & Hay-Smith, E. (2025). Pelvic Floor Muscle Training with Feedback or Biofeedback for Urinary Incontinence in Women. The Cochrane Database of Systematic Reviews, 3(3).
Good, M. M., & Solomon, E. R. (2019). Pelvic Floor Disorders. Obstetrics and Gynecology Clinics of North America, 46(3), 527-540.
Hallier, B. (2023). Efficacy of Pelvic Floor Muscle Training, Biofeedback and Electrical Stimulation as Physiotherapy Treatment Modalities for Women with Postpartum Anal Incontinence. Journal of Pelvic, Obstetric and Gynaecological Physiotherapy, (133), 9-18.
Halski, T., Słupska, L., & Kasper, M. (2021). Leczenie zachowawcze dysfunkcji dna miednicy: podręcznik dla studentów i praktyków. Studio Impreso, Przemysław Biliczak Wydawca.
Hamedfar, M., Ghaderi, F., Pourmehr, H., Soltani, A., Ghojazadeh, M., & Vahed, N. (2024). Posterior Tibial Nerve Electrical Stimulation in Chronic Constipation: A Systematic Review and Meta-Analysis. Gastroenterology and Hepatology from Bed to Bench, 17(1), 6-16.
Herderschee, R., Hay-Smith, E., Herbison, G., Roovers, J., & Heineman, M. (2011). Feedback or Biofeedback to Augment Pelvic Floor Muscle Training for Urinary Incontinence in Women. Cochrane Database Systematic Reviews, 6(7).
Hite, M., & Curran, T. (2021). Biofeedback for Pelvic Floor Disorders. Clinics in Colon and Rectal Surgery, 34(1), 56-61.
Hua, J., Li, T., Liu, S., Zhang, D., Chen, X., Cai, W., & Chen, L. (2024). Self-Efficacy with Pelvic Floor Muscle Training Mediates the Effect of an App-Based Intervention on Improving Postpartum Urinary Incontinence Severity Among Pregnant Women: A Causal Mediation Analysis from a Randomised Controlled Trial. Midwifery, 135.
Huang, S., Tian, W., & Zheng, D. (2024). Clinical Study on Low-Frequency Electrical Pulse Acupoint Stimulation Combined with Pelvic Floor Muscle Exercise in the Treatment of Urinary Incontinence after Radical Prostatectomy. Archivos Espanoles de Urologia, 77(5), 591-597.
Huang, Y., Huang, Z., Ou, Y., Yin, L., Sun, Y., & Zong, H. (2024). Meta-Analysis of the Therapeutic Effect of Electrical Stimulation Combined with Pelvic Floor Muscle Exercise on Female Pelvic Floor Dysfunction. European Journal of Medical Research, 29(1), 380.
Hutchison, D., Ali, M., Zillioux, J., Ortiz, N., Smith, R., & Rapp, D. (2022). Pelvic Floor Muscle Training in the Management of Female Pelvic Floor Disorders. Current Bladder Dysfunction Reports, 17(11), 115-124.
Jochum, F., Garbin, O., Godet, J., Ragueneau, M., Meyer, C., Billecocq, S., Lecointre, L., Akladios, C., & Host, A. (2022). Prospective Evaluation of the Connected Biofeedback EMY Kegel Trainer in the Management of Stress Urinary Incontinence. Journal of Gynecology Obstetrics and Human Reproduction, 51(2).
Jokar, F., Fani, M., Isfahani, N., & Sabahi, R. (2025). Effectiveness of Biofeedback with Dilator Therapy for Sexual Function in Women with Primary Vaginismus: Randomized Controlled Trial Study. International Urogynecology Journal, 36(3), 557-565.
Kılıç, M. (2016). Incidence and Risk Factors of Urinary Incontinence in Women Visiting Family Health Centers. Springerplus, 5(1).
Laycock, J., & Jerwood, D. (2001) Pelvic Floor Muscle Assessment: The PERFECT Scheme. Physiotherapy, 87(12), 631-642.
Lew-Starowicz, Z., Lew-Starowicz, M., & Skrzypulec-Plinta, V. (2017). Zaburzenia seksualne związane z bólem. In Z. Lew-Starowicz, M. Lew-Starowicz, & V. Skrzypulec-Plinta (Eds.), Seksuologia (pp. 310-323). PZWL.
Li, S., Zhang, S., Zhao, L., & Xiong, X. (2025). Effect of Pelvic Floor Muscle Training Combined with Electrical Stimulation Therapy on Stress Urinary Incontinence: A Meta-Analysis. Urologia Internationalis, 109(4), 425-435.
Lunardi, A., Foltran, G., Carro, D., Silveira, L., Haddad, J., & Ferreira, E. (2025). Efficacy of Electrical Stimulation in Comparison to Active Training of Pelvic Floor Muscles on Stress Urinary Incontinence Symptoms in Women: A Systematic Review with Meta-Analysis. Disability and Rehabilitation, 47(13), 3256-3267.
Mack, I., Hahn, H., Gödel, C., Enck, P., & Bharucha, A. (2024). Global Prevalence of Fecal Incontinence in Community-Dwelling Adults: A Systematic Review and Meta-Analysis. Clinical Gastroenterology and Hepatology, 22(4), 712-731.
Majkusiak, W., & Barcz, E. (2017). Schorzenia dna miednicy. Uzasadnienie dla opracowania rekomendacji klinicznych. Ginekologia i Perinatologia Praktyczna, 2(4), 155-161.
Mao, W., Jiang, M., Chen, W., Du, J., & Xiao, Q. (2024). The Effect of Using Mobile Phone Applications for Intelligent Pelvic Floor Rehabilitation on Elderly Female Patients with Stress Urinary Incontinence. Technology and Health Care, 32(1), 229-241.
Mateus-Vasconcelos, E., Ribeiro, A., Antônio, F., Brito, L., & Ferreira, C. (2018). Physiotherapy Methods to Facilitate Pelvic Floor Muscle Contraction: A Systematic Review. Physiotherapy Theory and Practice, 34(6), 420-432.
Mencel, J. (2024). Biofeedback. Skrypt dla studentów fizjoterapii. Wydawnictwo Akademii Wychowania Fizycznego im. Polskich Olimpijczyków we Wrocławiu.
Min, L., Chunxue, Y., Qiubo, L., Xudong, D., Yan, Z., Guifang, Z., Kejia, H., Tianzi, G., & Qing, F. (2022). Effectiveness of Intravaginal Electrical Stimulation Combined with Electromyography Biofeedback-Mediated Pelvic Floor Muscle Training for Postpartum Symptomatic Pelvic Organ Prolapse: Protocol for the PROSPECT Randomized Trial. Trials, 23, 131.
Mira, T., Yela, D., Podgaec, S., Baracat, E., & Benetti-Pinto, C. (2020). Hormonal Treatment Isolated Versus Hormonal Treatment Associated with Electrotherapy for Pelvic Pain Control in Deep Endometriosis: Randomized Clinical Trial. European Journal of Obstetrics & Gynecology and Reproductive Biology, 134-141.
Muszyńska, J., Lewicka, M., & Sulima, M. (2022). Women’s Problems Associated with Pelvic Floor Muscle Dysfunction. Pielęgniarstwo XXI wieku / Nursing in the 21st Century, 21(3), 181-190.
Newman, D. (2014). Pelvic Floor Muscle Rehabilitation Using Biofeedback. Urologic Nursing, 34(4), 193-202.
Nunes, E., Sampaio, L., Biasotto-Gonzalez, D., Nagano, R., Lucareli, P., & Politti, F. (2019). Biofeedback for Pelvic Floor Muscle Training in Women with Stress Urinary Incontinence: A Systematic Review with Meta-Analysis. Physiotherapy, 105(1), 10-23.
Park, C., Wang, L., Koppen, I., Alpert, S., Diefenbach, K., Wood, R., Bali, N., Vaz, K., Yacob, D., Di Lorenzo, C., & Lu, P. (2024). Sacral Nerve Stimulation Leads to Long-Term Improvement in Fecal Incontinence and Quality of Life for Children with Functional and Organic Defecation Disorders. Neurogastroenterology and Motility, 36(9).
Patel, P., Green, M., Tram, J., Wang, E., Murphy, M., Abd-Elsayed, A., & Chakravarthy, K. (2025). Latest Advancements in Transcutaneous Electrical Nerve Stimulation (TENS) and Electronic Muscle Stimulation (EMS): Revisiting an Established Therapy with New Possibilities. Journal of Pain Research, 18, 137-153.
Peinado-Molina, R., Hernández-Martínez, A., Martínez-Vázquez, S., Rodríguez-Almagro, J., & Martínez-Galiano, J. (2023). Pelvic Floor Dysfunction: Prevalence and Associated Factors. BMC Public Health, 23(1).
Przydacz, M., Chlosta, M., & Chlosta, P. (2021). Population-Level Prevalence, Bother, and Treatment Behavior for Urinary Incontinence in an Eastern European Country: Findings from the LUTS POLAND Study. Journal of Clinical Medicine, 10(11), 2314.
Remneva, O., Ivanyuk, I., & Gal'chenko, A. (2022). Pelvic Floor Dysfunction in Women: Current Understanding of the Problem. Fundamental and Clinical Medicine, 7(1), 92-101.
Romanova, N. (2025). Electromyographic Signal as Feedback for Pelvic Floor Muscle Rehabilitation and Training. European Institute for Innovation Development International Conference “Actual Issues of Modern Science”, 215-221.
Sahin, N., Yesil, H., & Gorcan, B. (2022). The Effect of Pelvic Floor Exercises Performed with EMG Biofeedback or a Vaginal Cone on Incontinence Severity, Pelvic Floor Muscle Strength, and Quality of Life in Women with Stress Urinary Incontinence: A Randomized, 6-Month Follow-Up Study. International Urogynecology Journal, 33(10), 2773-2779.
Sarmento, A., Sá, B., Vasconcelos, A., Arcanjo, D., Durazzo, A., Lucarini, M., Leite, J., Sousa, H., & Kückelhaus, S. (2022). Perspectives on the Therapeutic Effects of Pelvic Floor Electrical Stimulation: A Systematic Review. International Journal of Environmental Research and Public Health, 19(21).
Shelly, B. (2016). Pelvic Muscle Exercises Using a Home Trainer for Pelvic Muscle Dysfunction: A Case Report. Urologic Nursing, 36(2), 82-87.
Szymanowski, P., Wójcik, A., Szepieniec, W., & Jóźwik, M. (2014). Kompleksowe leczenie schorzeń uroginekologicznych. Znaczenie fizjoterapii. Rehabilitacja w Praktyce, (3), 15-18.
Tian, N., Bai, J., Li, J. & Ji, C. (2024). Clinical Observation of Acupuncture Combined with Biofeedback Electrical Stimulation in the Treatment of Female Stress Urinary Incontinence. Applied Psychophysiology and Biofeedback, 49(4), 569-576.
Trinh, V., Huu, T., Sah, D., Choi, J., Yoon, H., Park, S., Jung, Y., & Lee, S. (2024). Redox Regulation of PTEN by Reactive Oxygen Species: Its Role in Physiological Processes. Antioxidants, 13(2), 199.
Voorham, J. C., De Wachter, S., Van den Bos, T. W. L., Putter, H., Lycklama À Nijeholt, G. A., & Voorham-van der Zalm, P. J. (2017). The Effect of EMG Biofeedback Assisted Pelvic Floor Muscle Therapy on Symptoms of the Overactive Bladder Syndrome in Women: A Randomized Controlled Trial. Neurourology and Urodynamics, 36(7), 1796-1803.
Voorham, J., Vaganée, D., Zalm, P., Nijeholt, G., Putter, H., & De Wachter, S. (2022). Sacral Neuromodulation Changes Pelvic Floor Activity in Overactive Bladder Patients-Possible New Insights in Mechanism of Action: A Pilot Study. Neuromodulation, 25(8), 1180-1186.
Wagner, B., Steiner, M., Huber, D., & Crevenna, R. (2022). The Effect of Biofeedback Interventions on Pain, Overall Symptoms, Quality of Life and Physiological Parameters in Patients with Pelvic Pain: A Systematic Review. Wiener klinische Wochenschrift, 134, 11-48.
Wang, X., Qiu, J., Li, D., Wang, Z., Yang, Y., Fan, G., Mao, X., Wang, J., Gao, S., Zhu, X., Xu, T., & Sun, Z. (2024). Pressure-Mediated Biofeedback with Pelvic Floor Muscle Training for Urinary Incontinence: A Randomized Clinical Trial. JAMA Network Open, 7(11).
Wang, X., Xu, X., Luo, J., Chen, Z., & Feng, S. (2020). Effect of App-Based Audio Guidance Pelvic Floor Muscle Training on Treatment of Stress Urinary Incontinence in Primiparas: A Randomized Controlled Trial. International Journal of Nursing Studies, 104.
Watson, T. (Ed.). (2008). Electrotherapy: Evidence-Based Practice (12th ed.). Churchill Livingstone.
Webb, J. C. (1910). Points for the Use of, and Indications for, Electrotherapy in Some Gynæcological Affections. Proceedings of the Royal Society of Medicine, 16-28.
Wolfe, D., Rosenstein, B., & Fortin, M. (2024). The Effect of EMS, IFC, and TENS on Patient-Reported Outcome Measures for Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Frontiers in Pain Research, 5.
World Health Organization. (2009). International Statistical Classification of Diseases and Related Health Problems. ICD-10. Volume I.
Wu, X., Zheng, X., Yi, X., Lai, P., & Lan, Y. (2021). Electromyographic Biofeedback for Stress Urinary Incontinence or Pelvic Floor Dysfunction in Women: A Systematic Review and Meta-Analysis. Advances in Therapy, 38(8), 4163-4177.
Zumrutbas, A. (2025). Understanding Pelvic Organ Prolapse: A Comprehensive Review of Etiology, Epidemiology, Comorbidities, and Evaluation. Société Internationale d’Urologie Journal, 6(1), 6.
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Prawa autorskie (c) 2025 Valentyna Tiupova
Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Na tych samych warunkach 4.0 Miedzynarodowe.
