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骨盤床の機能障害と神経疾患におけるリハビリテーション:病理生理学と学際的なアプローチの橋渡し - 焦点を当てたミニレビュー
Tugba Birben Kurt1, Derya Caglar2
1Department of Women's Health Physiotherapy, Guneysu Vocational School of Physical Therapy and Rehabilitation, Recep Tayyip Erdoğan University, Rize, Turkey.
Neurorehabilitation and neural repair
|February 12, 2026
まとめ
MSやパーキンソン病などの神経疾患における骨盤底機能障害 (PFD) は一般的です. 機能と生活の質を改善するために,骨盤床筋トレーニング (PFMT) を含む多学科リハビリテーションを支持する証拠があります.
科学分野:
- 神経学 神経学とは
- リハビリテーション医学 リハビリテーション医学
- 泌尿器科 泌尿器科とは
背景:
- 骨盤底機能不全 (PFD) は,多発性硬化症 (MS),パーキンソン病 (PD),脳卒中を含む神経疾患の一般的な合併症です.
- PFDは膀,腸,性機能に重大な影響を及ぼし,生活の質の低下と心理的社会的苦痛につながります.
- 神経性PFDの病理生理学は複雑で,複雑な神経メカニズムが含まれています.
研究 の 目的:
- 主要神経疾患における神経原性PFDの病理生理学,臨床表現,およびリハビリテーション戦略に関する現在の証拠をレビューする.
- 神経学的集団におけるPFDに関する臨床的および実験的研究から得られた発見を統合する.
- 神経性PFDの管理におけるリハビリテーション介入の役割を強調する.
主な方法:
- PubMed,Scopus,Web of Scienceのデータベースを介して,包括的な文献検索が行われました.
- 1990年から2025年の間に出版された神経疾患における尿路およびPFDに焦点を当てた研究が含まれました.
- 骨盤床筋トレーニング (PFMT),バイオフィードバック,神経筋肉電気刺激 (NMES),および皮膚経由の神経刺激などのリハビリテーションの介入は特に検討されました.
主要な成果:
- 神経性PFDは,多発性硬化症患者の90%まで,PD患者の60%まで,そして尿路症状のある脳卒中生存者のほぼ半数が罹患しています.
- 保守的なリハビリテーション,特にバイオフィードバックとNMESと組み合わせたPFMTは,筋肉機能を改善し,失禁を軽減し,生活の質を向上させる効果を示しています.
- 特定された重要な課題は,標準化されたリハビリテーションプロトコルの欠如と,患者の遵守に対する障壁です.
結論:
- ニューロゲン性PFDの管理には,PFMTと補助的な手法を統合した多学科的アプローチが推奨されます.
- 標準化され,証拠に基づいた臨床ガイドラインを開発するために,さらなる大規模なランダム化比較試験が必要である.
- リハビリテーション戦略の最適化は,神経原性PFDの患者のアウトカムを改善するために不可欠です.
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