産後の腹圧性尿失禁患者に対する生体力学に基づく体幹筋トレーニングの有効性

Postpartum stress urinary incontinence (SUI) is a frequent pelvic floor disorder caused by pregnancy- and delivery-related neuromuscular injury, leading to urine leakage during exertion. This study evaluated the efficacy and safety of combining biomechanics-based core training with standard PFMT in postpartum women with SUI. This retrospective study included 178 patients with postpartum SUI treated between May 2021 and May 2025. Based on the rehabilitation protocol, patients were divided into a control group receiving conventional PFMT and an observation group receiving additional biomechanics-based core training. Primary outcomes were changes in the 1-hour pad test and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Secondary measures included pelvic floor strength assessed by the modified Oxford scale and safety evaluation. Statistical comparisons were performed using paired and independent-samples t-tests and chi-square tests. Both groups showed significant posttreatment improvement, with greater benefits in the observation group. The 1-hour pad test decreased from 17.9 ± 7.1 g to 8.7 ± 5.9 g versus 18.7 ± 7.5 g to 12.9 ± 6.5 g in controls (P < .001). ICIQ-UI SF scores declined by 6.8 versus 4.1 points (P < .001). The rate of ≥50% urine loss reduction was higher in the observation group (70.0% vs 46.6%; RR = 1.50, 95% CI 1.16-1.95; P = .002). Modified Oxford scale improvement was also greater (+1.60 vs +0.90; P < .001). No serious adverse events occurred. Biomechanics-based core training significantly improved urinary continence, pelvic floor strength, and quality of life without increasing adverse events, suggesting it is a safe and effective adjunct to conventional PFMT for postpartum rehabilitation.