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Stress incontinence and the possibilities of targeted rehabilitation
VYHLÍDALOVÁ, Denisa
The topic of my bachelor thesis is stress incontinence and options of targeted physiotherapy. The first section contains theoretical background concerning mentioned problems. The theoretical section summarizes anatomical and physiological facts about urinary system and pelvic floor, and the theory of incontinence. There are described types of urinary incontinence and their causes. As next, there are mentioned the options of diagnostics and treatment especially of stress incontinence. Incontinence, i.e. involuntary leakage of urine, is one of the most widespread female inconveniences of recent years. It brings many problems, not only physical ones but also mental, and so that it has negative impact on quality of the life. This involuntary leakage of urine is not an illness to all intents and purposes but symptom with various causes. The most common cause are weakened muscles of pelvic floor, which belong to the deep stability system. They significantly support the whole stability system of the trunk. These muscles and fasciae of pelvic floor provide proper stabilization of urinary bladder, urethral closure, and urethra in proper position and by this they assure continence, especially when intra abdominal pressure increases. The muscles of pelvic floor and diaphragm participate together in breathing. The frequency of incidence of urinary incontinence increases depending upon the age. One of the incontinence types is stress incontinence. Urine leakage is always related to physical activity. Urine leakage happens when intra abdominal pressure increases and happens without contraction of detrusor. Unlike against other disorders, it is possible to fight successfully against incontinence not using only drugs and operative surgery. The treatment of incontinence is in recent years relatively successful and with the help of proper and regular exercise it is possible to prevent it. According to some recommendations, when treating stress incontinence, physiotherapy should be chosen as a primary treatment. The goal of physiotherapy is the effort to help patient to be able to activate muscles of pelvic floor in situations when the leakage of urine is expected. There was used the method of qualitative research in practical section of the thesis, using case studies of 2 patients suffering from stress incontinence. The thesis contains entry and final kinesiologic analysis completed with the query CONTILIFE, the plan with adequate exercises and measures, and the final success rate of the treatment. The goal of the thesis was to point out significant role of physiotherapy in the treatment of patient with stress incontinence, then outline the available rehabilitation methods and propose complex of appropriate exercises and measures. There was created a booklet with the list of exercises for each patient. Patients have exercised using these single exercises being previously instructed about them for eight weeks, and they were simultaneously controlled on regular basis. Patients were observed in a complex manner so that the individual therapy was made for each of them according to individual problems, revealed in entry kinesiologic analysis. Final results of this study showed that the chosen therapy was successful and patients mention not only subjective feeling of improvement of their incontinence problems during the day, but also an improvement of their physical condition and relief from the pain of the cervical and lumbar spine due to a complex approach and individual therapy.
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