Effects of special pelvic floor muscle training on the quality of life in women with urinary incontinence, a clinical trial
Background: Stress urinary incontinence (SUI) is the involuntary loss of urine which occurs with physical exertion and an increase in intra-abdominal pressure. Pelvic floor muscle training (PFMT) is generally recommended to reduce SUI. This study aimed to compare the effects of three different exercises in women with urinary incontinence by abdominal and pelvic floor muscle retraining.
Methods: A total of 81 patients with urinary incontinence (UI) were randomly allocated to the pelvic muscle training by biofeedback (BF), pelvic muscle training by biofeedback plus abdominal exercise (BF+AbdExs), and only abdominal exercise (AbdExs). All participants received 12 weeks of treatment. The outcome measure was maximal vaginal squeeze pressure and Quality of life (QOL) Questionnaire. Data analysis was performed using ANOVA and Kruskal-Wallis tests.
Results: The mean age of patients was 49.4 ± 8.4 years. The scores of QOL, pelvic floor muscle strength, and endurance increased in all groups after the treatment. The mean score of QOL in group BF+Abd.Exs ranged from 65.2 to 93.6, while in groups BF and AbdExs, it ranged from 61.8 to 85.6 and 63.6 to 79.1 respectively. More aspects of QOL improved significantly in the BF+ AbdExs group than in other group. However, the difference in pelvic floor muscle strength and endurance was not statistically significant among the three groups (p>0.05)Conclusion: An increase in pelvic floor muscle strength was associated with AbdExs, which improved QOL. Thus, the AbdExs seems to induce co-contraction in pelvic floor exercise. However, AbdExs alone is not adequate for improving incontinence.
Abrams P AKBLeal. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 2010; 29:213-305.
Wallner LP, Porten S, Meenan RT, Rosetti MC, Calhoun EA, Sarma AV, et al. Prevalence and severity of undiagnosed urinary incontinence in women. Am J Med 2009; 122(11):1037-42.
Yarnell JW VGRCeal. The prevalence and severity of urinary incontinence in women. J Epidemiol Community Health 1981; 35:71-4.
Halen BT, de Ridder D, Freeman RM, Swift S, Berghmans B, Lee J. An International Urogynecology Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 2010; 29(1):4.
Coyne KS, Kaplan SA, Chapple CR, Sexton CC, Kopp ZS, Bush EN, et al. Risk factors and comorbid conditions associated with lower urinary tract symptoms: EpiLUTS. BJU international 2009; 103(s3):24-32.
Biswas B, Bhattacharyya A, Dasgupta A, Karmakar A, Mallick N, Sembiah S. Urinary incontinence, its risk factors, and quality of life: A study among women aged 50 years and above in a rural health facility of West Bengal. Journal of mid-life health 2017; 8(3):130.
Abrams P, Smith AP, Cotterill N. The impact of urinary incontinence on health- related quality of life (HRQoL) in a real-world population of women aged 45- 60 years: results from a survey in France, Germany, the UK and the USA. BJU int 2015; 115(1):143-52.
Magon N, Kalra B, Malik S, Chauhan M. Stress urinary incontinence: What, when, why, and then what? Journal of mid-life health 2011; 2(2):57.
Sapsford R. Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Manual Therapy 2004; 9(1):3-12.
Sriboonreung T., Wongtra-ngan S., Eungpinichpong W., Laopaiboon M. Effectiveness of Pelvic Floor Muscle Training in Incontinent Women at Maharaj Nakorn Chiang Mai Hospital: A Randomized Controlled Trial. J Med Assoc Thai 2011; 94(1):1-7.
Hay-Smith J, M-rkved S, Fairbrother KA, Herbison GP. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2008; 4:CD.
Hay Smith J, Dean S, Burgio K, McClurg D, Frawley H, Dumoulin C. Pelvic floor muscle training adherence “modifiers": a review of primary qualitative studies- 2011 ICS State- of- the Science Seminar research paper III of IV. Neurourol Urodyn 2015; 34(7):622-31.
McClurg D, Frawley H, Hay Smith J, Dean S, Chen SY, Chiarelli P, et al. Scoping review of adherence promotion theories in pelvic floor muscle training ô2011 ics state of the science seminar research paper i of iv. Neurourol Urodyn 2015; 34(7):606-14.
Junginger B, Baessler K, Sapsford R, Hodges PW. Effect of abdominal and pelvic floor tasks on muscle activity, abdominal pressure and bladder neck. Int Urogynecol J 2010; 21(1):69.
Dumoulin C., Lemieux., Bourbonnais D., Gravel D., Bravo G.., Morin M. Physiotherapy for Persistent Postnatal Stress Urinary Incontinence: A Randomized Controlled Trial. The American College of Obstetricians and Gynecologists 2004; 104 (3).504-10
Hung HC. Hsiao SM., Chih SY. Lin H.H, Tsauo JY. An alternative intervention for urinary incontinence: Retraining diaphragmatic, deep abdominal and pelvic floor muscle coordinated function. Manual Therapy 2010; 15:273-9.
Sapsford RR, Hodges PW. The effect of abdominal and pelvic floor muscle activation on urine flow in women. Int Urogynecol J 2012; 23(9):1225-30.
Sapsford R.R., Hodges P.W., Richardson C.A., Cooper D.H., Markwell S.J., Jull G.A. Co-activation of the Abdominal and Pelvic Floor Muscles during Voluntary Exercises. Neurourol Urodyn 2001; 20:31-42.
- Huebner M., Riegel K., Hinninghofen H., Wallwiener D., Tunn R. & Reisenauer C, Pelvic Floor Muscle Training for Stress Urinary Incontinence: A Randomized, Controlled Trial Comparing Different Conservative Therapies Physiother. Res. Int. 2011; 133–140
Kamel DM, Thabet AA, Tantawy SA, Radwan MM. Effect of abdominal versus pelvic floor muscle exercises in obese Egyptian women with mild stress urinary incontinence: A randomised controlled trial. HKPJ 2013; 31(1):12-8.
Nojomi M., Baharvand P., Moradi lakeh M., Patric D.L. incontinence quality of life questionnaire (I-QOL): translation and validation study of the Iranian version. Int Urogynecol J 2009; 20:575-9.
Palmezoni VP, Santos MD, Pereira JM, Bernardes BT, Pereira-Baldon VS, Resende AP. Pelvic floor muscle strength in primigravidae and non-pregnant nulliparous women: a comparative study. Int Urogynecol J 2017; 28(1):131-7.
Laycock J WMDC. Patient assessment. In: Haslam J LJ, editor. Therapeutic management of incontinence and pelvic pain. 2nd ed ed. London: springer; 2008. . 56-66.
-Khoo CCK, Kujawa M, Reid S, Sahai A. Mixed urinary incontinence-what should we treat first? Journal of Clinical Urology 2017; 10(5):492-9.
Lucas MG, Bosch RJ, Burkhard FC, Cruz F, Madden TB, Nambiar AK, et al. EAU guidelines on assessment and nonsurgical management of urinary incontinence. European urology 2012; 62(6):1130-42.
- Rivalta M, Sighinolfi MC, Micali S, De Stefani S, Bianchi G. Sexual function and quality of life in women with urinary incontinence treated by a complete pelvic floor rehabilitation program (biofeedback, functional electrical stimulation, pelvic floor muscles exercises, and vaginal cones). J Sex Med 2010; 7(3):1200-8.
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 3.0 License.
pISSN: 2345-6167 eISSN: 2345-6159