A comparison between stabilization exercises and pelvic floor muscle training in women with pelvic organ prolapse.

Bülent Duran,Necmiye Ün Yıldırım,Nuriye Özengin

doi:10.4274/tjod.74317

Abstract

Objective:This study aimed to compare the effectiveness of stabilization exercises and pelvic floor muscle training in women with stage 1 and 2 pelvic organ prolapse.Materials and Methods:In a total 38 women with pelvic organ prolapse whose average age was 45.60 years, pelvic floor muscles were evaluated with electromyography, and prolapse with pelvic organ prolapse quantification system, and the quality of life with prolapse quality of life questionnaire. Afterwards, the subjects were divided into two groups; stabilization exercise group (n=19) and pelvic floor muscle training group (n=19). Stabilization exercise group were given training for 8 weeks, 3 times a week. Pelvic floor muscle training group were given eight-week home exercises. Each group was assessed before training and after eight weeks.Results:An increase was found in the pelvic muscle activation response in the 2 groups (p≤0.05). There was no difference in EMG activity values between the groups (p>0.05). A difference was found in the values Aa, Ba and C in subjects of each group (p≤0.05), and the TVL, Ap, Bp and D values of subjects in pelvic floor muscle training group (p≤0.05) in the before and after pelvic organ prolapse quantification system assessment, however, no difference was found between the groups (p≤0.05). A positive difference was found in the effect of prolapse sub parameter in each of the two groups, and in general health perception sub parameter in subjects of stabilization exercise group (p<0.05) in the prolapse quality of life questionnaire.Conclusions:It was concluded that both training programs increased the pelvic floor muscle strength, provided a decline in prolapse stages. Stabilization exercise has increased general health perception unlike home training, thus, these exercises can be added to the treatment of women with prolapse.

Highlights

The American College of Obstetricians and Gynecologists has defined pelvic organ prolapse (POP) as the prolapses of organs in pelvis into the vaginal canal and downwards outside the canal[1]
The patients were at stage 1 and 2 prolapse according to the POP Quantification System (POP-Q) and they have given birth at least one year ago
When we compared the POP-Q measurement values of the pelvic floor muscular training group and the stabilization exercise group, a statistically significant difference was not detected between the groups (p>0.05) (Figure 3)

Summary

Introduction

The American College of Obstetricians and Gynecologists has defined pelvic organ prolapse (POP) as the prolapses of organs in pelvis into the vaginal canal and downwards outside the canal[1]. Mechanical support and suggestions on life style, physiotherapy and rehabilitation program[5] are the methods used in the treatment of prolapse. The aims of application of physiotherapy and rehabilitation methods are increasing the strength, endurance and support of the pelvic floor muscles, preventing the deterioration of prolapse, helping to decrease the severity and frequency of symptoms caused by prolapse and preventing or delaying the surgery[2]. As far as we know, there is no study on the effects of stabilization exercises performed under physiotherapists supervision in clinics on the muscular strength, prolapse stages and life quality of the women with POP. In the light of the existing knowledge, our aim was to compare the effectiveness of stabilization exercises training and pelvic floor muscular training in women with stage 1 and 2 POP

Methods

Results

Conclusion