Effect of Pelvic Floor and Abdominal Muscle Exercise on Women with Stress Urinary Incontinence: A Quasi-experimental Study

Abstract

Introduction: International continence society and the international urogynaecology association defined the Urinary Incontinence (UI) as “the complaint of any involuntary urine loss”. Pelvic Floor Muscles (PFM) weakness leads to Stress Urinary Incontinence (SUI). There exists an association between physical exertions along with urinary loss in UI. For decreasing urine leak episodes in women, PFM exercises are recommended. The PFM serves as the inner unit and the transverse abdominal muscle, multifidus along with diaphragm act as core muscles. Therefore, for treating SUI, abdominal muscle strengthening might be efficient. Aim: To analyse the effect of combined PFM exercises and abdominal muscle exercises on SUI symptoms. Materials and Methods: A quasi-experimental study was executed with 15 subjects in the Experimental Group (EG) and 11 subjects in the Control Group (CG) via purposive sampling technique at outpatient department. The EG was treated with abdominal muscle exercises along with Pelvic Floor Exercises (PFE) for eight weeks while the CG was treated with PFE. Via phone calls, the training’s follow-up was conducted. PFM strength and the Questionnaire for Urinary Incontinence Diagnosis (QUID) were the outcome measures. The between group perineometer scores analysed with paired t-test. For examining the pre and post-test score of PFM strength scores the independent t-test was employed. For analysing the QUID score Wilcoxon signedrank test, Mann-Whitney U test was applied. Results: The mean of PFM strength (mmHg) for the interventional group was 5.4 while in the CG the mean was 1.64 as exhibited by the within group analysis (p=0.001). An enhancement in every component of QUID in the interventional group was shown in the post-test QUID score between groups which depicted a statistically significant difference in all the components (cough p=0.001, bending p=0.002, walk p=0.001). Conclusion: Abdominals and PFM exercise lessens the SUI symptoms even though PF exercise is the regular treatment aimed at SUI. Better improvement in SUI symptoms and PFM strength is possible by the abdominals along with eight week PF exercise program.