Effectiveness of pelvic floor, diaphragmatic and abdominal muscles training among females with stress urinary incontinence

Abstract

Physiotherapists teaching pelvic floor muscle (PFM) exercises for the treatment of stress urinary incontinence (SUI) discouraged the use of the abdominal muscles and their concomitant relaxation. These claims are now changing however, for recent studies have based their findings on the synergistic relationship between pelvic floor (PF), diaphragmatic and abdominal muscles. The study was a randomized controlled trial in which twenty nine (29) female subjects participated in the study and they were randomly allocated to two groups. The first group comprising 14 participants received PFMT as treatment while the remaining 15 participants received PFMT, diaphragmatic and abdominal muscles training combined. The primary outcome measure was a self-reported improvement, which was assessed by a 4-point Likert scale. Meanwhile a secondary outcome measure in the form of a 3-day voiding diary was also recorded. After a 6-weeks intervention period, a significant reduction in the frequency of urine leakage was recorded in both groups. The cured and improved rate in the training group who received PFMT combined with diaphragmatic and abdominal muscles training were 20% and 80% respectively at ( z = −3.42, P = 0.001) and for the control group who received PFMT were 0% and 93.3% respectively at ( z = −3.32, P = 0.001). A 6-weeks period intervention by retraining diaphragmatic, abdominal and PFM coordinated function ameliorate symptoms of SUI. This new approach stands as a potential alternative approach for women with SUI, particularly those who cannot take surgery as an option, including those who have difficulty in learning how to contract the PFM and those who cannot stand the use of vaginal cones and palpation.