Lifestyle and Exercise Interventions for Lumbopelvic Pain and Pelvic Floor Dysfunction: A New Protocol

Abstract

PURPOSE: The purpose of this study was to evaluate whether a protocol that included the implementation of lifestyle modifications and a specialized exercise program would improve the symptoms of pelvic floor dysfunction and mild pelvic organ prolapse in women. METHODS: The five-week IRB-approved study included 23 female subjects aged 43.0 + 9.0 years (Mean + S.D.) who exhibited symptoms of pelvic floor dysfunction as defined by 3 assessments (the Pelvic Floor Distress Inventory [PFIQ-7], the Oswestry Low Back Pain Disability, and the Pelvic Floor Impact [PFDI-SF20] questionnaires). The study also included InBody570 body composition measurements, pelvic alignment assessments, diastasis recti assessments, and manual external pelvic floor muscle activation assessments. Participants were instructed in specific lifestyle modifications and participated in an exercise program over the course of seven live group sessions, 45 minutes each, led by one or both of the investigator clinicians. They were also taught to perform a home exercise program at least 5 days per week and completed compliance forms that were returned at the next live group session. The clinicians were a licensed physical therapist and a clinical exercise physiologist. RESULTS: IBM SPSS version 24 statistical programming was utilized and non-parametric Wilcoxon “related-items” analyses were employed. A 0.05 level of significance was applied. The study results of the pre- and post- values indicated significant improvements of lower back pain (Oswestry, z(23) = -3.67, p < .05), significant improvements of the quality of life subjective emotional gauge (PFDI -20, z(23) = -4.11, p < .05), and significant improvements of bladder, bowel, and prolapse symptoms (PFIQ - 7, z(23) = -3.74, p < .05). CONCLUSIONS: The study was highly labor- and time-intensive, and the sample was not large enough to eliminate statistical bias. However, the successful results warranted a continuation of the study to include 40 female volunteers with no modifications to the study’s protocol using the same clinicians. Researchers are currently recruiting volunteers to complete the study.