Pelvic Floor Muscle Performance Research Articles

Real-World Evidence From a Digital Health Treatment Program for Female Urinary Incontinence: Observational Study of Outcomes Following User-Centered Product Design.

Urinary incontinence (UI) affects millions of women with substantial health and quality-of-life impacts. Supervised pelvic floor muscle training (PFMT) is the recommended first-line treatment. However, multiple individual and institutional barriers impede women's access to skilled care. Evidence suggests that digital health solutions are acceptable and may be effective in delivering first-line incontinence treatment, although these technologies have not yet been leveraged at scale. The primary objective is to describe the effectiveness and safety of a prescribed digital health treatment program to guide PFMT for UI treatment among real-world users. The secondary objectives are to evaluate patient engagement following an updated user platform and identify the factors predictive of success. This retrospective cohort study of women who initiated device use between January 1, 2022, and June 30, 2023, included users aged ≥18 years old with a diagnosis of stress, urgency, or mixed incontinence or a score of >33.3 points on the Urogenital Distress Inventory Short Form (UDI-6). Users are prescribed a 2.5-minute, twice-daily, training program guided by an intravaginal, motion-based device that pairs with a smartphone app. Data collected by the device or app include patient-reported demographics and outcomes, adherence to the twice-daily regimen, and pelvic floor muscle performance parameters, including angle change and hold time. Symptom improvement was assessed by the UDI-6 score change from baseline to the most recent score using paired 2-tailed t tests. Factors associated with meeting the UDI-6 minimum clinically important difference were evaluated by regression analysis. Of 1419 users, 947 met inclusion criteria and provided data for analysis. The mean baseline UDI-6 score was 46.8 (SD 19.3), and the mean UDI-6 score change was 11.3 (SD 19.9; P<.001). Improvement was reported by 74% (697/947) and was similar across age, BMI, and incontinence subtype. Mean adherence was 89% (mean 12.5, SD 2.1 of 14 possible weekly uses) over 12 weeks. Those who used the device ≥10 times per week were more likely to achieve symptom improvement. In multivariate logistic regression analysis, baseline incontinence symptom severity and maximum angle change during pelvic floor muscle contraction were significantly associated with meeting the UDI-6 minimum clinically important difference. Age, BMI, and UI subtype were not associated. This study provides real-world evidence to support the effectiveness and safety of a prescribed digital health treatment program for female UI. A digital PFMT program completed with visual guidance from a motion-based device yields significant results when executed ≥10 times per week over a period of 12 weeks. The program demonstrates high user engagement, with 92.9% (880/947) of users adhering to the prescribed training regimen. First-line incontinence treatment, when implemented using this digital program, leads to statistically and clinically substantial symptom improvements across age and BMI categories and incontinence subtypes.

Is There an Association between the Quality of Life of Incontinence Symptoms and the Hip Joint Muscles Strength in Women with Stress Urinary Incontinence?

Background For establishing an accurate target for rehabilitation of stress urinary incontinence (SUI), it is necessary to determine whether there is an association between the pelvic floor muscle (PFM) and hip joint muscle strength and quality of life (QoL) of incontinence symptoms. Purpose The purpose of the current study was to confirm the correlation between QoL of incontinence symptoms and PFM strength, hip extensor, abductor, and adductor strength in women with SUI. Study design Cross sectional study Methods Forty-two women with SUI were recruited for the present study. PFM performance was measured by perineometry. Hip extensor, abductor and adductor strength were measured by dynamometry. QoL of incontinence symptoms was measured by incontinence quality of life questionnaire (I-QOL). The significance of the correlations between I-QOL and hip joint muscle and PFM strength was assessed using Pearson correlation coefficients. Alpha value was set at 0.05. Results Avoidance and limiting behaviors factor in I-QOL was correlated with PFM strength (<italic>r</italic>=0.524, <italic>p</italic>&lt;0.05), hip adductor strength (<italic>r</italic>=0.356, <italic>p</italic>&lt;0.05) and hip abductor strength (<italic>r</italic>=0.352, <italic>p</italic>&lt;0.05) in the order. The total score in I-QOL was correlated with PFM strength (<italic>r</italic>=0.368, <italic>p</italic>&lt;0.05). Conclusions When designing which muscles to train for improving QoL of incontinence symptoms, the hip joint muscle as well as the PFM could be considered.

Comparing Motor Control of the Lumbosacral Region and Pelvic Floor Muscle Strength and Performance in Women with C-Section and Vaginal Birth

Background: Delivery is a physiological process that may cause neurophysiological changes in the lumbosacral region. Objectives: The current study aimed to compare motor control of the lumbosacral region and pelvic floor muscle strength and performance in women with C-section and vaginal birth. Methods: In this cross-sectional study, 120 prim parous women referring to healthcare centers in Karaj (Iran) during 2019 are studied. The participants were selected using convenience sampling. The motor control of the lumbosacral region was examined by four clinical tests (standing bent, active straight leg raising, bent knee fall out, and knee lift abdominal test) using a pressure biofeedback unit. Muscle strength and performance were measured using the Oxford scoring system and the PFPI-20 questionnaire, respectively. Data were analyzed using independent t-test, Mann-Whitney, and Chi-square tests. Statistical significance was considered when P value &lt; 0.05. Results: Based on the standing bent test, a significant difference was found between those in vaginal delivery and C-section groups (P = 0.011). Also, the mean scores of muscular strengths (P = 0.009) and pelvic floor muscular function (P = 0.01) in the vaginal delivery group were significantly higher than the C-section group. Conclusions: the mean scores of pelvic floor motor control, pelvic floor muscular strength, and function in the C-section group were higher than those in the vaginal delivery group. This study demonstrated the necessity of postpartum pelvic floor muscle rehabilitation, especially in vaginal delivery.

Transabdominal Ultrasound Imaging of Pelvic Floor Muscle Activity in Women With and Without Stress Urinary Incontinence: A Case-Control Study.

Transabdominal ultrasound (TAU) is an easy and noninvasive way to evaluate and retrain pelvic floor muscle (PFM) function. The purpose of this study was to compare PFM activity in women with and without urinary incontinence (UI) by measuring bladder base displacement (as a marker for PFM activity) using TAU during PFM contraction, Valsalva's maneuver, and abdominal curl. Sixty-three women, aged 20-55 years, volunteered to participate in this cross-sectional study: 21 were continent and 42 had UI (21 stress urinary incontinence [SUI] and 21 mixed urinary incontinence [MUI]). Mean bladder base displacement in millimeters was measured to evaluate differences between the three groups (continent, SUI, and MUI) and also between the continent and UI groups during the performance of each maneuver. No significant differences were seen between the three groups in bladder base elevation during PFM contraction (P > 0.05). Descent of the bladder base during Valsalva's maneuver and abdominal curl was significantly greater in women with SUI and MUI than in women in the continent group (P < 0.05). Comparison of the continent and UI groups showed no significant differences in elevation of the bladder base during PFM contraction, while descent of the bladder base was significantly greater in women with UI than in women in the continent group during Valsalva's maneuver and abdominal curl (P < 0.05). TAU indicated that bladder base descent was greater in women with SUI and MUI than those in the continent group during the performance of maneuvers that increased intra-abdominal pressure. This effect may be due to decreased PFM performance in women with urinary incontinence.

Development of a wireless accelerometer-based Intravaginal device to detect pelvic floor motion for evaluation of pelvic floor dysfunction

Urinary incontinence (UI) is experienced by an estimated 51% of women in the U.S. and often results from impaired function or weakening of the pelvic floor muscles. Pelvic floor muscle training (PFMT) is a frontline nonsurgical treatment, yet a number of symptomatic individuals cannot accurately perform a pelvic floor muscle contraction with simple verbal or written instruction. Long-term adherence to PFMT regimens is often a barrier to resolution of symptoms. Various biofeedback tools have been utilized to aid correct pelvic floor muscle performance and adherence. One novel device, the leva® Pelvic Digital Health System, utilizes an intravaginal probe embedded with MEMS accelerometer sensors that allow real-time visualization of the shape and motion of the vagina during PFMT. Early positive results with this device prompted design of a wearable version. The purpose of this study was to design a wearable, wireless clinical research device to optimize MEMS accelerometer sensor placement to detect maximal movement during a pelvic floor muscle exercise (PFME) and to test the form factor for retention and user acceptability. The device comprised a ring designed to sit at the fornix with an extension following the length of the vagina. This paper presents design components and results from clinical testing of 10 subjects. It was determined that a ring form factor alone, similar to other vaginal rings (pessaries, estrogen rings) provided less accurate visual information about PFME performance. By contrast, we determined that a ring with an extension allowed for device retention and improved real-time detection of vaginal shape and motion during PFMT.

Pelvic Floor Muscle Performance, Hip Mobility, and Hip Strength in Women With and Without Self-Reported Stress Urinary Incontinence

Objective: To describe pelvic floor muscle (PFM) function, hip mobility, and hip strength profiles and compare measures between women with and without self-reported stress urinary incontinence (SUI). Study Design: Descriptive. Background: Women with SUI present with PFM and hip impairments; yet comparative data in asymptomatic women are lacking. Methods and Measures: Adult women with (n = 21) or without (n = 20) SUI, with regular menses, were recruited. PFM performance, passive hip range-of-motion angles, and hip maximum isometric voluntary contractions (Nm/kg) (Biodex) were measured. Values were compared between groups and legs (dominant [Dom] and nondominant [Non-dom]) (significance: P < .05). Results: Women with SUI were older (P < .001), had higher parity, more tender points (Dom, P = .020), greater prone hip internal rotation (IR) angles (Non-dom, P = .025), lesser flexibility per Ober test (Non-dom, P = .013; Dom, P = .050), lower seated hip external rotation (ER) force (Non-dom, P = .008; Dom, P = .033), and lower hip abduction force (Non-dom and Dom, P < .001) than women without SUI. Leg differences for the SUI group were prone hip IR angles (P = .033), seated hip IR force (P = .015), and prone hip ER force (P < .001). Leg differences in women without SUI were PFM power (P = .005), prone hip angles (IR, P = .038; ER, P = .004), and prone hip ER force (P < .001). Conclusions: The lack of significant differences in PFM function between the 2 groups was unexpected. Greater hip strength and mobility along with unique between-leg differences may suggest a coping mechanism in asymptomatic women with similar PFM function as women with SUI. Investigating relationships among PFM and hip profiles and severity of SUI appears warranted. We have included a Video Abstract that highlights interesting findings in our article (see the Video Abstract, Supplemental Digital Content 1, available at:https://links.lww.com/JWHPT/A23)

Combination of pelvic floor and abdominal muscle exercises to reduce perineum pain in postpartum mothers

Background: Perineum Pain risks a lack of rest time which will affect the reduction in milk production and can interfere with the process of uterine contractions which further risks the occurrence of subinvolution. Previous studies have only examined pelvic floor muscle exercises, however, they have not been combined with abdominal exercise. The combination of abdominal muscle exercises can increase the effectiveness of pelvic floor muscle performance so that it will improve blood circulation and make muscles relaxed and inhibit the increase in lactic acid due to muscle spasms and ischemic tissue that makes pain.Objective: To find out the benefits of a combination of Pelvic Floor Muscle and Abdominal Muscle Exercises to Reduce Perineum Pain in Postpartum MothersMethods: This is a pre-experimental research with one group pretest-posttest design. The sample used was 16 people with random techniques. Statistical analysis was done by Wilcoxon while pain measurement was done by VAS instrument.Results: The results showed the mean of the pain before doing the exercise was 3.94 and the mean of the pain after doing exercise was 1.62. From statistical test results by Wilcoxon test, it obtained a significance value of 0.003 (p &lt;0.05). Thus it was concluded that there were significant differences in perineum Pain before and after Pelvic Floor and Abdominal Muscle ExercisesConclusion: Combination of pelvic floor muscle exercise and abdominal muscle can reduce perineum pain in postpartum mothers.

Multimodal Physical Therapy Intervention for Urinary Incontinence and Overactive Bladder in the Older Adult

Urinary incontinence (UI) and overactive bladder (OAB) are health conditions that have higher prevalence rates later in life and can lead to a profound negative effect on UI-related quality of life. Evidence is lacking on the effects of conservative multimodal physical therapy (PT) interventions for UI and OAB in the older population. This case study presents a multimodal PT intervention for a 71-year-old woman with UI and OAB. After 4 sessions, the patient demonstrated improved UI-related quality of life and significantly decreased urinary symptoms. Urinary Distress Index Short Form (UDI-6) scores improved from 54.6 to 16.67. Pelvic floor muscle performance improved with increased strength, endurance, and coordination. This case supports the use of multimodal PT interventions for older patients with UI and OAB.

Role of Pelvic Floor Muscles in Female Orgasmic Response

There are many important outcomes from the responsive muscle contractions in the female orgasm. A number of these outcomes are structural and these structural outcomes have a direct positive effect on the well-being of the woman. Though these direct physiological outcomes may or may not have an adaptive history, they affect the well-being of the woman and include structural load management, continence, and sexual function. These benefits of orgasm for adult women last a lifetime; positive outcomes do not end at menopause—female urinary incontinence and pain in the lower back, hip(s), and knee(s) are not a de facto consequence of aging. So although the conveyance of sperm helps the act of reproduction and is considered the major function of the orgasm, this reading is limited; glossing the appreciation of the female orgasm in maintaining pelvic floor muscle tone and missing the function of the clitoral gland in maintaining pelvic floor muscle tone. The point of this paper is to suggest that the role of the pelvic floor muscles in female orgasmic response has much more immediate and more wide-ranging physiological outcomes for the human female than the reproductive primacy perspectives suggested in many studies to date. Clearly defining the broad structural importance of the pelvic floor muscles in female orgasmic response would have positive epidemiological outcomes for all women. While pelvic floor muscle performance has psychological outcomes that synergistically affect the woman’s well-being, the psychological outcomes are not within the scope of this paper.

Vibrating vaginal balls to improve pelvic floor muscle performance in women after childbirth: a protocol for a randomised controlled feasibility trial.

This paper presents a feasibility trial protocol the purpose of which is to prepare for a future randomised controlled trial to determine the effectiveness of vibrating vaginal pelvic floor training balls for postpartum pelvic floor muscle rehabilitation. Vibrating vaginal pelvic floor training balls are available in Austria to enhance women's pelvic floor muscles and thus prevent or treat urinary incontinence and other pelvic floor problems following childbirth. Nonetheless, there is currently little empirical knowledge to substantiate their use or assess their relative effectiveness in comparison to current standard care, which involves pelvic floor muscle exercises. Single blind, randomised controlled feasibility trial with two parallel groups. It is planned to recruit 56 postpartum women in Vienna, who will be randomised into one of two intervention groups to use either vibrating vaginal balls or a comparator pelvic floor muscle exercises for 12weeks. As this is a feasibility study, study design features (recruitment, selection, randomisation, intervention concordance, data collection methods and tools) will be assessed and participants' views and experiences will be surveyed. Tested outcome measures, collected before and after the intervention, will be pelvic floor muscle performance as reported by participants and measured by perineometry. Descriptive and inferential statistics and content analysis will serve the preparation of the future trial. The results of this feasibility trial will inform the design and conduct of a full randomised controlled trial and provide insight into the experiences of women regarding the interventions and study participation.

Transabdominal ultrasound to assess pelvic floor muscle performance during abdominal curl in exercising women.

The aim of this study was to assess pelvic floor muscle (PFM) function using transabdominal ultrasound (TAUS) in women attending group exercise classes. Specific aims were to: (1) identify the ability to perform a correct elevating PFM contraction and (2) assess bladder-base movement during an abdominal curl exercise. Ninety women participating in group exercise were recruited to complete a survey and TAUS assessment performed by two qualified Continence and Women's Health physiotherapists with clinical experience in ultrasound scanning. The assessment comprised three attempts of a PFM contraction and an abdominal curl exercise in crook lying. Bladder-base displacement was measured to determine correct or incorrect activation patterns. Twenty-five percent (n = 23) of women were unable to demonstrate an elevating PFM contraction, and all women displayed bladder-base depression on abdominal curl (range 0.33-31.2mm). Parous women displayed, on average, significantly more bladder-base depression than did nulliparous women [15.5 (7.3) mm vs 11.4 (5.8) mm, p < 0.009). Sixty percent (n = 54) reported stress urinary incontinence (SUI). There was no association between SUI and the inability to perform an elevating PFM contraction (p = 0.278) or the amount of bladder-base depression with abdominal curl [14.1 (7.6) mm SUI vs 14.2 (6.7) mm non-SUI]. TAUS identified that 25% of women who participated in group exercise were unable to perform a correctly elevating PFM contraction, and all depressed the bladder-base on abdominal curl. Therefore, exercising women may be at risk of PFM dysfunction when performing abdominal curl activities.

Vaginal cones or balls to improve pelvic floor muscle performance and urinary continence in women postpartum: a quantitative systematic review and meta-analysis protocol.

To identify, critically appraise and synthesize the best current evidence on the use of vaginal cones or balls to improve pelvic floor muscle performance and urinary continence in women post partum. The vaginal use of cones or balls is a pelvic floor muscle training method that aims to enhance muscle performance and thereby prevent or treat urinary incontinence. Nonetheless to date, no systematic review has focused on the effectiveness of these devices specifically during the postpartum period. Quantitative systematic review with potential meta-analysis. The review will be undertaken by searching 14 scientific databases (including PubMed and CINAHL, without date restriction) and the world-wide web; experts will also be contacted for published and unpublished data. Included studies must be randomized or quasi-randomized trials and have female participants until 1 year after childbirth. The intervention will be compared with no treatment, placebo, sham treatment or active controls. Outcome measures will relate to pelvic floor muscle performance or urinary incontinence. Studies will be selected, 'risk of bias' assessed and data extracted by two reviewers independently. Following inter-reviewer agreement of included studies, data will be checked after entry into systematic review processing software. If appropriate, data will be synthesized by meta-analysis; if this is not possible, a narrative review only will be undertaken. The information gained from this systematic review will help midwives, nurses, other health professionals and women after childbirth decide how to promote female pelvic floor health and in defining further areas of study.

Does improved functional performance help to reduce urinary incontinence in institutionalized older women? a multicenter randomized clinical trial

BackgroundUrinary incontinence (UI) is a major problem in older women. Management is usually restricted to dealing with the consequences instead of treating underlying causes such as bladder dysfunction or reduced mobility.The aim of this multicenter randomized controlled trial was to compare a group-based behavioral exercise program to prevent or reduce UI, with usual care. The exercise program aimed to improve functional performance of pelvic floor muscle (PFM), bladder and physical performance of women living in homes for the elderly.MethodsTwenty participating Dutch homes were matched and randomized into intervention or control homes using a random number generator. Homes recruited 6–10 older women, with or without UI, with sufficient cognitive and physical function to participate in the program comprising behavioral aspects of continence and physical exercises to improve PFM, bladder and physical performance. The program consisted of a weekly group training session and homework exercises and ran for 6 months during which time the control group participants received care as usual. Primary outcome measures after 6 months were presence or absence of UI, frequency of episodes (measured by participants and caregivers (not blinded) using a 3-day bladder diary) and the Physical Performance Test (blinded). Linear and logistic regression analysis based on the Intention to Treat (ITT) principle using an imputed data set and per protocol analysis including all participants who completed the study and intervention (minimal attendance of 14 sessions).Results102 participants were allocated to the program and 90 to care as usual. ITT analysis (n = 85 intervention, n = 70 control) showed improvement of physical performance (intervention +8%; control −7%) and no differences on other primary and secondary outcome measures. Per protocol analysis (n = 51 intervention, n = 60 control) showed a reduction of participants with UI (intervention −40%; control −28%) and in frequency of episodes (intervention −51%; control −42%) in both groups; improvement of physical performance (intervention + 13%; control −4%) was related to participation in the exercise program.ConclusionsThis study shows that improving physical performance is feasible in institutionalized older women by exercise. Observed reductions in UI were not related to the intervention. [Current Controlled Trials ISRCTN63368283]

Comparisons of pelvic floor muscle performance, anxiety, quality of life and life stress in women with dry overactive bladder compared with asymptomatic women

Study Type - Therapy (case control) Level of Evidence 3b What's known on the subject? and What does the study add? Abnormal pelvic floor muscle function has been associated with chronic pelvic pain syndromes. This study adds evidence about pelvic muscle performance in women with dry overactive bladders. To determine if pelvic floor muscle surface electromyography (sEMG) measurements differed between women with dry overactive bladder (OAB) symptoms and asymptomatic controls. To determine whether pelvic floor muscle performance was associated with anxiety scores, quality of life and life stress measures We enrolled 28 women with urinary urgency and frequency without urinary incontinence, and 28 age-matched controls. sEMG was used to assess pelvic muscle performance. Participants also completed the Beck Anxiety Inventory, Pelvic Floor Distress Inventory, Pelvic Floor Impact Questionnaire and Recent Life Changes Questionnaire. Anxiety scores were significantly higher in women with dry OAB than in controls. No significant differences were found in sEMG measures of pelvic muscle contraction or relaxation between the two groups. There was no significant correlation between sEMG pretest resting baseline measurements and the Beck Anxiety Inventory, the Pelvic Floor Distress Inventory, the Pelvic Floor Impact Questionnaire or life stress scores among symptomatic women. As expected, women with dry OAB had significantly higher scores on the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire. This study supports a relationship between dry OAB symptoms and anxiety that warrants further exploration. Resting sEMG baselines were not elevated and did not support the hypothesis that women with dry OAB are unable to relax their pelvic floor muscles.

2174 NEAR INFRARED SPECTROSCOPY OF PELVIC FLOOR MUSCLES SHOWS THE EFFECT OF PELVIC FLOOR MUSCLE TRAINING IN WOMEN WITH STRESS INCONTINENCE

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Urodynamic Testing1 Apr 20112174 NEAR INFRARED SPECTROSCOPY OF PELVIC FLOOR MUSCLES SHOWS THE EFFECT OF PELVIC FLOOR MUSCLE TRAINING IN WOMEN WITH STRESS INCONTINENCE lynn stothers, Andrea Marques, Babak Shadgan, and Andrew Macnab lynn stotherslynn stothers Vancouver, Canada More articles by this author , Andrea MarquesAndrea Marques Campinas, Brazil More articles by this author , Babak ShadganBabak Shadgan Vancouver, Canada More articles by this author , and Andrew MacnabAndrew Macnab Vancouver, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2411AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Near-infrared spectroscopy (NIRS) monitors changes in muscle chromophore concentration of oxygenated (O2Hb), deoxygenated (HHb) and total hemoglobin (tHb). In exercise science, NIRS has been used to monitor rates of muscular fatigue and to modify exercise techniques in athletes. The objective of this study was to demonstrate the feasibility of NIRS to monitor pelvic floor muscle oxygen consumption during pelvic floor muscle training (PFMT) in women with stress urinary incontinence (SUI) compared to healthy controls. METHODS 20 adult women consented. Measures included: voiding diary, body mass index, Incontinence Impact Questionnaire, Sports Medicine Lifestyle Classification, multichannel urodynamics, leak point pressure and Brink Score. NIRS light emitting diodes (785, 808 and 830 nm) were integrated into a vaginal probe. Subjects completed daily and in person PFMT by a PhD physiotherapist weekly x 6 weeks. NIRS was recorded during; a) 3 maximal voluntary contractions, b) 1 minute of sustained maximal isometric contraction and c) 10 rapid continuous contractions. Statistical comparison examined chromophore concentrations before and after PFMT and to controls with p<0.05 as significant. RESULTS 82% of SUI women reported improved continence status following PFMT. SUI women responding to PFMT had a pattern of decreasing musclar O2Hb and tHb, with an increase in HHb during each contraction. Chromophore values returned to baseline following muscle relaxation (fig 1). The magnitude of changes of O2Hb, HHb and tHb were significantly higher after completion of the PFMT program compared to their baseline in women with improved continence. Non responding incontinent women had rates of oxygen decline >50% faster during isometric contraction compared to responders which was correlated to leak point pressure. Control women displayed statistically longer time to muscular fatigue. CONCLUSIONS NIRS interrogation of the pelvic floor demonstrated changes in oxygenation patterns following 6 weeks of PFMT. The feasibility of transvaginal NIRS for evaluation of pelvic floor muscle performance was demonstrated which could allow for personalized PFMT programs in women based on individual rates of muscular fatigue. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e871 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information lynn stothers Vancouver, Canada More articles by this author Andrea Marques Campinas, Brazil More articles by this author Babak Shadgan Vancouver, Canada More articles by this author Andrew Macnab Vancouver, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Strength and endurance of the pelvic floor muscles in continent women: An observational study

Objectives To describe the maximal strength and endurance of the pelvic floor muscles in a cohort of women with no history of incontinence; and to determine the effect of age, parity, hormonal status, previous gynaecological surgery and regular performance of pelvic floor muscle exercises on the strength and endurance of these muscles. Design Preliminary cross-sectional observational study. Setting Faculty of Health Sciences, University of Sydney, Australia. Participants Twenty-eight women aged 19 to 58 years, 16 of whom were under 40 years of age. Participants were excluded if they had a history of incontinence or were currently menstruating. Primary outcome measures Pelvic floor muscle strength assessed using a perineometer, and pelvic floor muscle endurance above 60% of maximal voluntary contraction. Secondary outcome measures The effect of age, parity, hormonal status, previous gynaecological surgery and regular performance of pelvic floor muscle exercises on the strength and endurance of these muscles. Results Maximum strength of the pelvic floor muscles was not correlated with endurance ( r = 0.21, P = 0.290) or age ( r = −0.31, P = 0.107); however, it was influenced by parity ( r = −0.44, P = 0.020). Endurance was significantly and positively correlated with age ( r = 0.38, P = 0.048). Conclusions This study provides preliminary data that age and parity may be important factors in pelvic floor muscle performance in women who are continent. A larger study that considers the variability associated with these variables will provide useful guidelines for prescription of exercise.

Biofeedback applications in gastroenterology.

Biofeedback applications in gastroenterology have been restricted to modification of pelvic floor muscle performance in patients with defecatory problems (incontinence, constipation) but, within this area, an increasing number of studies have proved its usefulness and its efficacy.