Pelvic Floor Muscle Training Research Articles

Effect of pelvic floor muscle exercise combined with infrared physiotherapy on postpartum urinary incontinence

Effect of pelvic floor muscle exercise combined with infrared physiotherapy on postpartum urinary incontinence

Effectiveness of Electrical Stimulation Combined with Pelvic Floor Muscle Training on Female Sexual Dysfunction with Overactive Bladder: A Randomized Controlled Clinical Trial.

(1) Background: Female sexual dysfunction (FSD) and overactive bladder (OAB) are prevalent disorders that significantly impair women's quality of life. While pelvic floor muscle training (PFMT) is a well-established treatment for OAB, its effectiveness for FSD remains uncertain. Recent studies suggest that intravaginal electrical stimulation (IVES) may enhance the effects of PFMT. Therefore, this study aimed to evaluate the efficacy of combining IVES with PFMT to improve sexual function and bladder control in women with OAB and FSD. (2) Methods: A total of 40 women with FSD and OAB as determined by the Female Sexual Function Index (FSFI) and Overactive Bladder Symptom Score (OABSS) were randomized into two groups: group 1, the intravaginal electrical stimulation group (IVESG) (n = 20), and group 2, the placebo control group (CG) (n = 20). Patients in both groups received PFMT during the trial, and the IVESG underwent 10 weeks of electrical stimulation. The primary outcome was the change in the FSFI score from baseline to week 4 and week 10. The secondary outcome was a comparison of the OABSS values at week 4 and week 10 of the trial. (3) Results: After treatment, the IVESG scores for the total FSFI, sexual arousal and orgasm, increased significantly (p < 0.05). After 10 weeks of treatment, the OABSS values for IVESG were significantly lower (p < 0.01). After 10 weeks of treatment, the percentage of patients with mild OAB in the IVESG and CG increased by 53.33% and 60%, respectively, while the percentage of patients with both moderate and severe OAB decreased, especially in the IVESG, where patients with severe OAB were non-existent after 10 weeks of treatment. (4) Conclusions: IVES combined with PFMT improved objective and subjective measures of FSD and OAB. There was a significant improvement in FSD (including arousal and orgasmic domain scores). This study concludes that IVES is an effective conservative treatment.

Antepartum pelvic floor muscle training (PFMT) plus perineal massage vs. postpartum PFMT alone: analysis of pelvic floor disorders, Quality of Life and sexual function.

The aim of this study was to analyze how antepartum pelvic floor muscle training (PFMT) plus perineal massage associated with postpartum PFMT have a significant impact on pelvic floor health during pregnancy and after delivery. One thousand two hundred thirty-three women were enrolled from January 2019 to December 2021. They were divided into two groups: 786 women underwent postpartum PFMT only, 447 women experienced both prepartum perineal massage and PFMT and postpartum PFMT. The primary endpoint was to evaluate prepartum perineal massage and PFMT's impact on delivery. The second endpoint was the evaluation of Quality of Life and sexual function at 3- and 12-months follow-up after delivery. Women who underwent prepartum PFMT experienced significantly lower percentage of episiotomy, high-grade obstetric tear or instrumental delivery and higher percentage of intact perineum. Furthermore, prepartum PFMT appeared to improve sexual function at 3 months follow-up, and it was associated with an earlier first sexual intercourse after childbirth. The incidence of stress urinary incontinence was significantly higher in women who experienced PFMT only in postpartum, both at 3- and 12-months follow-up, while the other examined clinical parameters did not show a significant difference. Prepartum PFMT has a role in preventing obstetric traumas and on improving Sexual Function and Quality of Live in the immediate postpartum. Moreover, prepartum PFMT in association with postpartum PFMT reduces the incidence of stress urinary incontinence in a higher percentage than postpartum PFMT only.

The effect of reflexology and pelvic floor muscle (Kegel) exercises on urinary incontinence in people with multiple sclerosis

Purpose: This study was conducted to determine the effects of reflexology and Kegel exercise on urinary incontinence in patients with multiple sclerosis (MS). Materials and methods: A single-blind, controlled pretest-posttest study was conducted. The study included 15 patients with MS who presented to the neurology outpatient clinic between March 2020 and February 2022. Patients were assigned to the reflexology, Kegel exercise, or control group using block randomization. Data were collected from all patients using a sociodemographic information form, and quality of life was assessed using the International Consultation on Incontinence Questionnaire–Short Form, Incontinence Quality of Life Scale, and Incontinence Severity Index. The Wilcoxon paired-samples test and Kruskal-Wallis test were used to analyze the data. Results: The mean age of the patients was 39.86 ± 9.99 years, and the mean MS duration was 104.46 ± 84.12 months. International Consultation on Incontinence Questionnaire–Short Form scores did not differ significantly between the groups before or after the intervention (P = 0.788). Incontinence Quality of Life Scale total and subscale scores also did not differ between the groups, but significant improvement was noted in the reflexology group between the pretest and posttest assessments (P = 0.970). Incontinence Severity Index scores did not differ between or within the groups (P = 0.193). Conclusion: Reflexology and Kegel exercise did not exert different effects on urinary incontinence, whereas reflexology improved incontinence-related quality of life.

The Effectiveness of Adding Transvaginal Radiofrequency to Pelvic Floor Muscle Training for 6 Weeks in Women with Stress Urinary Incontinence. A Double-Blind Randomised Controlled Trial.

The objective was to evaluate the clinically beneficial effect of adding transvaginal monopolar non-ablative radiofrequency (RF) to pelvic floor muscle training (PFMT) on leakage severity, quality of life and urinary incontinence-related symptoms in women with stress urinary incontinence (SUI). A double-blind randomised controlled trial was conducted, with a 6-week intervention and a 6-month follow-up. Participants were randomly assigned to the experimental group (PFMT plus RF; n = 18) or the control group (PFMT plus placebo; n = 20). The primary outcome was the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). Secondary outcomes included the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), self-efficacy, female sexual function, pelvic floor muscle dynamometry, 1-h pad test and number of SUI episodes per week. Inferential analyses of the data were performed using a two-factor analysis of variance. Both groups achieved a statistically significant improvement in ICIQ-SF over time. However, the differences observed in the experimental group exceeded the minimal clinically important differences by 4 points (MD = -9.4, 95% CI = -12.6 to -6.3), which was not observed in the control group (MD = -3.9, 95% CI = -6.9 to -1.0). This was maintained at the 6-month follow-up with a significant time*group interaction (p < 0.001, ηp2 = 0.150). There was no time*group interaction in the other variables (p > 0.05). Additionally, a significant difference in favour of the experimental group was observed in the 1-h pad test and episodes of SUI per week (p < 0.05). This study highlights the beneficial effects of adding transvaginal RF to PFMT on the severity and amount of leakage, as well as on the quality of life and urinary incontinence-related symptoms in women with moderate SUI. Future trials are needed to assess the effects of this intervention in women with severe SUI.

Education on Kegel Exercises as an Effort to Accelerate Healing of Perineal Wounds in Postpartum Mothers at the Driyorejo Gresik Community Health Center

Infections in the postpartum period are caused by delays in perineal wound healing. Kegel exercises are exercises to strengthen the pelvic floor muscles, help prevent urinary incontinence problems, and can stretch the perineal tissue as the baby's birth canal. Accelerate healing of perineal wounds in postpartum mothers at the Driyorejo Gresik Community Health Center through Kegel exercise education. This community service was carried out on postpartum mothers with perineal wounds in the Driyorejo Gresik Community Health Center working area in March 2024. The number of postpartum mothers who were given Kegel exercises was 30 people. Service activities are divided into 3 stages, namely preparation, implementation and evaluation. The results of the activity showed a decrease in REEDA scores after doing Kegel exercises. Giving Kegel exercises can speed up the healing of perineal wounds. Kegel exercises given to postpartum mothers for 7 days and done 3 times a day with movements that activate the pubococcygeal muscles can improve blood and oxygen circulation to the muscles and tissues around the perineum.

Retrospective Evaluation of the Efficacy of Electrophysiological Appropriate Techniques for Nocturia Following Radical Prostatectomy.

This study retrospectively examines the effectiveness of low-frequency electrical stimulation for addressing nocturia in patients experiencing urinary incontinence after undergoing radical prostatectomy. We reviewed the outcomes of 32 patients who had undergone radical prostatectomy and subsequently experienced urinary incontinence. These patients were divided into the control group (n = 16) who received pelvic floor muscle training and the treatment group (n = 16) who underwent electrophysiological appropriate technique treatment in conjunction with pelvic floor muscle training. We assessed changes in nocturnal voided volume, polyuria index, and nocturia-related quality of life at three different time points: before treatment, after 2 weeks, and at the 3-month follow-up. After 3-month follow-up, both groups exhibit reductions in nocturnal voided volume, and polyuria index compared with baseline and the 2-week mark (p < .05). Treatment group outperformed the control group (p < .05). The quality of life in the treatment group remained consistently high, while the control group did not show a statistically significant difference from baseline (p > .05). The total effective rate was significantly higher in the treatment group (93.75%) than in the control group (75.00%, p = .044). This retrospective analysis suggests that electrophysiological appropriate technique treatment effectively mitigates nocturnal, leading to improved quality of life in patients with urinary incontinence following radical prostatectomy in the near term.

Stabilization Exercises Combined with Pelvic Floor Exercises for Pregnancy Related Low Back Pain: A Randomized Clinical Trial

Stabilization Exercises Combined with Pelvic Floor Exercises for Pregnancy Related Low Back Pain: A Randomized Clinical Trial

Pelvic floor muscle training for female urinary incontinence: development of a programme theory from a longitudinal qualitative case study

BackgroundUrinary incontinence (UI) negatively affects the well-being of women globally. Pelvic Floor Muscle Training (PFMT) is a complex intervention that aims to decrease UI symptoms. Information about how the multiple complex components involved in PFMT achieve and maintain the desired effect are rarely studied as a whole. The evidence base lacks data about how women experience PFMT over time and in the longer-term. This study explored women’s experiences of biofeedback-assisted PFMT and PFMT alone, to identify and understand what influenced self-reported adherence to PFMT, and UI outcomes over time.MethodsThis rigorous longitudinal qualitative case study, nested within a randomised controlled trial, recruited forty cases (women with stress or mixed UI; 20 in biofeedback-assisted and 20 in PFMT alone group). A case included up to four semi-structured interviews with each woman (prior to starting PFMT, end of treatment [6 months], 12 months, 24 months). Analysis followed case study analytic traditions, resulting in a Programme Theory about PFMT from the perspectives of women with UI.FindingsThe theory demonstrates factors that motivated women to seek UI treatment, and how these influenced long-term adherence. Therapists who delivered PFMT played a crucial role in supporting women to know how to undertake PFMT (to have capability). Some, but not all, women developed self-efficacy for PFMT. Where women did not have PFMT self-efficacy, adherence tended to be poor. When women had PFMT self-efficacy, the conditions to support adherence were present, but contextual factors could still intercede to inhibit adherence. The intercession of contextual factors was individual to a woman and her life, meaning any particular contextual factor had inconsistent influences on PFMT adherence over time for individual women and exerted varying influences across different women.ConclusionLong term adherence to PFMT is a complex interaction between many different factors. Enquiring about an individual woman’s motivation to seek treatment and understanding the contextual factors that affect an individual woman will enable a practitioner to support longer-term adherence.

Examining the impact of weight loss and exercise on pelvic organ prolapse (POP) management

Introduction: Pelvic organ prolapse is a descent of pelvic organs such as the bladder, cervix, apex of the vagina, and rectum which create herniation and slide into the direction of the vagina entrance. Pelvic prolapse is caused by ligament and muscle weakness, and its risk increases with age, parity, and obesity. Proper exercise and weight loss can be a key component of pelvic prolapse management, especially in the I-III stages. Those interventions may decrease the need for pelvic surgery and the risk of complications that can arise from it. Purpose of the study: This study aimed to explore the effectiveness of weight loss and exercise on pelvic organ prolapse (POP) symptoms and staging. Materials and methods: A comprehensive analysis of research papers available on PubMed, and Google Scholar was undertaken using the keywords: ‘weight loss pelvic prolapse’, ‘exercise in pelvic prolapse’, ‘pelvic floor dysfunction’, ‘pelvic floor muscle training’, ‘hypopressive exercises’, ‘biofeedback prolapse’ Results: Conventional weight loss does not reduce the intensity of the pelvic prolapse symptoms. However, weight loss that is achieved via bariatric surgery is effective in reducing symptoms arising from pelvic organ prolapse. Furthermore, the bigger the amount of weight loss the greater improvement in symptoms. Pelvic floor muscle training showed improvement in symptoms and in the staging of pelvic organ prolapse. Hypopressive exercises are not as effective as pelvic floor muscle training. Biofeedback and supervised exercises are helpful in proper exercise execution, and thus may improve the strength of the pelvic floor muscles.

Recent Advances in Diagnosing and Treating Post-Prostatectomy Urinary Incontinence.

Radical prostatectomy and radiotherapy are common first-line treatments for clinically localized prostate cancer. Despite advances in surgical technology and multidisciplinary management, post-prostatectomy urinary incontinence (PPI) remains a common clinical complication. The incidence and duration of PPI are highly heterogeneous, varying considerably between individuals. Post-prostatectomy urinary incontinence may result from a combination of factors, including patient characteristics, lower urinary tract function, and surgical procedures. Physicians often rely on detailed medical history, physical examinations, voiding diaries, pad tests, and questionnaires-based symptoms to identify critical factors and select appropriate treatment options. Post-prostatectomy urinary incontinence treatment can be divided into conservative treatment and surgical interventions, depending on the severity and type of incontinence. Pelvic floor muscle training and lifestyle interventions are commonly conservative strategies. When conservative treatment fails, surgery is frequently recommended, and the artificial urethral sphincter remains the "gold standard" surgical intervention for PPI. This review focuses on the diagnosis and treatment of PPI, based on the most recent clinical research and recommendations of guidelines, including epidemiology and risk factors, diagnostic methods, and treatment strategies, aimed at presenting a comprehensive overview of the latest advances in this field and assisting doctors in providing personalized treatment options for patients with PPI.

Differences in Perineal Wound Healing Between Doing Kegel Exercises and Not Doing Kegel Exercises

Perineal wounds are lacerations or injuries that occur along the birth canal (perineum) due to the delivery process. Wound healing is the process of replacing and repairing damaged tissue function. The purpose of this study was to see the difference in perineal wound healing between those who did Kegel exercises and those who didnot do Kegel exercises. The research method uses a Quasi-Experimental with the Posttest Only Control Group Design approach. The number of samples taken were 18 postpartum women with perineal wounds at PMB Sri Puji UW S.Tr.Keb. The sampling technique used was purposive sampling. Data collection techniques using observation sheets. Statistical test using the Mann Whitney. The results of the study after being given the treatment obtained the value of Asymp.Sig = 0.028, thus the Asymp.Sig was smaller than α &lt;0.05, thus it can be said that there was a difference in the group that did Kegel exercises and those who did not do Kegel exercises. Because there is a significant difference, it can be said that "there is an effect of doing Kegel exercises on the healing of perineal wounds in postpartum women" at PMB Sri Puji UW S.Tr.Keb Sampang. It is hoped that the results of the research can become information for the development of health sciences, especially health in postpartum women in healing perineal wounds and reducing delays in perineal wound healing. As well as management by doing Kegel exercises to speed up the healing process of perineal wounds.

Effectiveness of Pelvic Floor Muscle Training for Treating Faecal Incontinence

The purpose of this study is to examine the effect of pelvic floor muscle training on faecal incontinence. Faecal incontinence is a condition in which stool leaks from the anus involuntarily or uncontrollably. Faecal incontinence is common in elderly people and patients with underlying diseases, but the pathophysiology of faecal incontinence is diverse, and treatment methods must be varied accordingly. Among the known treatment methods, in this study, we focused on pelvic floor muscle training, which can be performed in daily life. The literature was searched for papers that present existing knowledge and address current perspectives. Extracted studies included papers that report scientific consensus. After reviewing the literature, it appears that it is possible to effectively train patients to defecate twice a day, approximately 30 min after breakfast and dinner, by having them attempting to defecate, even when there is no such urge. Pelvic floor muscle training can improve urinary and faecal incontinence by strengthening the contractile force of the pelvic floor muscles such as the external anal sphincter and levator ani. However, the specific types of faecal incontinence patients that can effectively benefit from pelvic floor muscle training is unclear. It is important for patients to understand the pelvic floor muscle training program and to develop sufficient motivation to continue training at home.

Effectiveness of Kegel Exercises on Perineal Wound Healing among Postpartum Women

Perineal wound refers to laceration or wound that occur along the birth canal (perineum) due to the delivery process. Wound healing is a method involved with replacement and repairment of the capacity of damaged tissue. This study aims to determine the effectiveness of Kegel exercises on perineal wound healing. This was a quasi-experimental study with one group pre-test – post-test design. 45 women with perineal wounds at the Arosbaya Bangkalan Community Health Center were selected as the study samples through a random sampling technique. Data were collected using observation sheet. t test was applied for the statistical tests. The study results obtained a calculated t value that was higher than the t table value (-16.523&gt;-2.015) and significance value of &lt;0.05 (0.000 &lt; 0.05). Thus, it can be concluded that H0 was rejected and H1 was accepted, which indicated an effect of Kegel exercises on perineal wound healing among postpartum women at Arosbaya Community Health Center, Bangkalan, both before and after Kegel exercises. It is expected that the study findings can provide information for the development of health science, especially regarding the health of postpartum women during perineal wound healing process. In addition, management through Kegel exercises to accelerate the perineal wound healing process is expected to eliminate delays in such process

Trajectory of pelvic floor muscle training adherence in Chinese women with postpartum stress urinary incontinence and its related factors: A longitudinal study

ObjectiveNumerous studies have shown that pelvic floor muscle training (PFMT) adherence in women with postpartum stress urinary incontinence is low and influenced by many factors. However, most previous studies have been cross-sectional studies on PFMT adherence. Neglecting physiological and psychological recovery after childbirth may lead to changes in the adherence to PFMT. This longitudinal study investigated the developmental trajectory of PFMT adherence at 8, 10, and 12 weeks postpartum and the associated factors in China. MethodsA total of 213 women with postnatal stress urinary incontinence who visited the obstetric pelvic floor clinic of a Grade A tertiary specialist maternity hospital in Beijing, China between January 2018 and January 2019 were selected. Compliance levels were measured using PFMT compliance questionnaires at 8, 10, and 12 weeks postpartum. Data on self-efficacy, postpartum social support, and other influencing factors were collected at 12 weeks postpartum. Differences in PFMT compliance scores were analyzed using repeated-measures analysis of variance. Multiple stepwise linear regression analyses were used for multivariate analysis. ResultsThe PFMT compliance scores at 8, 10, and 12 weeks postpartum were 13.47 ​± ​4.42, 10.76 ​± ​4.46, and 7.95 ​± ​5.54, which were at a moderate level and showed a decreasing trend over time. Multiple stepwise line regression analysis showed that the factors influencing compliance with PFMT in women with postpartum stress urinary incontinence were knowledge-attitude-practice of PFMT (t ​= ​4.251, P ​< ​0.001), postpartum social support level (t ​= ​4.304, P ​< ​0.001), and self-efficacy level of PFMT (t ​= ​8.577, P ​< ​0.001). ConclusionThe PFMT compliance of Chinese women with postpartum stress urinary incontinence was moderate, with a downward trend. More effective methods should be chosen to improve women's PFMT compliance based on their situation, such as improving patient self-efficacy, social support, and knowledge-attitude-practice.

Prevalence and Experience of Urinary Incontinence Among Elite Female Gaelic Sports Athletes.

This study was aimed at identifying the prevalence and experience of urinary incontinence (UI) among elite female Gaelic sports athletes in Ireland. A cross-sectional study comprising an anonymous online survey of elite Gaelic sports (Camogie and Ladies Gaelic Football) players. Players were asked about their background information, knowledge of the pelvic floor and practice of pelvic floor muscle training (PFMT), as well as their experiences of UI. The prevalence and severity of UI was assessed using the International Consultation on Incontinence Questionnaire-UI Short Form (ICIQ-UI-SF) questionnaire. Logistic regression was used to evaluate risk factors. A total of 185 players responded (25 ± 5years) and 95.3% (n = 176) were nulliparous. Forty-one percent (n = 75) of players had learned about PFMT and 13% (n = 24) had performed PFMT within the last 4 weeks. The ICIQ-UI-SF was completed by 159 players, with UI reported by 61.6% (n = 98), 52% (n = 51) of whom experienced stress urinary incontinence (SUI). A significant association was found between UI and longer weekly sporting activity time (OR 1.05, 95% CI 1.002 to 1.008). Parous players were more likely to experience UI (p = 0.025). Jumping and sprinting activities were the most commonly reported triggers, with pre-voiding and wearing protection (liners, pads) the most commonly adopted UI management strategies. Only ten players reported receiving treatment for UI. Urinary incontinence is prevalent among this cohort of elite female Gaelic sports athletes. Many players used strategies to manage their UI whereas few sought help for what is a treatable condition. Findings suggest the need for education of players regarding pelvic floor health and treatment options available.

Group-based pelvic floor muscle training for pregnant women: A randomized controlled feasibility study.

This study aims to test the feasibility and acceptability of a group-based pelvic floor muscle training for pregnant women in China and facilitate women's adherence to the pelvic floor muscle training programme. Urinary incontinence is a prevalent health problem in women worldwide, especially in pregnant women. Supervised pelvic floor muscle training is recommended as the first-line conservative treatment for urinary incontinence. However, the implementation and effectiveness of pelvic floor muscle training are limited by insufficient human resources and low adherence. Group-based interventions may improve people's adherence to interventions by facilitating peer support. However, it has been investigated in a limited number of maternity studies. Feasibility testing randomized controlled trial, accompanied by a mixed methods process evaluation. This study was guided by the Medical Research Council framework for complex interventions and the Behaviour Change Wheel guide to developing interventions. A three-phase, mixed-methods design was used in this study. This study reported the feasibility of the group-based pelvic floor muscle training programme. Semi-structured reviews were conducted following the intervention to explore the acceptability of the programme. The study included 48 pregnant women with a recruitment rate of 52.17%. The adherence rate to the training programme was 66.67%. The intervention was positively valued, in particular the support promoting participants' adherence, but additional changes need to be made to the programme for a future trial. Group-based pelvic floor muscle training programme provides a possible way of delivering pelvic floor muscle training with limited health professionals in China. The study showed promising results concerning the acceptability and feasibility of the intervention, which were well perceived by both pregnant women and the midwife. Group-based pelvic floor muscle training may have the potential of reducing the prevalence of urinary incontinence in pregnant women with insufficient healthcare professionals. This study assessed the feasibility of delivering group-based pelvic floor muscle training in pregnant women in China. The group-based pelvic floor muscle training is acceptable to both pregnant women and the midwife, but integrating online and face-to-face sessions need to be considered. The findings of this study provided evidence for delivering group-based pelvic floor muscle training to pregnant women in China. The study has adhered to CONSORT guidelines (Table S1) and TIDier checklist (Table S2). The patient and public have been invited as stakeholders during the development of the intervention. They worked with healthcare professionals to co-design the group-based pelvic floor muscle training programme. The trial was registered on ClinicalTrials.gov (NCT05242809) under the title 'Development and Feasibility Testing of a Group-based PFMT Programme for Antenatal Women in Nanjing City in China'.

Effects of hypopressive exercise associated with aerobic and muscle strength training on the treatment of fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecologic cancer: A randomized clinical trial protocol.

Therapeutic exercise has an important role in the population living with cancer as it improves function and quality of life and reduces the symptoms of cancer treatment. There is little clinical evidence on the effects of hypopressive exercise in women with gynecological cancer. Evaluate the effects of 4 weeks of hypopressive exercise associated with muscle strength training and aerobic exercises on fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecological cancer compared to a group that will perform conventional training. This randomized, single-blinded clinical trial study is set in the Clinical Research Laboratory, Department of Kinesiotherapy, at a Chilean University. Patients will be randomly assigned to an experimental group of hypopressive exercises associated with muscle strength training and aerobic exercises or a control group of muscle strength training and aerobic exercises. Twelve tele-rehabilitation sessions will be performed. Women over 18 years of age with gynecologic cancer who have been prescribed radiotherapy or chemotherapy will participate. Fatigue, quality of life, urinary incontinence symptoms, and sexual function will be assessed before and after the intervention. The results of this clinical trial have important implications for specific treatment for the cancer population and generate new techniques in the practice of oncology-specialized kinesiologists. Hypopressive exercise is expected to reduce incontinence symptoms due to neuromuscular activation of the pelvic floor muscles. However, more studies are needed to confirm the beneficial effects of hypopressive exercises in face-to-face or remote rehabilitation.

Penerapan Kegel Exercise terhadap Penyembuhan Luka Perineum pada Ibu Post Partum

Background: Post partum is a condition where the reproductive organs are restored to their pre-pregnancy state. The process of childbirth almost 90% experience perineal tears. To be able to accelerate perineal wounds can be with pharmacological and non-pharmacological measures, one of which is non-pharmacological action with kegel exercise, kegel exercise is pelvic muscle training by contracting the muscles. Objective: to describe the results of observations of wound healing and changes in wound characteristics in post partum women. Methods: This research is a case study research using descriptive methods, namely by observing 2 (two) respondents of post partum women with perineal rupture. Performed for 7 days of application and wound evaluation on day 8. Results: This application shows that before Kegel exercise was performed, both respondents' perineal wound conditions were classified as moderate wounds, namely wet wounds, perineal closure, no signs of infection. After evaluation on the eighth day, the wound condition of Mrs. D and Mrs. E was classified as a good wound, namely dry perineal wounds closing and no signs of infection. Conclusion: There are differences in wound healing and changes in perineal wound characteristics in postpartum women.

At What Point in the Menstrual Cycle Are the Pelvic Floor Muscles at Their Weakest?

Pelvic floor muscle (PFM) strength is a critical factor for optimal pelvic floor function. Fluctuations in strength values based on different phases of the menstrual cycle (MC) could signify a need for a paradigm shift in evaluating, approaching, and planning training. This research aims to examine and contrast the pelvic floor muscle strength during different phases of the menstrual cycle. A prospective observational study employing digital assessment with the modified Oxford scale and vaginal dynamometry measurements was performed, in order to assess the baseline strength and the contraction strength of the PFMs in eumenorrheic females at three different phases of the MC: the early follicular phase (EFP), the late follicular phase (LFP), and the mid-luteal phase (MLP). During two complete cycles, tympanic temperature and body weight were measured and the urinary luteinizing hormone concentration was tested to determine the time of ovulation. In total, 216 dynamometric measurements of PFM strength were obtained from eighteen nulliparous women (25.72 ± 5.03 years). There were no differences between the baseline strength (p = 0.886) and the contraction strength (p = 0.756) with the dynamometric speculum. In the post hoc analysis, the baseline strength, contraction strength, and strength showed no significant differences between MC phases. As no differences in PFM strength in women were found, the PFMs do not seem to be weaker at any time during the menstrual cycle. It appears that the assessment, establishment, and monitoring of a PFM training program could be initiated at any point in the cycle.