Pelvic Floor Muscle Strength Research Articles

Core Stabilization Exercise in Prenatal and Postnatal Women With Urinary Incontinence: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

The aim of the study is to evaluate the effect size of core stabilization exercise for prenatal and postnatal women through measures of urinary symptoms, voiding function, pelvic floor muscle strength and endurance, quality of life, and pain scores. The PubMed, Embase, Cochrane Library, and Scopus databases were searched. Randomized controlled trials were selected and subjected to meta-analysis and risk of bias assessment. Ten randomized controlled trials were selected, and 720 participants were included. Ten articles using seven outcomes were analyzed. Relative to the control groups, the core stabilization exercise groups exhibited superior results for urinary symptoms (standardized mean difference = -0.65, 95% confidence interval = -0.97 to 0.33), pelvic floor muscle strength (standardized mean difference = 0.96, 95% confidence interval = 0.53 to 1.39), pelvic floor muscle endurance (standardized mean difference = 0.71, 95% confidence interval = 0.26 to 1.16), quality of life (standardized mean difference = -0.9, 95% confidence interval = -1.23 to 0.58), transverse muscle strength (standardized mean difference = -0.45, 95% confidence interval = -0.9 to -0.01), and voiding function (standardized mean difference = -1.07, 95% confidence interval = -1.87 to 0.28). Core stabilization exercises are safe and beneficial for alleviating urinary symptoms, improving quality of life, strengthening pelvic floor muscles, and improving transverse muscle function in prenatal and postnatal women with urinary incontinence.

Objective Changes in Pelvic Floor Muscle Strength and Length in Women With High-Tone Pelvic Floor Dysfunction After Pelvic Floor Physical Therapy (RELAX Trial)

Although pelvic floor physical therapy (PFPT) is effective in treating high-tone pelvic floor dysfunction (HTPFD), data on the mechanism of improvement are limited. This study aimed to compare squeeze intravaginal closure force after 6 weeks of PFPT in women affected by HTPFD and, secondarily, to describe changes in levator dimensions and short-term effects of PFPT on bladder, bowel, and pain symptoms. We conducted a prospective cohort study of patients undergoing 6 sessions of PFPT for the diagnosis of HTPFD. At baseline, we measured intravaginal closure force using an instrumented speculum, levator hiatal dimension using a 3-dimensional endovaginal ultrasonography, and symptom severity using 3 validated questionnaires. Intravaginal closure force and symptoms were reevaluated after the second, fourth, and sixth PFPT sessions, and levator hiatus was reevaluated at the sixth session. Twenty-six women were enrolled and 22 completed 6 sessions and are included in the analysis. Contrary to our hypothesis, mean ± SD vaginal closure force (N) did not demonstrate a significant change (3.27 ± 2.34 vs 3.67 ± 2.02 N, P = 0.18). However, mean levator hiatal area (cm2) increased between visit 1 (13.71 ± 1.77 cm2) and visit 6 (14.43 ± 2.17 cm2, P = 0.05), as did the transverse diameter (3.83 ± 0.03 vs 3.95 ± 0.03 cm, P = 0.04). Survey responses demonstrated significant improvements across all measures of genitourinary symptoms, pain, lower gastrointestinal symptoms and quality-of-life measures after 6 sessions of PFPT. Although the levator hiatal area increased after 6 sessions of PFPT (suggesting muscle lengthening), we were unable to demonstrate that this changed the force generated by pelvic floor muscles as measured by a speculum.

Construct, reliability and reproducibility of an ICF-based pelvic floor muscle strength scale

Background: The functional evaluation of the pelvic floor muscles (PFM) is a fundamental part of the algorithm for establishing the kinesiological-functional diagnosis, without which the eligibility of the most appropriate techniques for the treatment of dysfunctions related to the pelvic floor is nothing more than trial-and-error. However, there is no consensus in the literature regarding strength scales. Aims: to validate a digital strength scale for the pelvic floor muscles based on the International Classification of Disability, Functioning and Health (ICF). Method: a digital pressure scale, based on the five degrees of function/dysfunction of the ICF, was constructed and validated by a digital pressure dynamometer specially built for this purpose. The digital manual closing force data of dorsalis interosseous muscles (medium and indicator fingers) of 210 pelvic physiotherapists were collected and studied. Results: Construct: It was possible to construct a 5-degree strength scale for PFM. Face: all volunteers understood the scale and considered it easy to apply. Reliability and Reproducibility: The force of the 210 was always between 800 kfg and 1000 kgf, showing high reliability and reproducibility. Conclusion: the new scale for measuring and recording PFM strength based on the ICF showed high reliability and reproducibility and could be used for this purpose.

Comparison of the efficacy of intravaginal electrical stimulation in women with idiopathic overactive bladder naive and refractory to pharmacological agents.

This study aims to compare the effectiveness of intravaginal electrical stimulation (IVES) with regard to quality of life (QoL) and clinical parameters related to incontinence in women with idiopathic overactive bladder (iOAB) naive or refractory to treatment with pharmacological agents (PhA). In this prospective trial, PhA-naive women were included in Group 1 (n = 24) and women with PhA-resistant iOAB were included in Group 2 (n = 24). IVES was performed 3 days a week, with a total of 24 sessions for 8 weeks. Every session lasted 20 minutes. Women were evaluated for the severity of incontinence (24-hour pad test), pelvic floor muscle (PFM) strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes, and the number of pads), symptom severity (OAB-V8), quality of life (IIQ-7), treatment success (positive response rate), cure/improvement rate, and treatment satisfaction. A statistically significant improvement was found in all parameters for each group at the 8th week compared to the baseline values (p < 0.05). At the 8th week, there were no statistically significant differences in the severity of incontinence, PFM strength, incontinence episodes, nocturia, number of pads, QoL, treatment satisfaction, cure-improvement, or positive response rates between the two groups (p > 0.05). It was found that the frequency of voiding and symptom severity parameters were significantly more improved in Group 1 than in Group 2 (p < 0.05). Although IVES was more effective in PhA-naive women with iOAB, it also appears to be an effective treatment in the management of women with PhA-resistant iOAB. This study was registered with ClinicalTrials.gov under no. NCT05416450.

Long-term efficacy of the pelvic floor muscle rehabilitation for women with stress urinary incontinence.

Stress urinary incontinence is a common disease with many therapeutic ways, but it lacks long-term follow-up. This study aims to conduct a retrospective study on the long-term efficacy of women with mild and moderate stress urinary incontinence after pelvic floor rehabilitation treatment for 3-years so as to provide a more effective treatment plan for this disease. Data were collected from 279 female patients, who were diagnosed with stress urinary incontinence at the Pelvic Floor Rehabilitation Center of the Third Xiangya Hospital of Central South University from January 2017 to January 2019. All patients received health education and were instructed to perform Kegel exercises for 20 min daily at home. According to the treatment pattern, patients were divided into 3 groups as A, B, and C. Group A (n=94) received pelvic floor biofeedback, electrical stimulation and electroacupuncture; Group B (n=99) received pelvic floor biofeedback and electrical stimulation; Group C (n=86) only got pelvic floor function examinations and did not receive any pelvic floor treatment. The pelvic floor functional examinations included a pelvic floor electrophysiological test, pelvic organ prolapse quantitive examination (POP-Q), and stress urinary incontinence severity assessment. All patients were followed up with questionnaire consisting of the International Committee on Urinary Incontinence Questionnaire-Short Form (ICI-Q-SF) and the Quality of Life questionnaire of Urinary Incontinence (I-QOL) before and after the treatment, as well as at 1-, 2-, and 3-years after the treatment (5 times in total). Among the patients who received the treatment, 43 returned to the hospital, including 21 in group A (Group Areturn) and 22 in group B (Group Breturn). Pelvic floor electrophysiological test and POP-Q were performed on the 2 groups. For the leakage rate at the end of the treatment and the following 1-, 2-, and 3-years: Group A<Group B<Group C, and the recurrence rate of their leakage remained stable after 2 to 3 years of the treatment (P<0.05). Meanwhile, there was no significant difference in the I-QOL scores between Group A and Group B at the end of the treatment (P>0.05), but the I-QOL scores of Group A and Group B were much higher than that in Group C (both P<0.05). On the other hand, the I-QOL scores at 1-, 2-, and 3-years after the treatment were Group A>Group B>Group C (all P<0.05). In addition, the ICI-Q-SF scores at the end of the treatment and 1-, 2-, and 3-years after the treatment were Group A<Group B<Group C (P<0.05). There was also a significant effect of delivery on I-QOL and ICI-Q-SF scores after the treatment (P<0.05). Besides, the production method also had an impact on the ICI-Q-SF scores after the treatment (P<0.05). The results of the re-evaluation showed that there was no significant difference in the anterior vaginal wall prolapse score (point Aa) between Group A return and Group Breturn at the end of the treatment, but 3 years later, the score of anterior vaginal wall prolapse in Group Areturn was less than that in Group Breturn (P<0.05). Besides, no significant difference was found in the pelvic floor muscle strength between Group A return and Group Breturn at the end of the treatment (P>0.05). While the pelvic floor muscle strength in Group Areturn was much higher than that in Group Breturn (P<0.05) after 3 years of the treatment. What's more, the pelvic floor muscle potential in Group Areturn was much higher than that in Group Breturn (both P<0.05) at the end of the treatment and after 3 years of the treatment. Compared with pelvic floor biofeedback and electrical stimulation for stress urinary incontinence, electroacupuncture combined with pelvic floor electrical stimulation and biofeedback reveal more remarkable short-term efficacy and more stable long-term efficacy, which can significantly improve the quality of life in female patients.

Pelvic floor dysfunction and its impact on quality of life among female health care employees.

In today's fast-paced world, both men and women have to be equally competent to handle their responsibilities in order to look after their family members and children. In this pace of competency women tend to forget to take care of their own health and face many health issues, including pelvic floor dysfunction. This study aimed to analyse the prevalence rate of pelvic floor dysfunction among the working women in regards to their age and body mass index as well as their quality of life. One hundred sixty one post-partum working female participants from the medical fraternity were involved in this study after their consent was obtained. Pelvic floor muscle strength was assessed and their quality of life measured using King's health questionnaire. There was a strong correlation between the pelvic floor muscle dysfunction and its impact on the quality of life among the females with increasing age. Significant statistical significant difference of P(<0.0001) was noted. Pelvic floor dysfunction among females has a direct impact on their quality of life.

A solution-based approach to reducing adult sanitary &amp; PPE waste from rest homes in Aotearoa

Aim: This research project aims to explore solutions for minimising landfill contributions from incontinence and personal protective equipment (PPE) waste produced by rest home facilities (both care/support units and retirement villages) in Aotearoa.Research Question: What evidence-based solutions to decrease sanitary and PPE waste exist and can these be applied to rest homes in Aotearoa?&#x0D; Method: A narrative literature review was conducted surrounding PPE and sanitary waste minimisation, alongside interviews with industry representatives and waste experts, to ascertain the practicalities of such solutions in Aotearoa. A waste hierarchy for sanitary waste was created; highly recommended solutions were place at the top and least recommended at the bottom based on factors such as accessibility, environmental impact, and patient wellbeing.&#x0D; Results: The order of these solutions was (from top to bottom): pelvic floor muscle exercises, reusing, recycling, organic ecomposition, landfilling, and incineration. Fewer opportunities were available for waste minimisation of PPE; current alternatives to landfilling include companies such as Future Post (an organisation recycling face masks into functional fence posts). Developing technologies such as the disinfecting and recycling of PPE through Auckland University are emerging, although theyare not currently accessible for public contributions.&#x0D; Conclusion: For both sanitary and PPE waste, the requirement of such products should be minimised where possible (such as through awareness of hand hygiene (PPE) and pelvic floor muscle strength (sanitary waste)). If necessary, reusable rather than single-use products should be applied.&#x0D; Supervised by Ray O'Brien, Head of Sustainability, Sustainability Office, University of Otago and Arveen Horsefield, Arvida.Scholarship funded by: Arvida, Metlife Care, BUPA, Summerset, and Oceania Healthcare

Optimal Duration for Supervised Pelvic Floor Muscle Training in Stress Urinary Incontinence Women: A Prospective Study

Objectives: We evaluated the optimal duration of pelvic floor muscle training (PFMT) in stress urinary incontinence (SUI) patients. Methods: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from November 2018 to June 2019. We recruited 55 subjects diagnosed with SUI based on the questionnaire for urinary incontinence diagnosis (QUID) score &gt;4 and more than 2 grams of 1-hour pad test. Considering the inclusion and exclusion criteria, we taught and supervised them for PFMT and evaluated them every four weeks to observe the urogenital distress inventory-6 (UDI-6), incontinence impact questionnaire-7 (IIQ-7), 1-hour pad test, and perineometer score. We used the Wilcoxon test to evaluate the improvement at a significance level of P&lt;0.05. Results: Our subjects were mostly obese (65%), 30-55 years old (60%), and had &gt;2 children (90%). There were improvements in UDI-6 and IIQ-7 for every four weeks up to 12 weeks of PFMT (P&lt;0.05, 95% CI). Pelvic floor muscle strength only improved significantly (P=0.001 and P=0.006, respectively) after eight weeks of PFMT. Also, the 1-hour pad test score decreased significantly after four weeks of training (P&lt;0.001). Discussion: SUI distress and symptoms decrease after four weeks of Kegel exercises and continue to improve until 12 weeks of therapy. However, the 1-hour pad test reaches clinical and statistical significance during the first month of exercise with no further improvement clinically. Pelvic floor muscle strength increased significantly after eight weeks of training.

Voiding dynamics of pelvic organ prolapse: Large scale comparative study.

To determine the voiding dynamics of the patients with pelvic organ prolapse (POP). A retrospective patient file review was performed of 877 female patients with lower urinary tract symptoms. After exclusion criteria 373 female patients were eligible for the study. Two patient groups w/wo prolapse were identified. The symptoms, patient characteristics, patterns of free urine flow, and detrusor voiding pressure curves were compared between two groups. A comparison of the urodynamic findings between the subgroups (mild/moderate, severe, and w/o prolapse) was made and shown on a scatter plot graphics of Pdet Qmax versus Qmax as well. A total of 373 patients with median age 54 (18-92), 189 (51%) had varying degrees and forms of POP while 184 (49%) did not have any prolapse (p < 0.003). Logistic regression analysis results showed that older age [p = 0.023, odds ratio (OR) = 1.01, confidence interval (CI): (1.00-1.03)], weaker pelvic floor muscle strength [p = 0.032, OR = 1.67, CI: (1.04-2.69)], more frequent symptom of hesitancy [p = 0.003 OR = 2.15 CI: (1.29-3.58)], prolonged-tailed shaped curve pattern of free urine flow [p = 0.027 OR = 1.97 CI: (1.08-3.58)], and higher Pdet Qmax (22 cmH2 O) values [p = 0.002, OR = 1.02, CI: (1.00-1.03)] were the independent different features of the patients with prolapse. Subgroup urodynamic analysis showed significantly lower free flowmetry Qmax and higher Pdet Qmax values in patients with severe prolapse. Prolonged/tailed-shaped curve pattern of free urine flow was significantly more frequent in patients with prolapse. Voiding dynamics of the patients with prolapse were significantly different from the patients' w/o prolapse. They had higher Pdet Qmax values, more frequent symptom of hesitancy, and prolonged shaped free flow curve pattern. Free flow Qmax values were lower in patients with severe prolapse.

Impact of core stability exercises vs. interferential therapy on pelvic floor muscle strength in women with pelvic organ prolapse.

Pelvic organ prolapse (POP) is the descent of the pelvic organs into or through the vaginal walls. Females who have prolapse have symptoms that interfere with their daily lives, sexual function, and exercise. POP can have a negative effect on one's sexuality and body image. This study attempted to assess the significance of core stability exercises vs. interferential therapy on the power of the pelvic floor muscles in females with prolapsed pelvic organs. A randomized control trial was conducted on forty participants (aged between 40-60 years, diagnosed with mild degree pelvic organ prolapse participated in the research. Participants were randomly divided into two groups: (group A; n = 20) and (group B; n = 20). The participants were tested twice, before and after 12 weeks, during which group (A) performed core stability exercises while group (B) received interferential therapy. A modified Oxford grading scale and the perineometer were used to assess how the vaginal squeeze pressure changed. The study's findings demonstrated that the modified Oxford grading scale values and vaginal squeeze pressure had a non-statistically significant difference (p-value ≥ 0.05) between both groups pre-treatment while had a statistically significant difference (p-value ≤ 0.05) between both groups post-treatment in favor of group A. It was concluded that both training programs are efficient at strengthening the pelvic floor muscles, but the core stability exercises were more effective.

A novel radiofrequency modulation therapy versus routine physiotherapy modalities in treatment of myofascial pelvic pain syndrome: a pilot randomized trial.

The current study aimed to compare the effectiveness of novel radiofrequency modulation (RM) therapy with a tailored physiotherapy course for patients with chronic pelvic pain (CPP) of myofascial origin, also known as myofascial pelvic pain syndrome (MPPS). We enrolled 46 patients with myofascial CPP to compare the effectiveness of a 10-session routine physiotherapy course versus a 6-session RM with an integrated device (HIGGS) in alleviating MPPS morbidity and pelvic floor muscle (PFM) rehabilitation. The primary outcome was reduction in pelvic pain after the final session and in the follow-up period 3 months after the final intervention session. The 6-session therapy in the RM group and the manual, biofeedback, and transcutaneous electrical nerve stimulation therapies in the physiotherapy group were similarly effective in reducing pain and improving PFM endurance after the final intervention session in each group, whereas perineometer readings and PFM strength were associated with greater improvements in the physiotherapy group. The results of this study demonstrated comparable effectiveness of RM in the management of MPPS and improvement of PFM function compared to routine physiotherapy programs with fewer sessions of therapy.

Gestational diabetes mellitus and pelvic floor function 6 weeks postpartum in Chinese women.

With the significant increase in its incidence, gestational diabetes mellitus (GDM) has received growing attention for its effect on pelvic floor function. This study was aimed at investigating the association of GDM with pelvic floor function and diastasis recti abdominis (DRA) in postpartum women. This is a retrospective cohort study. At 6 weeks postpartum, 1,133 postpartum women with vaginal delivery underwent routine examinations including measurement of the pelvic floor muscle (PFM) strength and endurance, determination of the stress urinary incontinence (SUI) by questionnaire, quantification of pelvic organ prolapse (POP) and assessment of DRA. Statistical analysis was performed using binary logistic regression and multiple linear regression analysis. One hundred and seventy-six (176) of the 1,133 women were confirmed to be suffering from GDM, with a rate of 15.53% (176 out of 1,133). The age and pre-pregnancy body mass index of the GDM group were significantly higher than those without GDM (p < 0.05). The GDM group was more likely to have smaller gestational age and a higher chance of having to undergo a lateral episiotomy. No statistically significant differences are found in PFM endurance (B: -0.025, p = 0.462) or PFM strength (B: -0.001, p = 0.979) between women with and without GDM. And these two groups are not significantly different in terms of the prevalence of SUI (19.3% vs 20.4%), POP (35.8% vs 37.5%) and DRA (29.0% vs 25.8%; p > 0.05). Pelvic floor muscle function and SUI/POP/DRA prevalence of women at 6 weeks postpartum are not significantly affected by GDM.

Is vitamin D replacement effective in the treatment of postpartum urinary incontinence?

The main objective of this study was to compare the effectiveness of pelvic floor muscle training, and vitamin D replacement in the treatment of urinary incontinence in the postpartum period of pregnant women with vitamin D deficiency. The study was planned as an ancillary study of a study on the determination of the relationship between vitamin D deficiency and urinary incontinence in third-trimester pregnant women. Total 61 women who defined urinary incontinence at postpartum 8th week were included in the study. The participants were divided into two groups: the vitamin D replacement group and the pelvic floor muscle training (PFMT) group. Participants in both groups received appropriate treatment for 12 weeks. İnitial evaluations of which Pelvic Organ Prolapse-Quantification stage, International Consultation on Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) query, and pelvic floor muscle strength were repeated after 12 weeks of treatment for each patient. In the vitamin D replacement group, there was a significant increase in Oxford scores measured after treatment compared with pre-treatment and a significant decrease in ICIQ-FLUTS scores. In the comparison of the groups, it was determined that the changes in the Oxford and ICIQ-FLUTS scores of the vitamin D group after treatment were significantly higher than those of the PFMT group. In this pilot study, it was determined that the effectiveness of vitamin D replacement in the treatment of pelvic floor dysfunction in pregnant women with hypovitaminosis D was significantly higher than PFMT. Vitamin D replacement may be useful in the treatment of urinary incontinence in pregnant women with hypovitaminosis D.

Does a Kegel Exercise Program Prior to Resistance Training Reduce the Risk of Stress Urinary Incontinence?

This comparative pre-post intervention study investigated the feasibility and benefits of Kegel exercises amongst incontinent women, prior to commencing resistance training (RT), to reduce the risk of stress urinary incontinence (SUI) compared to a group of women without prior Kegel exercises (KE). Incontinence severity index (ISI) score, pelvic floor muscle strength (PFMS), and body composition (such as body mass index (BMI), fat, and muscle mass), were obtained pre and post intervention. Results demonstrated that RT reduced SUI to a significantly greater extent only if preceded by KE as was observed in the Kegel exercise plus RT group (KE + RT) over time. The improvements in total ISI in both the KE + RT and RT groups were large (d = 1.50 and d = 1.17 respectively). A two-way ANOVA indicated a statistically significant improvement in average PFMS within the KE + RT group over time and between the two groups. A positive correlation was found between the average strength of pelvic floor muscles and SUI. Participants in KE + RT group demonstrated a significant increase in muscle mass (p ≤ 0.001) and concomitant reduction in fat mass (p = 0.018). This study determined a dedicated program of KE preceding a RT program improved average pelvic floor muscle strength and was effective in reducing SUI among incontinent women.

Foley Balloon Pull Test of Pelvic Floor Muscle Strength.

Methods for pelvic floor muscle (PFM) strength testing are limited by their subjective nature, prohibitive cost, training burden, or lack of validation. The objectives of this study are to validate a new, inexpensive, and accessible method for PFM strength testing using a 30-mL Foley balloon inserted into the vagina, the Foley Balloon Pull Test (FPT), and to demonstrate external validity by comparing the subjective Oxford Muscle Grading Scale (OMGS) scores to measurements obtained with the FPT. Secondary objectives include demonstrating repeatability and internal validity of the FPT. Participants underwent PFM strength testing with the OMGS on a 0 to 5 scale. A gauge was attached to the Foley balloon to measure the force required to remove the balloon from the vagina. Three measures at rest and 3 measures during maximal muscle contraction were recorded. Cross-sectional data were analyzed. One hundred one participants were included; there were no adverse events. The ratio of contraction FPT measurements to at-rest measurements revealed moderate linear and rank order correlation with the OMGS ( R2 = 0.54, P < 0.001, and R2 = 0.58, P < 0.001). The reliability of repeated measurements was highly correlated, with intraclass correlation coefficients >0.95. An FPT ratio of 1.75 discriminated between weak (0-2) and strong (3-5) OMGS scores with an area under the curve of 0.86. The FPT is an internally reliable, simple, and externally valid method of PFM strength testing.

Strength and Bioelectrical Activity of the Pelvic Floor Muscles and Sexual Function in Women with and without Stress Urinary Incontinence: An Observational Cross-Sectional Study.

Stress urinary incontinence (SUI) results from an increase in intravesical pressure, which exceeds the pressure at which the urethra remains closed. Symptoms cause social and sexual intercourse discomfort directly or indirectly, which affect health-related quality of life and are associated with pelvic floor muscle (PFM) dysfunction. We aimed to verify the variation in strength and PFM bioelectrical activity and sexual function in women with SUI. Additionally, we analyzed the impact of this dysfunction on quality of life. This was an observational cross-sectional study. Women aged 25-55 years with frequent sexual intercourse were included. Women with SUI were included in a study group (G2, n = 17), and those without any type of incontinence were included in a control group (G1, n = 16). Primary outcomes were level of strength and PFM bioelectrical activity and sexual function as determinants of worse SUI in the control group. Secondary outcomes were associated between the primary outcomes and severity of urinary loss, impact on daily life, and quality of life in women with SUI. In the domains evaluated in the Female Sexual Function Index (FSFI), only sexual desire was lower in women with SUI (G2) than in the controls (p = 0.033). During analysis of G1 variables, a positive and moderate correlation was observed between power/myoeletric activation and maximum voluntary contraction (MVC) (p &lt; 0.01), peak (p &lt; 0.01), and mean amplitudes (p = 0.017). There was a high positive correlation between sexual arousal and other variables, including vaginal lubrication, sexual orgasm, and total FSFI value (p &lt; 0.001 for all analyses). During evaluation of G2 variables, the MVC was positively correlated with the peak and mean amplitudes (p &lt; 0.0001). Additionally, there was a high and positive correlation between the mean amplitudes (%MVC) and personal relationships (KHQ) (p = 0.001); the same was observed between the total (ICIQ) and activities of daily living (ICIQ) (p &lt; 0.0001). Therefore, women with SUI presented with lower sexual desire and bioelectric activity but were not related to PFM strength. Additionally, the domains of sexual function and certain variables of quality of life are aggravated by SUI.

The Effects of Pelvic Floor Rehabilitation on a Male Patient With Colostomy: A Case Report

The aim of this study was to investigate the effects of pelvic floor muscle training, consisting of pelvic floor muscle exercises and extracorporeal magnetic innervation, on a male patient with colostomy during the preclosure period. A male patient with colostomy (age: 23 years, body mass index: 24.21 kg/m2) was evaluated. The demographic characteristics and medical history of the patient were recorded. Pelvic floor muscle strength and endurance were assessed with anal perineometric sensor. Subjective perception of improvement was assessed with a Likert-type scale and quality of life was assessed with Visual Analog Scale. All assessments were performed before treatment, during the fourth week of treatment, immediately after treatment at 10 weeks, and at 6 weeks postclosure of the colostomy. Pelvic floor muscle exercises and extracorporeal magnetic innervation were applied for 10 weeks. Subjective perception of improvement, pelvic floor muscle strength, and endurance were enhanced but there was no improvement in quality of life from preclosure to the postclosure period. Pelvic floor muscle exercises and extracorporeal magnetic innervation are effective treatments for increasing the pelvic floor muscle strength and endurance and the subjective perception of healing in a patient with colostomy during the preclosure and postclosure periods. There is a need for randomized controlled studies on this subject with larger samples.

Efficacy of Core Strengthening Exercise Program in Postpartum Period - A Narrative Review

Introduction: One of the most eminent phase of women’s life is pregnancy. Pregnancy is a natural physiological process but postnatal complications poses a unique and gender-based challenge for physical therapist. Aim/Objectives: To compare various exercises to strengthen the core muscles after delivery in the postpartum period. Methodology: Total 70 studies were checked and total 39 were not suitable for the study. Total 20 articles were selected which were RCT. Result: It has been reported that the therapeutic exercises can improve lung functions by increasing forced vital capacity and forced expiratory volume. Conclusion: Based on included articles, this study concluded that core strengthening exercise improved strength of pelvic floor muscles, reduced lumbopelvic pain, and improved quality of life in postpartum women.

The Role of Physiotherapy in Parity-Induced Flatus Incontinence: A Case Report

Gas incontinence also known as Flatus incontinence is a common postpartum anal incontinence which impairs social participation and also lacks established protocol of management. Symptom persistency has been reported after perineal muscles repair due to weakness/ loss in function of the pelvic floor muscles. This case report describes about the importance and effectiveness of Pelvic Floor Muscle Rehabilitation (PMR) in a 28year old primiparous woman, four months postpartum who presented with parity-induced flatus incontinence aggravated after sexual activities at a the Physiotherapy clinic of a state government owned hospital located in the south eastern part of Nigeria. Pelvic Muscle Rehabilitation (PMR) and Stabilization exercises were administered thirty minutes (30mins) to forty-five minutes (45mins) three times (3x), a week (1 week) for four weeks (4weeks). There was a significant reduction in Mark’s (Vaizey) score by more than 2 points at the end of the four weeks of physiotherapy intervention and also patient recorded improvement in all the domains of faecal incontinence quality of life scale, pelvic floor muscle strength (anal squeeze pressure) and pelvic floor muscle function (endurance and coordination).

Detection of Occult Anal Sphincter Injuries in Primipara by 2D Transperineal Ultrasound and its Clinical Association: A Cohort Study

Introduction: Endoanal Ultrasound (EAUS), the gold standard for the detection of occult Obstetric Anal Sphincter Injuries (OASI) has limited clinical application due to its intrusiveness and need for specialised equipment and personnel. A 2D Transperineal Ultrasound (TPU) is simple, non invasive and shows a high degree of agreement with EAUS. Few studies have evaluated the use of 2D TPU in determining the incidence and clinical outcomes of occult OASI in primigravida. Aim: To study the incidence, risk factors, and clinical outcome of occult obstetric anal sphincter injury using 2D TPU in primigravida. Materials and Methods: The present cohort study was conducted in the Department of Obstetrics and Gynaecology in collaboration with the Department of Radiology at Guru Teg Bahadur Hospital, Delhi, India, from November 2018 to April 2020. A total of 200 low risk primigravida ≥36 weeks period of gestation underwent baseline TPU of the anal sphincter complex antenatally and on day 2 postpartum. On the basis of difference between pre and postdelivery measurements, they were divided into group I (n=91): women with occult OASI (diagnosed as thinning of the internal and External Anal Sphincter (EAS), interruption in the anal sphincter, alteration in mucosa and half-moon sign) and group II (n=109): no OASI. Group I was followed at two and six weeks postpartum with TPU and clinical tests were applied at 6 weeks to assess clinical outcomes of sphincter injury. Data was analysed using Chi-square test/Fisher’s-exact test for qualitative parameters, Analysis of Variance (ANOVA) for comparison of predelivery and postpartum measurements; and multiple logistic regression for determining sphincter injury determinants. Results: Incidence of occult OASI was 91/200 (45.5%). Significant risk factors for OASI were lower baseline thickness of anal sphincter, position of baby (p=0.028), longer duration of second stage of labour (p&lt;0.001), greater length and angle of episiotomy (p&lt;0.001) and greater baby weight (p=0.042). Group I had significantly lower pelvic floor muscle strength testing score (p&lt;0.001), Digital Rectal Examination Scoring System (DRESS) resting (p=0.013) and squeeze scores (p=0.008), weaker muscle contraction (p&lt;0.001), reduced anal sphincter tone, and was more clinically symptomatic at six weeks postpartum. Conclusion: The technique of 2D TPU is simple and feasible to detect OASI. Women, who sustain OASI, can be followed up in perineal clinic more meticulously, using TPU for pelvic floor rehabilitation.