Can hypopressive exercises provide additional benefits to pelvic floor muscle training in women with pelvic organ prolapse?

Resende, Ana Paula Magalhães; Stüpp, Liliana; Bernardes, Bruno Teixeira; Oliveira, Emerson; Castro, Rodrigo Aquino; Girão, Manoel Joâo Batista Castello; Sartori, Marair Grácio Ferreira

doi:10.1002/nau.21149

Cited by 55 publications

(70 citation statements)

References 18 publications

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“…Resende et al 13 reported results from a single‐blinded clinical trial where 58 women diagnosed of mild pelvic organ prolapse received a physical therapy treatment based on PFM exercises alone or combined with HEs. The PFM exercises significantly increased PFM strength, endurance, neuromuscular activation, 13 and thickness 14 regardless of whether or not women also performed HEs. Despite these results, HEs are currently being advocated by many clinicians for the treatment of pelvic floor dysfunctions in women.…”

Section: Discussionmentioning

confidence: 99%

Pelvic floor and abdominal muscle responses during hypopressive exercises in women with pelvic floor dysfunction

Navarro-Brazález

Sánchez

Prieto-Gómez

et al. 2020

Neurourology and Urodynamics

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Aim: To measure the neuromuscular activation of the pelvic floor and abdominal muscles concurrently with vaginal closure forces induced during a hypopressive exercise (HE) and to identify the contribution of the HEs sequences (posture and maneuver) in the muscle's activation. Methods:A cross-sectional study design was employed. Sixty-six women who had participated in a physical therapy program focused on HEs were recruited.Pelvic floor muscle (PFM) activation was measured using surface electromyography (sEMG) in supine and in the orthostatic position, and vaginal closure force was measured through vaginal dynamometry in supine. Activation of the abdominal, gluteal, and hip adductor muscles was measured using sEMG. Maximum effort voluntary contractions (MVCs) of the PFMs and reference contractions of the abdominal and hip muscles were acquired for normalization purposes. A HE was then performed in a supine position with one leg raised, then in an orthostatic position. Results: During the supine HE, the peak PFM sEMG amplitude was 74.4% to 86.5% (49.6%-109.6%) of MVC, the peak vaginal closure force was between 51.2% and 55.7% (95.5%-382.9%) of MVC, and the muscles of the lateral abdominal wall were activated between 25.4% and 35.3% of the reference contraction. During the orthostatic HE, PFM activation was 61.4% (40.1%-105.6%) of MVC, and the lateral abdominal wall muscles contracted at 22.8% of the reference activation level.Conclusions: The PFMs, abdominal, gluteal, and adductor muscles are activated during the performance of a HE. The activation level of the PFMs and abdominal muscles is likely insufficient to result in strength gains; however, they could have an endurance effect. K E Y W O R D Sdeep abdominal muscles, hypopressive exercises, pelvic floor dysfunction, pelvic floor muscles strength, surface electromyography, therapeutic exercise

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Section: Discussionmentioning

confidence: 99%

Pelvic floor and abdominal muscle responses during hypopressive exercises in women with pelvic floor dysfunction

Navarro-Brazález

Sánchez

Prieto-Gómez

et al. 2020

Neurourology and Urodynamics

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“…Few runners practiced exercises to strengthen their pelvic floor, but still showed good electrical activity in the maximal voluntary contraction. In a study of Resende et al [14], which examined 28 nulliparous volunteers, found MVC 99.8 mV, a result very similar to that of runners from more than 25 km (91.08 mV). In our sample of runners, no significant differences were observed between the groups in relation to pubovisceral muscle injuries or its thickness.…”

Section: Discussionmentioning

confidence: 71%

“…SEMG has been used to evaluate pelvic muscle activation patterns in women with urinary incontinence and genital prolapse, both in maximum voluntary contraction (MVC) and in Valsalva [13,14]. However, there are no studies in the literature comparing 3DUS and SEMG for pelvic floor evaluations on female runners.…”

Section: Introductionmentioning

confidence: 99%

Assessment of pelvic floor of women runners by three-dimensional ultrasonography and surface electromyography. A pilot study

et al. 2014

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Aim: To evaluate female runners' pelvic floor muscles using three-dimensional ultrasonography (3DUS) and surface electromyography (SEMG). Material and methods: A cross-sectional study was conducted on 24 female runners. SEMG was performed using surface electrodes inserted in the vagina. 3DUS was performed using perineal convex transducer. SEMG was evaluated at rest and with maximum voluntary contraction (MVC) and slow contraction. Levator ani muscle thickness, levator hiatus area and the angle between the levator muscles at rest and with MVC and Valsalva were evaluated using 3DUS. The women were divided into two groups (women running ≤ 25 km/week; women running > 25 km/week). Means, standard deviations and non-paired t tests were used for both groups. Results: Among the 24 women, 11 ran ≤ 25 km/week (16.91 ± 4.13 km/week) and 13 ran > 25 km/week (40.77 ± 1.15 km/week). The mean SEMG at rest and with MVC and slow contraction were 16.25, 65.86 and 71.41 mV, respectively. For the levator hiatus area at rest and with MVC and Valsalva, the means were 12.54, 10.06 and 16.57 cm2, respectively. Correlations between 3DUS and SEMG showed significant differences in SEMG at rest and levator thickness with Valsalva (r = 0.46; p = 0.04). Conclusions: 3DUS and SEMG are two feasible methods for evaluating female runners' pelvic floor. Correlations between 3DUS and SEMG showed significant differences in SEMG at rest and levator thickness with Valsalva.Keywords: pelvic floor, women runners, three-dimensional ultrasound, surface electromyography.Assessment of pelvic floor of women runners by three-dimensional ultrasonography and surface electromyography. A pilot study.

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“…The first did not find any acute effect of adding AHT to PFMT on PFM maximal voluntary contraction, endurance and muscle activation 8. The RCT followed 58 women with stage II POP in a 12 weeks’ intervention of adding AHT to PFMT.…”

Section: What Is the Aht And How Should It Work?mentioning

confidence: 98%

“…Let’s consider the two studies on the effect of the AHT for pelvic floor dysfunction: one experimental study8 and one RCT 9. The first did not find any acute effect of adding AHT to PFMT on PFM maximal voluntary contraction, endurance and muscle activation 8.…”

Section: What Is the Aht And How Should It Work?mentioning

confidence: 99%

Is abdominal hypopressive technique effective in the prevention and treatment of pelvic floor dysfunction? Marketing or evidence from high-quality clinical trials?

Martín-Rodríguez¹,

Bø

2017

Br J Sports Med

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Can hypopressive exercises provide additional benefits to pelvic floor muscle training in women with pelvic organ prolapse?

Abstract: Adding hypopressive exercises to PFMT does not improve PFM function. Both treatment groups performed better than the control group.

Cited by 55 publications

References 18 publications

Pelvic floor and abdominal muscle responses during hypopressive exercises in women with pelvic floor dysfunction

Pelvic floor and abdominal muscle responses during hypopressive exercises in women with pelvic floor dysfunction

Assessment of pelvic floor of women runners by three-dimensional ultrasonography and surface electromyography. A pilot study

Is abdominal hypopressive technique effective in the prevention and treatment of pelvic floor dysfunction? Marketing or evidence from high-quality clinical trials?

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