Dynamic lumbopelvic stabilization for treatment of stress urinary incontinence in women: Controlled and randomized clinical trial

Abreu, Nathalia de Souza; Boas, Bia de Castro Villas; Netto, José Murilo; Figueiredo, André Avarese de

doi:10.1002/nau.23261

Cited by 16 publications

(8 citation statements)

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“…Physical therapy focused on a voluntary contraction of the pelvic floor muscles (PFMs) is considered to be the firstline approach to the prevention and therapeutic management of pelvic floor disorders. [1][2][3] Most training programs focus on aspects of PFM hypertrophy 4 and/or motor control, 5 with training approaches focused on maximal and rapid contractions. 3,4 In 1980, Caufriez hypothesized that because the PFMs are mainly composed of connective tissue 6 and tonic muscle fibers (type I), 7 they might benefit from training through automatic and tonic activation rather than maximal activation.…”

Section: Introductionmentioning

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: Introductionmentioning

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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“…This idea has been supported by the study of Abreu et al, which did not find any differences in symptoms between the SUI group that performed dynamic lumbo-pelvic stabilization compared to the group performed PFM exercise after 5 weeks of training, whereas the stabilization exercise group showed better results in the evaluation after 90 days compared to the other group. 29 This study showed that in both groups, during the Valsalva maneuver and abdominal curl, the amount of bladder base descent did not change post-intervention compared to pre-intervention. In a study by McLean et al, the caudal displacement of the bladder neck, assessed by transperineal ultrasonography (TPUS), did not change during Valsalva maneuvers after PFM training in women with SUI.…”

Section: Interpretation Of Taus Datamentioning

confidence: 62%

The effect of trunk‐stabilizing muscle training in women with stress urinary incontinence: A randomized controlled trial

Fani,

Chitsaz,

Goharpey

et al. 2023

PM&R

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IntroductionThere is little evidence regarding the effect of trunk‐stabilizing muscles training on the improvement of stress urinary incontinence (SUI) symptoms.ObjectiveTo investigate the effect of trunk‐stabilizing muscles training on trans‐abdominal ultrasonography (TAUS) and clinical urological indices, and on the quality of life (QoL) in women with SUI.DesignRandomized controlled trial.SettingA university hospital.ParticipantsForty‐six women with SUI, aged 20‐55 years, were randomly assigned to experimental (n =23) and control group (n =23).InterventionsThe experimental group performed trunk stabilization exercises according to the Sapsford protocol, while the control group performed pelvic floor muscle (PFM) exercises for eight weeks.Main outcome measuresThe primary outcome measure was bladder base displacement (BBD), assessed by TAUS during PFM contraction (PFMC), Valsalva, and abdominal curl. The secondary outcome measures were PFM strength, the severity of urinary incontinence (UI), voiding diary, and QOL, assessed by the Modified Oxford Grading System, the severity index, frequency chart, and lower urinary tract symptoms‐QOL questionnaire respectively. All variables were assessed at baseline and after 8‐weeks of interventions.ResultsThe interaction of group and time wasn't significant for BBD during PFMC (p=0.98), Valsalva (p=0.28), abdominal curl (p=0.34), and secondary variables (p>0.05). The main effect of time was significant in both groups for BBD during PFMC, PFM strength, the severity of UI, voiding diary, and QoL (p<0.001), with effect size (d) of 0.30, 0.80, 2.05, 1.07, 1.03 in the control; and 0.49, 0.52, 1.75, 0.66, 0.88 in the experimental group respectively. The main effect of the group wasn't significant for BBD during PFMC (p=0.68), Valsalva (p=0.22), abdominal curl (p=0.53), and secondary variables (p>0.05).ConclusionsTrunk‐stabilizing muscles training and PFM exercise are equally effective in the improvement of PFM function, UI symptoms, and QOL in women with SUI. Both methods can be used interchangeably by physical therapists.This article is protected by copyright. All rights reserved.

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“…Tonic activation in PFM rehabilitation should begin with tonic activity, as this is often incomplete [ 7 ]. This is different from many other programs for SUI which focus on strong PFM holds (up to 10 s) [ 38 ], and retraining of a tonic PFM action involves very gentle and prolonged muscle holds.…”

Section: Discussionmentioning

confidence: 78%

Six-Week Pelvic Floor Muscle Activity (sEMG) Training in Pregnant Women as Prevention of Stress Urinary Incontinence

et al. 2018

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BackgroundPelvic floor muscle exercises are a widely used and well-established form of stress incontinence treatment, with success rates varying from 21% to 84%, although with a better subjective than objective outcome.Material/Methods“Incontinence Impact Questionnaire” (IIQ), PFM EMG assessment was done at the beginning and after the 6-week training program.ResultsStatistically significant differences appeared in the BASE and R values. In the symptomatic group (with SUI symptoms), the value of BASE was 3.26 μV, and after training it was 3.95 μV. The R values before and after training were 4.55 μV and 4.25 μV. In the symptomatic group (without SUI symptoms), the value of BASE was 2.88 μV and 3.52 μV and R values were 7.16 μV and 3.92 μV. In the control group, BASE was 3.05 μV and 4.11 μV and R was 7.82 μV and 4.39 μV.ConclusionsThe results indicate that a 6-week training process influences PFM EMG activity in pregnant women. During Q, the value of PFM activity after a training session tended to increase in the symptomatic and control groups, but in the symptomatic group it remains practically unchanged. Our results show the probable process of decreasing control of PFM activity during long-lasting contractions in symptomatic and control women. The comparison of BASE before and after training averaged the values of R after five 10-s contractions and showed an increase in the Base and decrease in the R.

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Dynamic lumbopelvic stabilization for treatment of stress urinary incontinence in women: Controlled and randomized clinical trial

Cited by 16 publications

References 30 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

The effect of trunk‐stabilizing muscle training in women with stress urinary incontinence: A randomized controlled trial

Six-Week Pelvic Floor Muscle Activity (sEMG) Training in Pregnant Women as Prevention of Stress Urinary Incontinence

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