The effectiveness of group-based pelvic floor muscle training in preventing and treating urinary incontinence for antenatal and postnatal women: a systematic review

Yang, Xiaowei; Zhang, Aixia; Sayer, Lynn; Bassett, Sam; Woodward, Sue

doi:10.1007/s00192-021-04960-2

Cited by 5 publications

(9 citation statements)

References 44 publications

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“…Group PFMT during pregnancy significantly reduced the prevalence of urinary incontinence during pregnancy (RR 0.67, 95% CI 0.57–0.80, p < 0.00001, I 2 = 0%) 30 and postpartum urinary incontinence (RR 0.66, 95% CI 0.52–0.84, p = 0.0008, I 2 = 0%) 30 …”

Section: Resultsmentioning

confidence: 98%

“…The methodological quality of the reviews was assessed using JBI's Critical Appraisal Checklist for Systematic Reviews and Research Syntheses 27 . Four studies scored the maximum 11/11 points 7,28–30 (see Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…7,28,[32][33][34] Women are encouraged to be physically active and to do aerobic exercise and muscle strengthening activities, including PFMT, to prevent and treat symptoms of the dysfunctions of PFM. [38][39][40] Interestingly, even though exercise is recommended, the interventions in the included reviews 29,30,[33][34][35] focused mainly on PFMT. This is surprising, because it is known that doing solely PFMT does not guarantee that women will be able to control the PFM, for example, while exercising or doing daily activities.…”

Section: Discussionmentioning

confidence: 99%

“…The interventions and the degree of description of the interventions in the reviews were heterogeneous. The exercise protocols varied from solely pelvic floor muscle training (PFMT) 29,30,[33][34][35] to combinations of aerobic exercise and PFMT. 28,32 In 2 reviews, the exercise interventions included various sports, for example, strength training, stretching, or aerobic exercise.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Effectiveness of exercise interventions on urinary incontinence and pelvic organ prolapse in pregnant and postpartum women: umbrella review and clinical guideline development

Ryhtä,

Axelin,

Parisod

et al. 2023

JBI Evidence Implementation

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Introduction and aims: Dysfunction related to pelvic floor muscles (PFM) is common among pregnant and postpartum women and can cause symptoms such as urinary incontinence or pelvic organ prolapse (POP). As part of developing a nationwide clinical practice guideline for nursing in Finland, the aim of this umbrella review is to summarize the existing evidence about the effectiveness of exercise interventions on urinary incontinence and POP in pregnant and postpartum women. To promote knowledge translation, recommendations for health care professionals are presented. Methods: We conducted an umbrella review to summarize the existing evidence. The JBI methodology for umbrella reviews was used to guide the review. The level of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, and recommendations based on the evidence were formulated by a clinical guideline working group. Results: Altogether, 9 systematic reviews, reporting findings from 89 original studies, were included. The methodological quality of the reviews was evaluated using JBI's checklist. The highest level of evidence was found for preventing the symptoms of postpartum urinary incontinence through exercise and pelvic floor muscle training (PFMT) during pregnancy. Moderate-level evidence showed that exercise and PFMT are likely to reduce the symptoms and severity of urinary incontinence, but the level of evidence was low on PFMT reducing the symptoms of POP. Conclusion: We recommend encouraging and guiding pregnant and postpartum women to exercise and train PFM. We also recommend identifying pregnant and postpartum women with symptoms of PFM dysfunction and directing them to a physiotherapist or other health care professional specializing in pelvic floor function.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of exercise interventions on urinary incontinence and pelvic organ prolapse in pregnant and postpartum women: umbrella review and clinical guideline development

Ryhtä,

Axelin,

Parisod

et al. 2023

JBI Evidence Implementation

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“…In the studies included in this review, we observed that they carried out a long-term treatment program (AHLUND et al, 2013;LIN et al, 2020), that there was no change in the periodization of training, which probably may have impacted the results, which could have been even better. The heterogeneity of treatments, in relation to frequency, volume, duration, and time after delivery, has a great impact on treatment outcomes and makes it difficult to analyze and compare outcomes (WOODLEY et al, 2020;YANG et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Physical therapy treatment for pelvic floor strengthening in women after vaginal delivery: A systematic review

Bairrada,

Bardin,

Ferrari

et al. 2023

Innovation in Health Research Advancing the Boundaries of Knowledge

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Introduction: Pregnancy and vaginal birth are considered risk factors for pelvic floor dysfunction (PFD) development, as urinary incontinence (UI), fecal incontinence (FI), pelvic organ prolapse (POP) and sexual dysfunction. Pelvic floor muscle training (PFMT) is a physiotherapeutic resource for PFD treatment, considered UI golden standard treatment with benefits also proven in postpartum women. Though, the lack of standardization of protocols brings gaps in scientific knowledge. Objective: To answer the question “Postpartum pelvic floor muscle training affects pelvic floor muscle strength, urinary function and sexual function?”. Methods: systematic review involving randomized clinical trials. Databases: PubMed, Cochrane Central Register of Controlled Trials, PEDro, LILACS, SciELO, EMBASE e MEDLINE, beyond gray literature. Two reviewers selected the studies through the Rayyan program. Were included studies conducted with primiparous women up to one year after childbirth that used the following resources: vaginal cones or balls, electric stimulation, biofeedback, and PFMT, that have compared resources to usual care, placebo, or other treatment. The risk of bias was assessed using the PEDro Scale by two reviewers. Results: 1.381 articles were found, with 508 duplicates. After titles and abstract reading 79 were included for complete reading, then only eight were included for analysis. Most articles compared PFMT and PFMT instructions. Using the PEDro Scale, three included articles scored 8, one scored 7, one scored 6, two scored 5 and only one study scored 4. The main outcomes assessed were PFM contraction strength, endurance time, UI, and sexual function. Strength was mainly assessed by manometry and Oxford Scale, UI by questionnaires and Pad Test, and sexual function by questionnaires. Five studies showed improvement in PFM strength in the intervention group, two studies showed improvement in UI in the intervention group, and two studies showed improvement in sexual function in the intervention group. Conclusion: PFMT was beneficial for primiparous women up to one year after vaginal delivery, improving PFM strength, UI, and sexual function. Nevertheless, more studies with greater quality and greater homogeneity of the protocols and populations are needed.

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Exercise Testing and Prescription in Pregnancy

Santos-Rocha

Gutiérrez

Szumilewicz

et al. 2022

Exercise and Physical Activity During Pregnancy and Postpartum

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The effectiveness of group-based pelvic floor muscle training in preventing and treating urinary incontinence for antenatal and postnatal women: a systematic review

Cited by 5 publications

References 44 publications

Effectiveness of exercise interventions on urinary incontinence and pelvic organ prolapse in pregnant and postpartum women: umbrella review and clinical guideline development

Effectiveness of exercise interventions on urinary incontinence and pelvic organ prolapse in pregnant and postpartum women: umbrella review and clinical guideline development

Physical therapy treatment for pelvic floor strengthening in women after vaginal delivery: A systematic review

Exercise Testing and Prescription in Pregnancy

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