International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training

Bø, Kari; Anglès‐Acedo, Sònia; Batra, Achla; Brækken, Ingeborg Hoff; Chan, Yi Ling; Ferreira, Cristine Homsi Jorge; Kruger, Jennifer; Yadav, Manisha; Dumoulin, Chantale

doi:10.1007/s00192-022-05324-0

Cited by 23 publications

(24 citation statements)

References 89 publications

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“…Pelvic floor muscle training has level 1/recommendation A to be effective in the treatment of UI and POP [55][56][57]. We have not found any RCTs or studies using other designs investigating the effect of PFMT on POP in women who engage in regular physical exercise or those who engage in heavy lifting or strenuous physical work.…”

Section: The Postpartum Periodmentioning

confidence: 99%

Strenuous physical activity, exercise, and pelvic organ prolapse: a narrative scoping review

et al. 2023

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Introduction and hypothesis High-intensity physical activity and exercise have been listed as possible risk factors for pelvic organ prolapse (POP). The aim of the present study is to conduct a literature review on the prevalence and incidence of POP in women who engage in regular physical activity. In addition, we review the effects of a single exercise or a single session of exercise on pelvic floor support. Finally, the effect of exercises on POP in the early postpartum period is reviewed. Methods This is a narrative scoping review. We searched PubMed and Ovid Medline, the Physiotherapy Evidence Database (PEDro), and the Cochrane Database of Systematic Reviews up to May 2022 with the following MeSH terms: “physical activity” AND “exercise” AND “pelvic floor” AND “pelvic organ prolapse”. Results Eight prevalence studies were retrieved. Prevalence rates of symptomatic POP varied between 0 (small study within different sports) and 23% (Olympic weightlifters and power lifters). Parity was the only factor associated with POP in most studies. Three studies evaluated the pelvic floor after a single exercise or one session of exercise and found increased vaginal descent or increased POP symptoms. One prospective cohort study reported the development of POP after 6 weeks of military parashot training, and one randomized trial reported increased POP symptoms after transverse abdominal training. There is scant knowledge on exercise and POP in the postpartum period. Conclusions Prevalence of POP in sports varies widely. Experimental and prospective studies indicate that strenuous exercise increased POP symptoms and reduced pelvic floor support.

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Section: The Postpartum Periodmentioning

confidence: 99%

Strenuous physical activity, exercise, and pelvic organ prolapse: a narrative scoping review

et al. 2023

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“…One study did specific PFMT as part of a Pilates class in addition to PFMT home training [ 23 ]. This study was presented and classified as PFMT by the authors and the results have been reported elsewhere [ 2 ]. Four studies (two reporting data on different outcome measures from the same study) compared PFMT with hypopressive exercise [ 10 , 24 – 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…To date there is 1A level/recommendation for PFMT as first-line treatment for POP [ 1 , 2 ]. No adverse effects have been reported from PFMT.…”

Section: Discussionmentioning

confidence: 99%

“…To date there has been a grade A recommendation based on level 1 evidence on pelvic floor muscle training (PFMT) being an effective treatment in reducing symptoms and stages of pelvic organ prolapse (POP) [ 1 , 2 ]. Understanding of how and why PFMT is effective in the treatment of both stress urinary incontinence (SUI) and POP is based on the anatomical, biomechanical, and exercise science rationale for actions during a single PFM contraction and the effects of doing regular PFMT over time [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In parallel to the anatomical, biomechanical, and exercise science rationale and evidence from RCTs and systematic review of PFMT for POP [ 1 , 2 ], there are suggestions in the literature that other exercise programs or techniques may have an equal or better effect than PFMT [ 10 , 11 ]. In addition, there is significant and recurrent exposure of other exercise programs or techniques, especially hypopressive exercise, on social media channels (such as YouTube, Instagram, and TikTok) advertising and selling exercise programs to treat POP [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Are hypopressive and other exercise programs effective for the treatment of pelvic organ prolapse?

et al. 2022

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Introduction and hypothesis Pelvic floor muscle training (PFMT) is effective for the treatment of pelvic organ prolapse (POP), but other exercise programs have also been promoted and used. The aim of this review was to evaluate the effect of hypopressive and other exercise programs besides PFMT for POP. Methods A literature search was conducted on Ovid Medline, EMBASE, CINAHL, Cochrane, PEDro, and Scopus databases from January 1996 to 30 December 2021. Only randomized controlled trials (RCTs) were included. The keywords were combinations of “pelvic organ prolapse” or “urogenital prolapse,” and “exercise therapy,” “hypopressive exercise,” “Kegel,” “pelvic floor muscle training,” “pelvic floor muscle exercises,” “Pilates,” “treatment,” “yoga,” “Tai Chi.” Methodological quality was assessed using the PEDro rating scale (0–10). Results Seven RCTs containing hypopressive exercise, yoga or breathing and hip muscle exercises in an inverted position were retrieved and analyzed. PEDro score ranged from 4 to 7. There was no additional effect of adding hypopressive exercise to PFMT, and PFMT was more effective than hypopressive exercise alone. The studies that included the term “yoga” included regular PFMT and thus can be classified as PFMT. Hip exercises in an inverted position added to PFMT vs PFMT alone showed better improvement in some secondary outcomes but not in the primary outcome, POP stage. Conclusions There are few RCTs assessing the effects of other exercise programs besides PFMT in the treatment of POP. To date, there is no evidence that other exercise programs are more effective than PFMT for POP.

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Can you breathe yourself to a better pelvic floor? A systematic review

Bø

Driusso

Ferreira

2023

Neurourology and Urodynamics

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Introduction: Some authors suggest that breathing exercises should be recommended instead of or in combination with pelvic floor muscle training (PFMT) to prevent and treat urinary incontinence (UI) and pelvic organ prolapse (POP). Aims: The primary aim of the present study was to investigate the evidence for breathing as an intervention alone or in addition to PFM contraction in treatment of UI and POP.Materials & Methods: This systematic review included short-term experimental studies and randomize controlled trials (RCTs) indexed on PubMed, EMBASE, and PEDro database. A form was used to extract data that was analyzed qualitatively due to the heterogeneity in interventions and outcome measures of the included studies. The individual methodological quality of RCTs was analyzed using the PEDro scale. Results: A total of 18 studies were included, 374 participants from short-term experimental studies and 765 from nine RCTs. PEDro score varied from 4 to 8.Activation of the PFM during expiration was significantly less than during a PFM contraction. In general, the RCTs showed that training the PFM is significantly more effective to improve PFM variables and UI and POP than breathing exercises, and that adding breathing exercises to PFMT have no additional effect. Conclusion: This systematic review indicates that the evidence for incorporating breathing exercise in clinical practice in addition to or instead of PFMT is scant or non-existing, both based on short-term experimental studies and small RCTs.

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International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training

Cited by 23 publications

References 89 publications

Strenuous physical activity, exercise, and pelvic organ prolapse: a narrative scoping review

Strenuous physical activity, exercise, and pelvic organ prolapse: a narrative scoping review

Are hypopressive and other exercise programs effective for the treatment of pelvic organ prolapse?

Can you breathe yourself to a better pelvic floor? A systematic review

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