Pelvic floor muscle training: a practical guide

Okeahialam, Nicola Adanna; Oldfield, M.; Stewart, Ellie; Bonfield, Carol; Carboni, Cristiane

doi:10.1136/bmj-2022-070186

Cited by 3 publications

(5 citation statements)

References 33 publications

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“…The PFMs function through a constant state of muscular activity, maintaining continuous, coordinated and responsive contraction and relaxation to task, alongside passive support from the surrounding tissues and fascia (29,31). For example, in response to increases in intraabdominal pressure, the female PFMs reflexively contract in an upward and forward motion closing the vagina, urethral sphincter, and anal sphincter (29).…”

Section: Anatomy and Physiology Of The Pelvic Floormentioning

confidence: 99%

“…Importantly, both research and clinical experience have highlighted that more than 44% to 70% of females are not recruiting their PFMs correctly (87,88). As a result, supervised PFM assessment and training is recommended as the first line management for symptomatic women (31,39,86). This emphasizes the importance of having a pelvic health physical therapist as part of the sports medicine multidisciplinary team who can conduct the PFM assessment and training.…”

Section: Strength and Conditioning For The Pelvic Floormentioning

confidence: 99%

“…Therefore using exercise prescription principles female athletes should engage in focused PFM training of one to two repetitions of ballistic PFM recruitment alongside three sets of 8 to 12 sustained close to maximum PFM contractions repeated three to four times per week (24). This can be built into a wider training program; however, some athletes may find PFM training more achievable when implemented as a daily habit whereby they engage in three sets of 8 to 12 sustained PFM contractions plus one to two ballistic repetitions everyday (31). Furthermore, there are ample digital applications that could be considered useful within Femtech (93) to prompt reminders and reinforce educational components of PFM training directly from an athletes smart phone or device (94,95).…”

Section: Strength and Conditioning For The Pelvic Floormentioning

confidence: 99%

“…Current understanding of the behavior and functionality of the PFMs is that they respond to movement-related load in an anticipatory and reflexive manner (31). In activities such as running and jumping, studies have demonstrated that there is a lengthening of the PFMs and feed-forward muscle activation prior to an individual making impact with ground.…”

Section: The Pelvic Floormentioning

confidence: 99%

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Sports Medicine and the Pelvic Floor

Donnelly

Moore

2023

Curr Sports Med Rep

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The female athlete is seen as a specialist population meaning female considerations, such as pelvic floor dysfunction, are not widely taught within sports medicine. Females have unique anatomical characteristics compared with males including a wider pelvic diameter and an additional orifice in the form of the vagina. Furthermore, symptoms of pelvic floor dysfunction are prevalent among female athletes and transitional periods in their lifespan. They also are a barrier to training and performance. Therefore, it is essential that sports medicine practitioners understand how to identify and manage pelvic floor dysfunction. This report aims to describe the anatomy and function of the pelvic floor, outline the types and rates of pelvic floor dysfunction, discuss evidence-based management, and raise awareness of perinatal bodily changes. Practical recommendations are made to aid sports organizations and sports medicine practitioners in supporting the female athlete and in using a proactive approach to manage the perinatal athlete.

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Section: Anatomy and Physiology Of The Pelvic Floormentioning

confidence: 99%

Section: Strength and Conditioning For The Pelvic Floormentioning

confidence: 99%

Section: Strength and Conditioning For The Pelvic Floormentioning

confidence: 99%

Section: The Pelvic Floormentioning

confidence: 99%

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Sports Medicine and the Pelvic Floor

Donnelly

Moore

2023

Curr Sports Med Rep

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“…Currently, biofeedback methods are mainly performed in hospitals because they require specialized equipment and techniques. As PFMT needs to be continued mainly at home for continuous training [11], an easy and non-invasive biofeedback method available at home by themselves that can enable the patient to verify the correct PFM contraction in real time is needed.…”

Section: Introductionmentioning

confidence: 99%

Pelvic floor muscle contraction automatic evaluation algorithm for pelvic floor muscle training biofeedback using self-performed ultrasound

Muta,

Takahashi,

Tamai

et al. 2024

BMC Women's Health

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Introduction Non-invasive biofeedback of pelvic floor muscle training (PFMT) is required for continuous training in home care. Therefore, we considered self-performed ultrasound (US) in adult women with a handheld US device applied to the bladder. However, US images are difficult to read and require assistance when using US at home. In this study, we aimed to develop an algorithm for the automatic evaluation of pelvic floor muscle (PFM) contraction using self-performed bladder US videos to verify whether it is possible to automatically determine PFM contraction from US videos. Methods Women aged ≥ 20 years were recruited from the outpatient Urology and Gynecology departments of a general hospital or through snowball sampling. The researcher supported the participants in their self-performed bladder US and videos were obtained several times during PFMT. The US videos obtained were used to develop an automatic evaluation algorithm. Supervised machine learning was then performed using expert PFM contraction classifications as ground truth data. Time-series features were generated from the x- and y-coordinate values of the bladder area including the bladder base. The final model was evaluated for accuracy, area under the curve (AUC), recall, precision, and F1. The contribution of each feature variable to the classification ability of the model was estimated. Results The 1144 videos obtained from 56 participants were analyzed. We split the data into training and test sets with 7894 time series features. A light gradient boosting machine model (Light GBM) was selected, and the final model resulted in an accuracy of 0.73, AUC = 0.91, recall = 0.66, precision = 0.73, and F1 = 0.73. Movement of the y-coordinate of the bladder base was shown as the most important. Conclusion This study showed that automated classification of PFM contraction from self-performed US videos is possible with high accuracy.

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Applications of Nurses and Midwives for Teaching Pelvic Muscle Exercise to Women

BENLİ

ÖZDEMİR

Kulakaç

2023

Samsun Sağlık Bilimleri Dergisi

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Amaç: Bu çalışmanın amacı, Karadeniz bölgesinde yer alan bir ilin devlet ve üniversite hastanesinin kadın doğum kliniklerinde çalışmakta olan sağlık personelinin Pelvik Kas Egzersizi (PKE)’ni bir girişim olarak Hemşirelik Girişimleri Sınıflaması (Nursing Intervention Classification-NIC)’na göre uygulama durumunu belirlemektir. Yöntem: Araştırmanın yöntemi, tanımlayıcıdır. Çalışmanın evrenini, Karadeniz bölgesinde yer alan bir ilin devlet ve üniversite hastanesinin kadın doğum kliniklerinde çalışmakta olan hemşire ve ebeler oluşturmuştur. Çalışmada örneklem seçiminde, anne sütü, kadın 1-2-3, perinatoloji, klinikleri ve kadın doğum kliniği ve doğumhane dahil edilmiş ve örneklem sayısının 73 olmasına karar verilmiştir. Araştırma verilerinin toplanmasında, Kişisel Bilgi Formu ve NIC’in Pelvik Kas Egzersizi Aktiviteleri Formu kullanılmıştır. Formda yer alan 13 tane emredici ifade, ‘….bilgilendiririm…’ ve ‘…öğretirim…’ gibi geniş zaman ifadelerine dönüştürülmüştür. 3’lü Likert tipi Ölçeği’ne dönüştürülen bu form, her bir girişimin sağlık profesyonelleri tarafından uygulama durumunu belirlemede kullanılmıştır. Bulgular: NIC’in PKE Aktiviteleri Formuna göre hemşire ve ebelerin hastalarına pelvik kas egzersizleri girişimlerini uygulanma oranları %4,1-72,6 arasında değişmektedir. “Boşaltım baskısını fark edebilme durumunu belirleme hakkında bireyi bilgilendiririm.” ve “Bireyi, üretra ve anüs etrafındaki kas halkasını, sanki idrar ya da gaitasını tutuyormuş gibi sıkması, sonra gevşetmesi konusunda bilgilendiririm.” girişimlerini birçok kez kullandım/kullanıyorum oranı en yüksek olarak bulunmuştur (her iki girişim için %30,1) ve hiç kullanmadım ifadesine verilen en yüksek oran ise “Kadınları, bir parmaklarını vajinaya koyarak ve sıkarak, Levator ani ve ürogenital kaslarını fark edebilecekleri konusunda bilgilendiririm.” girişimi için %72,6 olarak elde edilmiştir. Araştırmaya katılan hemşire ve ebelerin 8 numaralı girişim için birkaç kez kullandım ifadesine verdiği en yüksek oran ise %54,8’dir. Sonuç: Araştırmanın önemli bir sonucu olarak hemşire ve ebelerin pelvik kas egzersizi girişim basamaklarını hastalarına uygulama oranları 2 madde dışında %30’un altındadır. Pelvik Kas Egzersizi girişimlerinin NIC’e göre uygulanması, uluslararası ebe ve hemşirelik uygulama standartlarına ulaşılmasına ve bu alanda ortak bir dil birliği oluşturulmasına katkı sağlayacaktır. Aynı zamanda bu girişimlerin kullanılması kadın sağlığını geliştirmeye ve kadınların yaşam kalitesinin artırılmasına yardımcı olacaktır.

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Pelvic floor muscle training: a practical guide

Cited by 3 publications

References 33 publications

Sports Medicine and the Pelvic Floor

Sports Medicine and the Pelvic Floor

Pelvic floor muscle contraction automatic evaluation algorithm for pelvic floor muscle training biofeedback using self-performed ultrasound

Applications of Nurses and Midwives for Teaching Pelvic Muscle Exercise to Women

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