Pelvic Floor Muscle Training In Women Practicing High-impact Sports:
                    A Systematic Review

Fukuda, Fernanda Sayuri; Arbieto, Eliane Regina Mendoza; Roza, Thuane Da; Luz, Soraia Cristina Tonon da

doi:10.1055/a-1939-4798

Cited by 7 publications

(12 citation statements)

References 48 publications

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“…To our knowledge, this is the first RCT of PFMT in functional fitness exercisers. In a recent systematic review of PFMT in athletic women with SUI, 10 the results from the included studies showed promising results for improving SUI and PFM strength. However, none of the studies included functional fitness exercisers, and most studies were small scaled.…”

Section: Discussionmentioning

confidence: 99%

“…Regular PFMT has been shown to change pelvic floor morphology by increased muscle volume and stiffness, reduced opening of the levator hiatus (the surrounding area where the urethra, vagina and rectum pass through) and elevated resting position of the bladder and rectum 9. Despite a high prevalence of SUI in female strenuous exercisers, the knowledge of treatment options is sparse 10 11. Therefore, the aim of this study was to assess the effects of PFMT on SUI in female functional fitness exercisers.…”

Section: Introductionmentioning

confidence: 99%

“… 9 Despite a high prevalence of SUI in female strenuous exercisers, the knowledge of treatment options is sparse. 10 11 Therefore, the aim of this study was to assess the effects of PFMT on SUI in female functional fitness exercisers.…”

Section: Introductionmentioning

confidence: 99%

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Pelvic floor muscle training in female functional fitness exercisers: an assessor-blinded randomised controlled trial

Skaug,

Engh,

Bø

2024

Br J Sports Med

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ObjectiveStress urinary incontinence (SUI) is common among females during functional fitness training, such as CrossFit. The aim of this study was to assess the effect of pelvic floor muscle training (PFMT) on SUI in female functional fitness exercisers.MethodsThis was an assessor-blinded randomised controlled trial with a PFMT group (n=22) and a control group (n=25). The PFMT group followed a 16-week home-training programme with 3 sets of 8–12 maximum pelvic floor muscle (PFM) contractions daily and weekly follow-up/reminders by phone. The primary outcome was change in a total score of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). The secondary outcomes were perceived change of symptoms of SUI, change of PFM strength measured by vaginal manometry and symptoms of anal incontinence (AI) and pelvic organ prolapse (POP).Results47 women, mean age of 33.5 years (SD: 8.1), participated. At 16 weeks, there was a mean difference between groups of −1.4 (95% CI: −2.6 to −0.2) in the change of the ICIQ-UI-SF score in favour of the PFMT group. The PFMT group completed a mean of 70% (SD: 23) of the prescribed protocol. 64% in the PFMT group versus 8% in the control group reported improved symptoms of SUI (p<0.001, relative risk: 7.96, 95% CI, 2.03 to 31.19). There were no group differences in the change of PFM strength or AI/POP symptoms.ConclusionA 16-week home-training programme of the PFM led to improvements in SUI in female functional fitness exercisers. However, PFM strength and AI and POP symptoms did not improve significantly in the PFMT group compared with the control group.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pelvic floor muscle training in female functional fitness exercisers: an assessor-blinded randomised controlled trial

Skaug,

Engh,

Bø

2024

Br J Sports Med

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“…PFMT is a highly effective, low-risk (level 1A evidence) treatment for UI and POP in community-dwelling women 58 59. Promising preliminary results have also been demonstrated in high-impact athletes however studies to date involved small populations and had a high overall risk of bias 60 61…”

Section: Discussionmentioning

confidence: 99%

Women’s preferences for pelvic floor screening in sport and exercise: a mixed-methods study integrating survey and interview data in Australian women

Dakic,

Hay-Smith,

Lin

et al. 2023

Br J Sports Med

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ObjectivesOne in two women experiencing pelvic floor (PF) symptoms stop playing sport or exercising. The study examines the perspective of women with PF symptoms to inform acceptable screening practices within sport and exercise settings.MethodsExplanatory, sequential, mixed-methods design. Phase 1: survey of 18–65 years, symptomatic, Australian women (n=4556). Phase 2: semistructured interviews with a subset of survey participants (n=23). Integration occurred through connection of phases (study design, sampling) and joint display of data.ResultsFindings are represented in three threads: (1) ‘women (not) telling’; a majority of women had told no-one within a sport or exercise setting about their PF symptoms due to shame/embarrassment, lack of pelvic health knowledge and not wanting to initiate the conversation, (2) ‘asking women (screening for PF symptoms)’; women endorsed including PF symptom questions within existing sport and exercise screening practices but only when conducted in a respectful and considered manner and (3) ‘creating safety’; professionals can assist women to disclose by demonstrating expertise, trustworthiness and competency. If health and exercise professionals are provided with appropriate training, they could raise pelvic health awareness and promote a supportive and safe sport and exercise culture.ConclusionWomen with PF symptoms support health and exercise professionals initiating conversations about PF health to normalise the topic, and include PF symptoms among other pre-exercise screening questions. However, women should be informed on the relevance and potential benefits of PF screening prior to commencing. Safe screening practices require building trust by providing information, gaining consent, displaying comfort and genuine interest, and being knowledgeable within one’s scope of practice to the provision of advice, exercise modifications and referral as appropriate.

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“…Greater adaptations to PFM strength and power may be needed to counteract strain in the passive structures. Indeed, a recent systematic review concluded that athletes with incontinence benefit from PFM training, which decreases the frequency and the amount of leakage, 36 yet it does not eliminate it.…”

Section: Discussionmentioning

confidence: 99%

Differences in pelvic floor muscle morphology and function between female runners with and without running‐induced stress urinary incontinence

Berube,

McLean

2023

Neurourology and Urodynamics

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ObjectiveTo investigate the differences in pelvic floor muscle (PFM) morphology and function between female runners with and without running‐induced stress urinary incontinence (RI‐SUI).DesignThis was a cross‐sectional, observational study.MethodsExperienced female runners were recruited into two groups: runners who regularly experience RI‐SUI (n = 19) and runners who do not (n = 20). Active and passive pelvic floor muscle (PFM) properties were assessed using intravaginal dynamometry during maximal voluntary contractions (MVC) and during passive tissue elongation. The morphology of the urethra and PFMs was assessed using 2D and 3D transperineal ultrasound imaging. Independent t tests or Mann–Whitney U were used as appropriate to test group differences on all study outcomes, and Cohen's d effect sizes were calculated.ResultsThe rate of force development during the MVC was significantly higher in participants reporting RI‐SUI (p ≤ 0.05) and conversely, significantly lower during passive elongation of the PFMs (p ≤ 0.05) compared to runners with no history of leakage. Concurrently, the extent of bladder neck elevation between rest and maximum voluntary activation was significantly higher among those with RI‐SUI compared to those without. Although not significant, small to moderate effect sizes were observed for other outcomes—active force outcomes measured during MVC tended to be higher in runners with RI‐SUI, while passive force outcomes measured during passive tissue elongation tended to be lower. The cross‐sectional area of the urethral wall and the area of the levator hiatus tended to be larger in runners with RI‐SUI compared to those without.ConclusionRunners who experience RI‐SUI demonstrate better PFM contractile function but lower passive support when compared to their continent counterparts.

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Pelvic Floor Muscle Training In Women Practicing High-impact Sports: A Systematic Review

Cited by 7 publications

References 48 publications

Pelvic floor muscle training in female functional fitness exercisers: an assessor-blinded randomised controlled trial

Pelvic floor muscle training in female functional fitness exercisers: an assessor-blinded randomised controlled trial

Women’s preferences for pelvic floor screening in sport and exercise: a mixed-methods study integrating survey and interview data in Australian women

Differences in pelvic floor muscle morphology and function between female runners with and without running‐induced stress urinary incontinence

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