Re: Resende et al. Pelvic floor muscle training is better than hypopressive exercises in pelvic organ prolapse treatment: An assessor‐blinded randomized controlled trial

Can abdominal hypropressive technique improve stress urinary incontinence? an assessor‐blinded randomized controlled trial

“…22 In fact, AHT do not request direct PFM contraction, but its activation is believe to be due the movement of full expansion of the rib cage during contraction of inspiratory musculature (eg, serratus anterior, sternocleidomastoid, and scalene) and this movement is also known as diaphragmatic aspiration. 6,7 Other studies have demonstrated similar results. Resende et al 10 conducted a study comparing PFM function, measured by vaginal palpation and surface electromyography, of women with pelvic organ prolapse who were randomized to PFMT or AHT and found that women of PFMT group had greater improvement.…”

“…These results can be explained by the fact of strength gain is directly related to specificity of the training 22 . In fact, AHT do not request direct PFM contraction, but its activation is believe to be due the movement of full expansion of the rib cage during contraction of inspiratory musculature (eg, serratus anterior, sternocleidomastoid, and scalene) and this movement is also known as diaphragmatic aspiration 6,7 …”

“…Question 5 evaluates how much the urinary loss interferes in the woman's everyday life on a scale of 0 to 10, in which 0 represents not at all and 10 represents a great deal. 18 Using the total score value, it is possible to classify UI as mild (1-5), moderate (6)(7)(8)(9)(10)(11)(12), severe (13)(14)(15)(16)(17)(18), or very severe (19)(20)(21). 19 PFM evaluation was performed using vaginal palpation and manometry.…”

“…They also supposedly decrease intra‐abdominal pressure. According to Rebulido and Chulvi‐Medrano, 7 they are a progressive and rhythmic sequence of postural stretching poses associated with a specific breathing technique and, according to authors, this is the most important during technique execution: three controlled lateral costal breaths followed by a low pulmonary volume breath hold where full expansion of the rib cage is performed by inspiratory muscle contraction (eg, serratus anterior, sternocleidomastoid, and scalene). This maneuver (breath‐hold with complete rib cage expansion) also known as diaphragmatic aspiration 7 …”

“…This maneuver (breathhold with complete rib cage expansion) also known as diaphragmatic aspiration. 7 According Caufriez 5 and Rebulido e Pinash 6 the main indications AHT are to treat diastasis recti in the postpartum period, to improve lower back pain, to treat pelvic organ prolapse and UI. 5,6 Regarding to prolapse, available evidence does not support its indication, [8][9][10] however, when it comes to SUI, no studies were found favorable or not to its indication.…”