The role of vaginal palpation in motor learning of the pelvic floor muscles for women with stress urinary incontinence: study protocol for a randomized controlled trial

Abstract

Background: Approximately 30 to 50% of women are unable to correctly perform pelvic floor muscle (PFM) contractions. For women to benefit from a pelvic floor muscle training (PFMT) programme for stress urinary incontinence (SUI), the awareness phase of PFMT cannot be omitted. The purpose of this study is to evaluate whether vaginal palpation together with verbal instructions about PFMs and body awareness techniques helps women with SUI learn how to correctly contract the PFMs and improve their functions. Methods: This single-centre, double-blind randomized controlled trial with two intervention groups was designed following the standard protocol items for randomized interventional trials (SPIRIT). The results will be reported in a manner consistent with the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Patients with SUI (n = 172) will be recruited. The experimental group will receive verbal instructions about PFM function and body awareness techniques together with vaginal palpation; the control group will receive similar protocol without vaginal palpation. The primary outcome includes the number of fast-twitch muscle fibres assessed by vaginal palpation and visual observation. Secondary outcomes include power and muscular endurance that will be assessed by visual observation and vaginal palpation (Oxford scale), the use of accessory muscles during the voluntary contraction of PFMs, and the self-efficacy and the expectations for the results using the self-efficacy scale of pelvic floor exercises. Discussion: This study will determine whether vaginal palpation can help women with SUI to correctly perform PFM contractions and improve their functions. Trial registration: ClinicalTrials.gov NCT 03325543. Registered on 30 November 2017. Study protocol version 1; 30 November 2020. Prospectively registered.

Avaliacao de mulheres com incontinencia urinaria de acordo com a Classificacao Internacional de Funcionalidade, Incapacidade e Saude - CIF

“…Entretanto, aproximadamente 30 a 50% das mulheres são incapazes sequer de realizar corretamente as contrações dos músculos do assoalho pélvico, mesmo depois de terem sido instruídas 14 . Portanto, existe uma necessidade de se avaliar melhor todas as funções envolvidas na IU para que o programa de treino seja de fato efetivo.…”

The effects of one‐time soft tissue therapy on pelvic floor muscle electromyographic signals in women with urinary incontinence: A randomized intervention trial

“…Before the intervention, all participants received 30 min teaching session which consisted of (1) information about the anatomy and function PFM; (2) verbal instructions on how to correctly localize and activate PFM without synergistic muscles activation and breath holding; and (3) biofeedback training of correct PFM activation with the intravaginal probe (based on motor learning concepts related to the PFMs 22 ). The physiotherapist gave instructions about the location of the PFM with anatomical figures and muscle function was explained verbally.…”