Pelvic floor muscle function in women with urinary incontinence treated with different therapeutic techniques: A pre-post randomized controlled pilot study.

BACKGROUND

Studies have suggested abdominal hypopressive technique (AHT) as a therapeutic approach to treat urinary incontinence (UI) and improve pelvic floor muscle (PFM) strength. This controlled pilot study, using a pre-post-test design in three different groups, investigated the maximal voluntary contraction (MVC) and the vaginal resting pressure (VRP) of PFM before and immediately after three therapeutic training sessions: of a) PFM training (PFMT), b) AHT, or c) AHT associated with MVC of the PFM (AHT + MVC), in upright and lying positions among women with UI. Additionally, the study investigated if there was a difference in VRP or MVC values when measured at lying or upright positions.

METHODS

The ICIQ-UI-SF questionnaire was used to assess UI symptoms. Seventeen incontinent women (13 with mixed UI, 3 with stress UI, and 1 with urgency UI) were randomized to one of the 3 therapeutic training groups. Peritron® manometer was used to assess the VRP and MVC measurements. All participants were evaluated both in the lying and upright position, before and after a 40-min training session.

RESULTS

Immediately after the training session, the values of MVC decreased significantly in all groups in the lying position (mean difference of 34.2, 30.5, and 28.4 for PFMT, AHT and AHT + MVC, respectively). In the upright position, the values of MVC decreased significantly for PFMT and AHT + MVC groups (mean difference of 34.7 and 41.8, respectively), indicating PFM fatigue. In the upright position, the AHT group had the lowest VRP values after the training, suggesting no change in muscle tone.

CONCLUSION

The significant reduction in the MVC, especially in upright position, in the groups who performed PFM contraction, provides data for a specific PFM strengthening. The AHT group was also the one who had the lowers VRP values after the training, suggesting no change in muscle tone. These findings suggest that isolated work on the AHT may not be effective to training the PFM.

CLINICAL TRIALS REGISTER NUMBER: BLINDED.