This study evaluated if imagining interrupting the flow of urine really elicits contractions of the pelvic floor muscles (PFM) in stress-incontinent postpartum women.
Methods:
A total of 21 postpartum women with recent vaginal deliveries performed four trials of Kegel’s exercises, each prompted by a different contraction technique. PFM activities were measured with a surface electromyography via a vaginal electrode. Inferential statistics of repeated-measures one-way analysis of variance with Bonferroni post hoc analysis were performed to compare the effective recruitment of the PFMs across the four trials.
Results:
PFM activities significantly varied across the four trials (p<0.001), with ‘imagination of interrupting urine flow’ eliciting the least muscular activity (25.40±10.98) and ‘abdominal bracing with hip adduction’ elicited the highest activity (49.67±11.33).
Conclusion:
Findings showed that utilizing many contraction techniques during Kegel’s education is more effective compared to educating patients with one contraction technique.
HelenAC. Digital assessment of the pelvic floor muscles: a neglected technique, https://www.womenshealthcare.com (2018, accessed 16 July 2020).
2.
ParkS-HKangC-B. Effect of Kegel exercises on the management of female stress urinary incontinence: a systematic review of randomized controlled trials. Adv Nurs2014; 2014: 640262.
3.
KegelAH. Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gynecol1948; 56: 238–249.
4.
SampselleCMMillerJMMimsB. Effect of pelvic muscle exercise on transient incontinence during pregnancy and after birth. Obstet Gynecol1998; 91: 406–412.
5.
MasonLGlennSWaltonI, et al. The instruction in pelvic floor exercises provided to women during pregnancy or following delivery. Midwifery2001; 17: 55–64.
6.
BumpRCHurtWGFantlJA, et al. Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol1991; 165: 322–329.
7.
OjukwuCPOjukwuCSOkemuoAJ, et al. Contraction techniques adopted for pelvic floor muscle exercise education by Nigeria-based physiotherapists: a preliminary study. Niger J Med 2021; In press.
8.
HirschAWeirauchGSteimerB, et al. Treatment of female urinary incontinence with EMG-controlled biofeedback home training. Int Urogynecol J1999; 10: 7–10.
9.
KandadaiPO’DellKSainiJ. Correct performance of pelvic muscle exercises in women reporting prior knowledge. Female Pelvic Med Reconstr Surg2015; 21: 135–140.
10.
MiqueluttiMACecattiJGMakuchMY. Evaluation of a birth preparation program on lumbopelvic pain, urinary incontinence, anxiety and exercise: a randomized controlled trial. BMC Preg Childbirth2013; 13: 154.
11.
CohenJ. Statistical power analysis for behavioural sciences. 2nd ed.Hillsdale, NJ: Lawrence Erlbaum Associates, 1998.
12.
HajebrahimiSNourizadehDHamedaniR, et al. Validity and reliability of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and its correlation with urodynamic findings. Urol J2012; 9: 685–690.
13.
SlavinVGambleJCreedyDK, et al. Perinatal incontinence: psychometric evaluation of the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form and Wexner Scale. Neurourol Urodyn2019; 38: 2209–2223.
14.
NeumannPGillV. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J2002; 13: 125–132.
15.
SapsfordRHodgesP. Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med Rehab2001; 82: 1081–1088.
16.
EsentiniGEl DibRRighessoLAR, et al. Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis. Clinics2019; 74: e1319.
17.
AmorimACCacciariLPPassaroAC, et al. Effect of combined actions of hip adduction/abduction on the force generation and maintenance of pelvic floor muscles in healthy women. PLoS One2017; 12: e0177575.
18.
CorreiaGNFerreiraCHJAveiroMC, et al. Pelvic floor muscle training decreases hip adductors isometric peak torque in incontinent women: an exploratory study. Fisioter Mov (Impr)2013; 26: 183–190.
19.
BumpRCMattiassonABøK, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol1996; 175: 10–17.
20.
SteinMDiscippioWDaviaM, et al. Biofeedback for the treatment of stress and urge incontinence. J Urol1995; 153: 641–643.
21.
BoKIngeborgHBMajidaM, et al. Constriction of the levator hiatus during instruction of pelvic floor or transversus abdominis contraction: a 4D ultrasound study. Int Urogynecol J2009; 20: 27–32.
22.
FerlaLDarskiCPaivaLL, et al. Synergism between abdominal and pelvic floor muscles in healthy women: a systematic review of observational studies. Fisioter Mov (Impr)2016; 29: 399–410.
23.
NeelsHDe WachterSWyndaeleJJ, et al. Common errors made in attempt to contract the pelvic floor muscles in women early after delivery: a prospective observational study. Eur J Obstet Gynecol Reprod Biol2018; 220: 113–117.
24.
FrankDLKhorshidLKifferJF, et al. Biofeedback in medicine: who, when, why and how?Ment Health Fam Med2010; 7: 85.
25.
MorinMCarrollM-SBergeronS. Systematic review of the effectiveness of physical therapy modalities in women with provoked vestibulodynia. Sex Med Rev2017; 5: 295–322.
26.
PereiraVMeloMCorreiaG, et al. Vaginal cone for postmenopausal women with stress urinary incontinence: randomized, controlled trial. Climacteric2011; 15: 45–51.
