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01-11-2016 | Original Article

Effectiveness of adding voluntary pelvic floor muscle contraction to a Pilates exercise program: an assessor-masked randomized controlled trial

Authors: Luiza Torelli, Zsuzsanna Ilona Katalin de Jarmy Di Bella, Claudinei Alves Rodrigues, Liliana Stüpp, Manoel João Batista Castello Girão, Marair Gracio Ferreira Sartori

Published in: International Urogynecology Journal | Issue 11/2016

Abstract

Introduction and hypothesis

The purpose of this study was to evaluate the effectiveness of adding voluntary pelvic floor muscle contraction (PFMC) to a Pilates exercise program in sedentary nulliparous women.

Methods

Fifty-seven healthy nulliparous and physically inactive women were randomized to a Pilates exercise program (PEP) with or without PFMC. Forty-eight women concluded this study (24 participants for each group). Each woman was evaluated before and after the PEP, by a physiotherapist and an urogynecologist (UG). Neither of the professionals was revealed to them. This physiotherapist measured their pelvic floor muscle strength by using both a perineometer (Peritron) and vaginal palpation (Oxford Scale). The UG, who performed 3D perineal ultrasound examinations, collected their data and evaluated the results for pubovisceral muscle thickness and the levator hiatus area (LA). Both professionals were blinded to the group allocation. The protocol for both groups consisted of 24 bi-weekly 1-h individual sessions of Pilates exercises, developed by another physiotherapist who specializes in PFM rehabilitation and the Pilates technique.

Results

The PEP+ PFMC group showed significantly greater strength improvements than the PEP group when comparing the Oxford scale, vaginal pressure and pubovisceral muscle thickness during contraction measurements at baseline and post-treatment.

Conclusions

Our findings suggest that adding a voluntary PFMC to a Pilates exercise program is more effective than Pilates alone in improving PFM strength in sedentary nulliparous women.

Pilates JH (1998) Your health. Presentation Dynamics, Incline Village, NV

Lysycia J (2005) YogaPilates: a balanced workout for healthy living. Octopus, London, pp 18–21

Ungaro A (2002) Pilates body in motion. Dorling Kindersley, London, pp 8–23

Culligan PJ, Scherer J, Dyer K, Jennifer L, Geri Guingon-White P, Delvecchio D, Vangeli M (2010) A randomized clinical trial comparing pelvic floor muscle training to a Pilates exercise program for improving pelvic muscle strength. Int Urogynecol J 21:401–408CrossRefPubMed

Bo K, Herbert R (2013) There is not yet strong evidence that exercises regimens other than pelvic floor muscle training can reduce stress urinary incontinence in women: a systematic review. J Physiother 59:159–168CrossRefPubMed

Bo K (2004) Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? Int Urogynecol J Pelvic Floor Dysfunct 15(2):76–84CrossRefPubMed

Braekken IH, Majida M, Engh ME, Bø K (2010) Morphological changes after pelvic floor muscle training measured by 3-dimensional ultrasonography: a randomized controlled trial. Obstet Gynecol 115(2 Pt 1):317–324CrossRefPubMed

Dietz HP, Shek C, Clarke B (2005) Biometry of the pubovisceral muscle and levator hiatus by three dimensional pelvic floor ultrasound. Ultrasound Obstet Gynecol 25(6):580–585CrossRefPubMed

Toozs-Hobson P, Khullar V, Cardozo L (2001) Three-dimensional ultrasound: a novel technique for investigating the urethral sphincter in the third trimester of pregnancy. Ultrasound Obstet Gynecol 17:412–424CrossRef

10.

Shek KL, Dietz H-P (2013) Pelvic floor ultrasonography: an update. Minerva Ginecol 65(1):1–20PubMed

11.

Bø K, Finckenhagen HB (2001) Vaginal palpation of pelvic floor muscle strength: inter-test reproducibility and comparison between palpation and vaginal squeeze pressure. Acta Obstet Gynecol Scand 80:883–887CrossRefPubMed

12.

Bø K, Sherburn M (2005) Evaluation of female pelvic-floor muscle function and strength. Phys Ther 85:269–282PubMed

13.

Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310CrossRefPubMed

14.

Bo K, Kvarstein B, Hagen RH et al (1990) Pelvic floor muscle exercise for the treatment of female stress urinary incontinence. II. Validity of vaginal pressure measurements of pelvic floor muscle strength and the necessity of supplementary methods for control of correct contraction. Neurourol Urodyn 9:479–487CrossRef

15.

Bo K (1992) Pressure measurements during pelvic floor muscle contractions: the effects of different positions of the vaginal measuring device. Neurourol Urodyn 11:107–113CrossRef

16.

Da Rozaa T, Mascarenhas T, Araujo M, Trindade V, Natal Jorge R (2013) Oxford Grading Scale vs manometer for assessment of pelvic floor strength in nulliparous sports students. Physiotherapy 99:207–211CrossRef

17.

Key J (2013) “The core”: understanding it, and retraining its dysfunction. J Bodyw Mov Ther 17:541–559CrossRefPubMed

18.

Coleman TJ, Nygaard IE, Holder DN et al (2015) Intra-abdominal pressure during Pilates: unlikely to cause pelvic floor harm. Int Urogynecol J 26:1123–1130CrossRefPubMedPubMedCentral

19.

Queiroz B, Cagliari M, Amorim C et al (2010) Muscle activation during four Pilates core stability exercises in quadruped position. Arch Phys Med Rehabil 91(1):86–92

20.

Critchley DJ, Pierson Z, Battersby G (2001) Effect of Pilates mat exercises and conventional exercise programmes on transversus abdominis and obliquus internus abdominis activity: pilot randomized trial. Man Ther 16(2):183–189CrossRef

21.

Stüpp L, Resende AP, Petricelli CD, Nakamura MU, Alexandre SM, Zanetti MR (2011) Pelvic floor muscle and transversus abdominis activation in abdominal hypopressive technique through surface electromyography. Neurourol Urodyn 30:1523–1526CrossRef

22.

Resende APM, Stüpp L, Bernardes BT, Oliveira E, Castro RA, Girão MJBC, Sartori MGF (2012) Can hypopressive exercises provide additional benefits to pelvic floor muscle training in women with pelvic organ prolapse? Neurourol Urodyn 31:121–125CrossRefPubMed

23.

Bernardes BT, Resende APM, Stüpp L et al (2012) Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial. Sao Paulo Med J 130(1):5–9CrossRefPubMed

24.

Sapsford R, Hodges P (2001) Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med Rehabil 82:1081–1088CrossRefPubMed

25.

DeLancey JO, Low LK, Miller JM, Patel DA, Tumbarello JA (2008) Graphic integration of causal factors of pelvic floor disorders: an integrated life span model. Am J Obstet Gynecol 199:610–615CrossRefPubMedPubMedCentral

Title: Effectiveness of adding voluntary pelvic floor muscle contraction to a Pilates exercise program: an assessor-masked randomized controlled trial
Authors: Luiza Torelli
Zsuzsanna Ilona Katalin de Jarmy Di Bella
Claudinei Alves Rodrigues
Liliana Stüpp
Manoel João Batista Castello Girão
Marair Gracio Ferreira Sartori
Publication date: 01-11-2016
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 11/2016
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-016-3037-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effectiveness of adding voluntary pelvic floor muscle contraction to a Pilates exercise program: an assessor-masked randomized controlled trial

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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