Ability to contract the pelvic floor muscles and association with muscle function in incontinent women
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ORIGINAL ARTICLE
Ability to contract the pelvic floor muscles and association with muscle function in incontinent women Fátima Faní Fitz 1 & Letícia Missen Paladini 1 & Letícia de Azevedo Ferreira 1 & Márcia Maria Gimenez 1 & Maria Augusta Tezelli Bortolini 1 & Rodrigo Aquino Castro 1 Received: 16 April 2020 / Accepted: 23 July 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis Many women with pelvic floor dysfunction are unable to perform pelvic floor muscle (PFM) contraction. We aimed to assess the ability to contract the PFM and to evaluate the association with muscle function in Brazilian women with urinary incontinence. Methods We conducted a retrospective cross-sectional study including incontinent women over the age of 18. The assessment of PFM contraction was carried out by bidigital palpation via the PERFECT scheme. We categorized our population as: group absent: women not able to contract the PFM with verbal instructions; group 1 (1st command): women able to contract their PFM after verbal instructions; group 2 (2nd command): women who needed additional training on PFM anatomy and functioning to contract them. We compared the groups regarding their PFM functionality. We used ANOVA for demographic data and MannWhitney test for association analyses and P value < 0.05 for statistical significance. Results Among 139 women included, 21 (15.1%) were not able to perform the contraction of the PFM. Sixty-five (46.7%) contracted their PFM voluntarily at the first command and 53 (38.1%) at the second command. There was a significant reduction in the PFM function in group 2 in terms of power (p < 0.001), endurance (p < 0.001) and fast contraction (p < 0.001) compared to group 1. Conclusion A high percentage (53.2%) of women were not able to contract their PFM voluntarily without training in PFM anatomy and functioning. Those women had impaired muscle function compared to women able to perform PFM after receiving exclusively oral instructions. Keywords Motor skills . Pelvic floor . Physical fitness . Urinary incontinence
* Fátima Faní Fitz [email protected] Letícia Missen Paladini [email protected] Letícia de Azevedo Ferreira [email protected] Márcia Maria Gimenez [email protected] Maria Augusta Tezelli Bortolini [email protected] Rodrigo Aquino Castro [email protected] 1
Department of Gynaecology, Federal University of São Paulo, Rua Napoleão de Barros, 608 – Vila Clementino, São Paulo, SP CEP 04024-002, Brazil
Abbreviations ANOVA analysis of variance model BMI body mass index ES electrical stimulation ICS International Continence Society IUGA International Urogynecological Association MUI mixed urinary incontinence OAB Overactive bladder PFM pelvic floor muscle PFMT pelvic floor muscle training PT physical therapist SUI stress urinary incontinence UUI urgency urinary incontinence
Introduction Urinary incontinence affects women of various ages, and it has a great impact on quality of life. The rates vary between 10
Int U
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