Pelvic floor muscle exercise and training for coping with urinary incontinence

The pelvic floor consists of levator ani muscles including puborectalis, pubococcygeus and iliococcygeus muscles, and coccygeus muscles. Pelvic floor muscle exercise (PFME) is defined as exercise to improve pelvic floor muscle strength, power, endurance, relaxation, or a combination of these parameters. PFME strengthens the pelvic floor muscles to provide urethral support to prevent urine leakage and suppress urgency. This exercise has been recommended for urinary incontinence since first described by Kegel. When treating urinary incontinence, particularly stress urinary incontinence, PFME has been recommended as first-line treatment. This article provides clinical application of PFME as a behavioral therapy for urinary incontinence. Clinicians and physical therapist should understand pelvic floor muscle anatomy, evaluation, regimen, and instruct patients how to train the muscles properly.

Comparative Study on the Effects of Pelvic Floor Muscle Exercises and Abdominal Muscle Training in Functional Constipation among Children

To compare the effects of pelvic floor muscle exercise and abdominal muscle training, breathing exercises and abdominal massage in children with functional constipation. Functional constipation is one the most common gastrointestinal condition in pediatrics practice with an estimation prevalence ranging from 0.7% to 29.6%. It has a multifactorial pathophysiology mainly consisting of stool with holding and delayed colonic transit.30 subjects who met theRome-III criteriafor pediatric functional constipationwere randomly divided into 2 groups. Group-A was trained with pelvic floor muscle exercise along with squat walking for 5 min under supervision of parents. Exercise duration was increased 5 min per week, for two consecutive weeks and remained the same for the next six weeks and Kegels was performed for 10 seconds. Group-B was given isometric training of the abdominal muscle which was carried out in two ways. The patient was either lying down in a left lateral decubitus position with the hip and knee flexed at 90° with two series of eight contractions and relaxations until the third week and was then increased to two series of 12 contractions and relaxations for 6 weeks. In the sitting or lying down method, training began with one series of three contractions and relaxations lasting 10 s which was increased to five repetitions in the third week until the sixth week along with abdomen tuck-in exercise. Diaphragmatic breathing and abdominal massage was given to both groups in common. The intervention of the study was about 8 weeks.Results of statistical analysis showed that both Pelvic Floor Muscle Exercises and Abdominal Muscle Training are effective in treating functional constipation among children. However pelvic floor muscle exercise was better than abdominal muscle training on the basis of Wexner Construction Scoring System

Assessment of Efficacy of Pelvic Floor Muscle Exercise (PFME) on Urinary Incontinence among Middle Aged Women

Background: Urinary incontinence (UI) is a familiar manifestation that can affect women of all ages, with a wide range of severity and nature. While rarely life-threatening, incontinence may seriously influence the physical, psychological and social wellbeing of affected individuals. Objective: The main objective of the study is to assess the effectiveness of pelvic floor muscle exercises (PFME) or Kegel’s exercise on urinary incontinence among middle aged women of selected urban community of Raipur (C.G). Methodology: A community based quazi - experimental study was conducted among 60 middle aged women having mild to moderate degree of urinary incontinence. The sample were selected by nonrandomised purposive technique The baseline data were collected from 60 samples (30 in experimental group and 30 in control group) by standardised tool - Questionnaire for urinary incontinence diagnosis (QUID) on urinary incontinence. The experimental group was taught to practise Kegel’s exercise for 4 week followed by post- test of both control & experimental group to compare the data for effectiveness. Results: Comparison of mean and SD of pre-test and post-test level of urinary incontinence among middle aged women in experimental group & control group (un paired t -test) showed that the calculated value (2.1) of t was higher than the table value (2) at 0.05 level which shows that PFME is effective in improving symptoms of urinary incontinence if practised on regular basis. Factors positively associated with urinary incontinence were parity, type of delivery and nature of work. Conclusion: Middle aged women with urinary incontinence will be greatly benefitted with regular pelvic floor muscle exercise. Health care practitioner should train & educate them on correct ways of performing Kegel’s exercise at community level.

PELVIC FLOOR MUSCLE EXERCISE AND PHYSICAL THERAPY MAY IMPROVE SYSTEMIC SCLEROSIS-ASSOCIATED FECAL INCONTINENCE

Gastrointestinal involvement in systemic sclerosis (SSc) is observed in up to 90% of patients. Resolution of some of these gastrointestinal complications is challenging without the support of physical therapy and rehabilitation. One of these complications, SSc-associated fecal incontinence, which can be devastating for those affected, is seen in up to 39%. Studies focusing on fecal incontinence and its treatment are scarce. The hypothesis presented herein suggests that pelvic floor muscle exercise, biofeedback therapy, and neuromodulation methods might be effective and safe treatment strategies for patients affected by this debilitating complication.

Advanced Care Planning Information and Public Institutions of Higher Education

This review was designed to identify behavior change techniques used to enhance pelvic floor muscle exercise (PFME) interventions to prevent and treat urinary incontinence among women. A systematic search of peer-reviewed literature was conducted to identify interventions for adult women to address UI with PFME. A taxonomy of BCTs was used to code intervention content. Ten articles were retrieved. Across the ten interventions, 111 BCTs were described, and 34 unique BCTs were identified. The most frequently coded BCTs included Instruction on how to perform the behavior (BCT 4.1; n=10 studies), Demonstration of the behavior (BCT 6.1; n=9 studies), Behavioral practice/rehearsal (BCT 8.1; n=9), and Credible source (BCT 9.1; n=9 studies). Specific findings indicate that a core intervention of four techniques is commonly used, and supported by complementary techniques from the categories feedback and monitoring as well as goals and planning.