Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jan;34(1):43-52.
doi: 10.1007/s00192-022-05407-y. Epub 2022 Nov 23.

Are hypopressive and other exercise programs effective for the treatment of pelvic organ prolapse?

Kari Bø  1   2 , Sònia Anglès-Acedo  3 , Achla Batra  4 , Ingeborg H Brækken  5   6 , Yi Ling Chan  7 , Cristine Homsi Jorge  8 , Jennifer Kruger  9 , Manisha Yadav  10 , Chantale Dumoulin  11
Affiliations
Review

Are hypopressive and other exercise programs effective for the treatment of pelvic organ prolapse?

Kari Bø et al. Int Urogynecol J. 2023 Jan.

Abstract

Introduction and hypothesis: Pelvic floor muscle training (PFMT) is effective for the treatment of pelvic organ prolapse (POP), but other exercise programs have also been promoted and used. The aim of this review was to evaluate the effect of hypopressive and other exercise programs besides PFMT for POP.

Methods: A literature search was conducted on Ovid Medline, EMBASE, CINAHL, Cochrane, PEDro, and Scopus databases from January 1996 to 30 December 2021. Only randomized controlled trials (RCTs) were included. The keywords were combinations of "pelvic organ prolapse" or "urogenital prolapse," and "exercise therapy," "hypopressive exercise," "Kegel," "pelvic floor muscle training," "pelvic floor muscle exercises," "Pilates," "treatment," "yoga," "Tai Chi." Methodological quality was assessed using the PEDro rating scale (0-10).

Results: Seven RCTs containing hypopressive exercise, yoga or breathing and hip muscle exercises in an inverted position were retrieved and analyzed. PEDro score ranged from 4 to 7. There was no additional effect of adding hypopressive exercise to PFMT, and PFMT was more effective than hypopressive exercise alone. The studies that included the term "yoga" included regular PFMT and thus can be classified as PFMT. Hip exercises in an inverted position added to PFMT vs PFMT alone showed better improvement in some secondary outcomes but not in the primary outcome, POP stage.

Conclusions: There are few RCTs assessing the effects of other exercise programs besides PFMT in the treatment of POP. To date, there is no evidence that other exercise programs are more effective than PFMT for POP.

Keywords: Exercise; Hypopressive; Kegel; Pelvic floor muscle training; Physical therapy; Pilates.

PubMed Disclaimer

Conflict of interest statement

None.

References

    1. Dumoulin C, Adewuyi T, Booth J, et al. Adult conservative management. In: Abrams P, Cardozo L, Wagg A, Wein A, et al., editors. 6th International Consultation on Incontinence. ICI-ICS. Bristol: International Continence Society; 2017. pp. 1443–1628.
    1. Bø K, Anglès-Acedo S, Batra A, et al. International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: pelvic floor muscle training. Int Urogynecol J. 2022;33(10):2633–2667. doi: 10.1007/s00192-022-05324-0. - DOI - PMC - PubMed
    1. Bø K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(2):76–84. doi: 10.1007/s00192-004-1125-0. - DOI - PubMed
    1. Bø K. Physiotherapy management of urinary incontinence in females. J Physiother. 2020;66(3):147–154. doi: 10.1016/j.jphys.2020.06.011. - DOI - PubMed
    1. Braekken IH, Majida M, Engh ME, Bo K. Test-retest reliability of pelvic floor muscle contraction measured by 4D ultrasound. Neurourol Urodyn. 2009;28(1):68–73. doi: 10.1002/nau.20618. - DOI - PubMed