The effects of an 8-week hypopressive exercise training program on urinary incontinence and pelvic floor muscle activation: A randomized controlled trial

Abstract

Background: Pelvic floor dysfunction and urinary incontinence are two of the most frequent gynecological problems, and pelvic floor muscle training is recommended as a first-line treatment, with new approaches such as hypopressive exercises. This study aimed to analyze the efficacy of an 8-week supervised training program of hypopressive exercises on pelvic floor muscle strength and urinary incontinence symptomatology.

Design: Blinded randomized controlled trial.

Settings: Women with pelvic floor dysfunction and urinary incontinence symptoms, aged 18-60 years.

Participants: A total of 117 participants were randomly allocated to the hypopressive exercises group (n = 62) or a control group that received no intervention (n = 55) and completed the study.

Main outcome measures: Clinical and sociodemographic data were collected, as well as pelvic floor muscle strength (using the Modified Oxford Scale); the genital prolapse symptoms, colorectal symptoms, and urinary symptoms (with the Pelvic Floor Distress Inventory [PFDI-20]); the impact of pelvic floor disorders (PFD) on women's lives (with the Pelvic Floor Impact Questionnaire [PFIQ-7]); and the severity of urinary incontinence symptoms (using the International Consultation on Incontinence Questionnaire [ICIQ]).

Results: The results showed an improvement in the hypopressive group in the pelvic floor muscle strength F (1117) = 89.514, p < 0.001, a significantly lower score for the PFIQ7 total score, t (112) = 28.895, p < 0.001 and FPDI20 t (112) = 7.037, p < 0.001 as well as an improvement in ICIQ-SF values after 8 weeks of intervention in comparison with the control group.

Conclusions: After performing an 8-week of hipopressive exercises intervention, a decrease in pelvic floor disorders associated symptoms can be observed. In addition, pelvic floor muscle contractility is improved and a decrease in severity and symptoms associated with urinary incontinence has been reported.

Keywords: hypopressive exercise; pelvic floor muscle; pelvic floor muscle training; pelvic organ prolapse; urinary incontinence.

Figure 1

Fypopressive exercise poses

Figure 2

Flow chart of participant's allocation

Figure 3

Modified Qxford Scale change scores

Figure 4

Inter‐ and intragroup comparison regarding the impact of pelvic floor dysfunctions on quality of life PFIQ‐7 and subscales (UIQ7, CRAIQ7 y POPIQ7). CRAIQ7, Colorectal‐Anal Impact Quessionnery; PFIQ7, Plevic Floor Impact Quessionnery Sort Form; POPIQ7, Pelvice Qrgan Prolapse Impact Quessionnaire; UIQ7, Urinary Incountinence Impact Questionnairy. **p < 0.01, ***p < 0.001.

Figure 5

Inter‐ and intragroup comparison of severity and symptoms associated with urinary incontinence on women's quality of life ICIQSF: international Consultation on Incontinence Questionnaire_Urinary Incontinence Short Form.***p < 0.001.