Effects of Osteopathic Manipulations and Muscle Training on the Myoelectric Activity of the Pelvic Floor
Condition: Urinary Incontinence
MeSH terms: Urinary Incontinence; Enuresis
Study type: Interventional

Summary: 
      The objective of this study was to compare the effects of four different interventions on
      pelvic floor muscle electromyographic activity in women with stress urinary incontinece: i) a
      global osteopathic protocol (myofascial, visceral, and articular techniques), ii) one
      manipulation technique (high velocity, low amplitude (HVLA)/thrust) of the sacroiliac joint
      and T10-L2, iii) Pelvic Floor Muscle training, and iv) a control group with no intervention.
      The hypothesis is that the global osteopathic protocol and HVLA technique can increase pelvic
      floor muscle electromyographic activity to a level greater than or equal to the standard care
      established in the literature (pelvic floor muscle training).
    

Detailed description: 
      Participants represented a convenience sample and were recruited from hospitals,
      urogynecology doctors' clinics, invitations via social networks, gyms, clubs, and sports
      consultants. Women had to be between 30 and 60 years old and report symptoms of urine loss
      due to exertion in the last six months.The participants were randomly allocated into four
      groups (G1 = intervention using an HVLA/thrust technique for the sacroiliac and T10-L2
      joints, G2 = global osteopathic protocol, G3 = PFT, and G4 = control) by a blinded researcher
      with a spreadsheet of random numbers.The primary outcome measure was surface electromyography
      (EMG) performed at five different times: before the intervention and immediately, 30 minutes,
      60 minutes, and four weeks after. This evaluation was performed by a physiotherapist with ten
      years of experience in urogynecology and expertise in PFM electromyographic evaluation who
      was blinded to the group allocation.
    

Intervention name(s): HVLA; global osteopathic protocol; pelvic floor muscle training
Intervention type(s): Other; Other; Other
Intervention description(s): High velocity, low amplitude manipulation for the sacroiliac joint and T10-L2. The interventions were performed once a week for four weeks by a physiotherapist with a degree in in osteopathy and ten years of clinical experience. Each visit lasted about 5 minutes.; Myofascial, visceral, and articular techniques. Complete treatment in order to restore and rebalance internal tensions and improve the visceral mobility: muscle inhibition techniques for the psoas muscle; deep massage in the obturator foramen; stretching for the greater omentum; lift of the uterus, ovary, and bladder ; abdominal maneuver; and thrust of sacroiliac joint and T12-L1. The interventions were performed once a week for four weeks by a physiotherapist with a degree in in osteopathy and ten years of clinical experience. Each visit lasted about 15 minutes.; Pelvic floor muscle training for four weeks, with a weekly face-to-face visit lasting 10-20 minutes. In this intervention, participants were instructed to perform three sequences of exercises: contractions and relaxations (three seconds of sustained contractions and six seconds of rest), ten sustained contractions (ten seconds of sustained contractions and 20 seconds of rest), and five contractions associated with a cough. These exercises were performed in the standing, sitting, and lying positions
Other intervention name(s): thrust
Allocation: Randomized
Intervention model: Factorial Assignment
Intervention model description: This study randomized 40 women with symptoms of stress uriray incontinence who were divided into four intervention groups of ten women each (G1: only the high velocity, low amplitude manipulation for the sacroiliac joint and T10-L2; G2: global osteopathic protocol with myofascial, visceral, and articular techniques; G3: pelvic floor muscle training; and G4: control).
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: pelvic floor training; osteopathy; urinary incontinence