The Effects of the Pelvic Floor and Abdominal Muscle Training on Urinary Incontinence
Condition: Urinary Incontinence
MeSH terms: Urinary Incontinence; Enuresis
Study type: Interventional

Summary: 
      To investigate the effects of the pelvic floor and abdominal muscle training on the severity
      of incontinence in women with stress and mixed urinary incontinence.
    

Detailed description: 
      The aim of this study is to investigate the effect of incontinence severity on the pelvic
      floor and abdominal muscle strengthening training in women with stress urinary incontinence
      (UI). Sixteen patients with stress and mixed UI were included in the study. According to the
      24-hour pad test (24hPT), individuals were divided into two groups as group 1 (24hPT 4-20gr,
      mild group, n: 9) and group 2 (24hPT 21g and above in 24hPT, moderate-severe group, n: 7).
      Pelvic floor muscle training (PFMT) and abdominal muscle training were applied to the groups
      for 6 weeks.

      PFMT was given as a home-based exercise program to increase pelvic floor muscle (PFM)
      strength and endurance. Before starting the program, PFM was taught first schematically and
      then by the biofeedback method. It was ensured that the patient learned the PFM. Fast and
      slow pelvic floor contractions were taught for both type 1 and type 2 muscle fibres. For slow
      contractions, it was asked to gradually contract in 5 seconds, wait at a maximum of 5 seconds
      and gradually relax in 5 seconds. For fast contractions, it was asked to contract at a
      maximum of 2 seconds and then to relax. Patients were asked to perform 10 slow contractions
      after every 10 rapid contractions. 10 fast + 10 slow contractions were accepted as 1 set
      exercise. Subjects were asked to make 10 sets every day for 6 weeks.

      Strengthening exercises for transversus abdominus and internal obliques abdominus muscles
      were given as a home program and the details were written below:

      Transversus Abdominus: Patients were in the crook lying position and were asked to contract
      their abdominal muscles strongly and statically. Fifteen repetitions were carried out; each
      one consisting of contraction for 10 s followed by relaxation for 20 s. After 15 repetitions,
      patients rested for 5 min. The sequence was then repeated for two sets of 15 repetitions.

      Internal Obliquus Abdominus: Patients were in the crook lying position and were asked to
      contract their abdominal muscles strongly and statically and then try to touch the furthest
      point of their legs with their fingertips for 15 repetitions consisting of contraction for 10
      s followed by relaxation for 20 s. After 15 repetitions, patients rested for 5 min. The
      sequence was then repeated on the other leg.

      Urinary incontinence, pelvic floor muscle strength measurement, quality of life, symptom, and
      the presence of pelvic floor dysfunction were evaluated respectively using 24hPT,
      Electromyography (EMG) Biofeedback device, King's Health Questionnaire, Urogenital Distress
      Inventory, and Global Pelvic Floor Bother Questionnaire. Evaluations were performed at the
      beginning and at the end of the physiotherapy program, and a subjective improvement rate was
      determined.
    

Intervention name(s): Exercises Training
Intervention type(s): Other
Intervention description(s): Pelvic Floor Muscle Training: For slow contractions, it was asked to contract in 5 seconds gradually, wait at a maximum of 5 seconds and gradually relax in 5 seconds. For fast contractions, it was asked to contract at a maximum of 2 seconds and then to relax. 10 fast + 10 slow contractions were accepted as 1 set exercise. (10 sets x Every Day x 6 weeks)
Transversus Abdominus: Patients were in the crook lying position and were asked to contract their abdominal muscles strongly and statically. 15 repetitions were carried out, each consisting of contraction for 10 s and relaxation for 20 s. 2 sets of 15 repetitions were done.
Internal Obliquus Abdominus: Patients were in the crook lying position and were asked to contract their abdominal muscles strongly and statically and then try to touch the furthest point of their legs with their fingertips for 15 repetitions consisting of contraction for 10 s followed by relaxation for 20 s. The sequence was then repeated on the other leg.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Rectus Abdominus; Pelvic Floor Muscle Training; Stress Urinary Incontinence; Quality of Life; Biofeedback; Home Exercises