The Effects of Training by Virtual Reality or Gym Ball on Pelvic Floor Muscle Strength in Postmenopausal Women: a Randomized Controlled Trial

Overview

Journal Braz J Phys Ther

Specialty Rehabilitation Medicine

Date 2016 Jul 21

PMID 27437716

Citations 10

Authors

Natalia M Martinho

Valeria R Silva

Joseane Marques

Leonardo C Carvalho

Denise H Iunes

Simone Botelho

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the effectiveness of abdominopelvic training by virtual reality compared to pelvic floor muscle training (PFMT) using a gym ball (a previously tested and efficient protocol) on postmenopausal women's pelvic floor muscle (PFM) strength.

Method: A randomized controlled trial was conducted with 60 postmenopausal women, randomly allocated into two groups: Abdominopelvic training by virtual reality - APT_VR (n=30) and PFMT using a gym ball - PFMT_GB (n=30). Both types of training were supervised by the same physical therapist, during 10 sessions each, for 30 minutes. The participants' PFM strength was evaluated by digital palpation and vaginal dynamometry, considering three different parameters: maximum strength, average strength and endurance. An intention-to-treat approach was used to analyze the participants according to original groups.

Results: No significant between-group differences were observed in most analyzed parameters. The outcome endurance was higher in the APT_VR group (p=0.003; effect size=0.89; mean difference=1.37; 95% CI=0.46 to 2.28).

Conclusion: Both protocols have improved the overall PFM strength, suggesting that both are equally beneficial and can be used in clinical practice. Muscle endurance was higher in patients who trained using virtual reality.

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References

Morin M, Dumoulin C, Bourbonnais D, Gravel D, Lemieux M . Pelvic floor maximal strength using vaginal digital assessment compared to dynamometric measurements. Neurourol Urodyn. 2004; 23(4):336-41. DOI: 10.1002/nau.20021. View

Madill S, Pontbriand-Drolet S, Tang A, Dumoulin C . Effects of PFM rehabilitation on PFM function and morphology in older women. Neurourol Urodyn. 2013; 32(8):1086-95. DOI: 10.1002/nau.22370. View

Marques J, Botelho S, Pereira L, Lanza A, Amorim C, Palma P . Pelvic floor muscle training program increases muscular contractility during first pregnancy and postpartum: electromyographic study. Neurourol Urodyn. 2012; 32(7):998-1003. DOI: 10.1002/nau.22346. View

Sapsford R, Hodges P . Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med Rehabil. 2001; 82(8):1081-8. DOI: 10.1053/apmr.2001.24297. View

Alves F, Riccetto C, Adami D, Marques J, Pereira L, Palma P . A pelvic floor muscle training program in postmenopausal women: A randomized controlled trial. Maturitas. 2015; 81(2):300-5. DOI: 10.1016/j.maturitas.2015.03.006. View

Botelho S, Martinho N, Silva V, Marques J, Alves F, Riccetto C . Abdominopelvic kinesiotherapy for pelvic floor muscle training: a tested proposal in different groups. Int Urogynecol J. 2015; 26(12):1867-9. DOI: 10.1007/s00192-015-2699-4. View

Botelho S, Pereira L, Marques J, Lanza A, Amorim C, Palma P . Is there correlation between electromyography and digital palpation as means of measuring pelvic floor muscle contractility in nulliparous, pregnant, and postpartum women?. Neurourol Urodyn. 2012; 32(5):420-3. DOI: 10.1002/nau.22321. View

Hay-Smith J, Herderschee R, Dumoulin C, Herbison P . Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women: an abridged Cochrane systematic review. Eur J Phys Rehabil Med. 2012; 48(4):689-705. View

Botelho S, Martinho N, Silva V, Marques J, Carvalho L, Riccetto C . Virtual reality: a proposal for pelvic floor muscle training. Int Urogynecol J. 2015; 26(11):1709-12. DOI: 10.1007/s00192-015-2698-5. View

10.

Madill S, McLean L . Relationship between abdominal and pelvic floor muscle activation and intravaginal pressure during pelvic floor muscle contractions in healthy continent women. Neurourol Urodyn. 2006; 25(7):722-30. DOI: 10.1002/nau.20285. View

11.

Junginger B, Seibt E, Baessler K . Bladder-neck effective, integrative pelvic floor rehabilitation program: follow-up investigation. Eur J Obstet Gynecol Reprod Biol. 2014; 174:150-3. DOI: 10.1016/j.ejogrb.2013.12.022. View

12.

Bo K, Hilde G . Does it work in the long term?--A systematic review on pelvic floor muscle training for female stress urinary incontinence. Neurourol Urodyn. 2012; 32(3):215-23. DOI: 10.1002/nau.22292. View

13.

Pereira V, Escobar A, Driusso P . Effects of physical therapy in older women with urinary incontinence: a systematic review. Rev Bras Fisioter. 2012; 16(6):463-8. DOI: 10.1590/s1413-35552012005000050. View

14.

Quartly E, Hallam T, Kilbreath S, Refshauge K . Strength and endurance of the pelvic floor muscles in continent women: an observational study. Physiotherapy. 2010; 96(4):311-6. DOI: 10.1016/j.physio.2010.02.008. View

15.

Marques A, Stothers L, Macnab A . The status of pelvic floor muscle training for women. Can Urol Assoc J. 2010; 4(6):419-24. PMC: 2997838. DOI: 10.5489/cuaj.10026. View

16.

Elkins M, Moseley A . Intention-to-treat analysis. J Physiother. 2015; 61(3):165-7. DOI: 10.1016/j.jphys.2015.05.013. View

17.

Dumoulin C, Hay-Smith E, Habee-Seguin G . Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2014; (5):CD005654. DOI: 10.1002/14651858.CD005654.pub3. View

18.

Elliott V, de Bruin E, Dumoulin C . Virtual reality rehabilitation as a treatment approach for older women with mixed urinary incontinence: a feasibility study. Neurourol Urodyn. 2014; 34(3):236-43. DOI: 10.1002/nau.22553. View

19.

Morin M, Dumoulin C, Gravel D, Bourbonnais D, Lemieux M . Reliability of speed of contraction and endurance dynamometric measurements of the pelvic floor musculature in stress incontinent parous women. Neurourol Urodyn. 2007; 26(3):397-403. DOI: 10.1002/nau.20334. View

20.

KEGEL A . Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gynecol. 1948; 56(2):238-48. DOI: 10.1016/0002-9378(48)90266-x. View