A Comparison of Pelvic Floor Muscle Exercises and Spinal Stabilization Exercises in Women with Stress Urinary Incontinence

Overview

Journal Int Urogynecol J

Publisher Springer

Specialties Gynecology & Obstetrics
Urology

Date 2024 Nov 19

PMID 39560763

Authors

Esra Bayramoglu Demirdogen

Tufan Ulcay

Muhammet Sahin Bagbanci

Seyda Toprak Celenay

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: The objective was to compare the effects of pelvic floor muscle exercise (PFME) and spinal stabilization exercise (SSE) on urinary symptoms, pelvic floor muscle strength (PFMS), quality of life (QoL), core stability, balance, spinal posture, and perception of subjective improvement (PSI) in women with stress urinary incontinence (SUI).

Methods: Patients were randomly divided into PFME (n = 25) and SSE (n = 25) groups. The exercises of both groups was applied 3 days a week for 8 weeks. Urinary symptoms, PFMS, QoL, core stability, balance, spinal posture, and PSI were assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and pad test, the Modified Oxford Scale (MOS), the King's Health Questionnaire (KHQ), the Sahrmann test, the Biodex Balance System, a Spinal Mouse device, and a Likert-type scale respectively.

Results: The ICIQ-SF, pad test, KHQ, and static balance scores of both groups decreased, whereas the MOS and Sahrmann scores increased (p < 0.05). All balance scores and sacral angles decreased in the SSE group (p < 0.05). The KHQ-Physical and KHQ-Emotional scores decreased more in the PFME group than in the SSE group, whereas core stability increased more and sacral angle decreased more in the SSE group than in the PFME group (p < 0.05). The PSI were similar (p > 0.05).

Conclusion: Both PFME and SSE were effective in improving urinary symptoms, PFMS, QoL, and PSI in women with SUI. SSE was superior to PFME in improving core stability, balance, and sacral position. SSE may be an alternative method in the treatment of SUI.

References

Haylen B, Ridder D, Freeman R, Swift S, Berghmans B, Lee J . An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2009; 29(1):4-20. DOI: 10.1002/nau.20798. View

Hunskaar S, Lose G, Sykes D, Voss S . The prevalence of urinary incontinence in women in four European countries. BJU Int. 2004; 93(3):324-30. DOI: 10.1111/j.1464-410x.2003.04609.x. View

Smith M, Coppieters M, Hodges P . Is balance different in women with and without stress urinary incontinence?. Neurourol Urodyn. 2007; 27(1):71-8. DOI: 10.1002/nau.20476. View

Iguchi S, Inoue-Hirakawa T, Nojima I, Noguchi T, Sugiura H . Relationships between stress urinary incontinence and trunk muscle mass or spinal alignment in older women. Low Urin Tract Symptoms. 2021; 14(1):10-16. PMC: 9290447. DOI: 10.1111/luts.12403. View

Cacciari L, Dumoulin C, Hay-Smith E . Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a cochrane systematic review abridged republication. Braz J Phys Ther. 2019; 23(2):93-107. PMC: 6428911. DOI: 10.1016/j.bjpt.2019.01.002. View

Ghaderi F, Mohammadi K, Amir Sasan R, Niko Kheslat S, Oskouei A . Effects of Stabilization Exercises Focusing on Pelvic Floor Muscles on Low Back Pain and Urinary Incontinence in Women. Urology. 2016; 93:50-4. DOI: 10.1016/j.urology.2016.03.034. View

de Souza Abreu N, de Castro Villas Boas B, Netto J, Figueiredo A . Dynamic lumbopelvic stabilization for treatment of stress urinary incontinence in women: Controlled and randomized clinical trial. Neurourol Urodyn. 2017; 36(8):2160-2168. DOI: 10.1002/nau.23261. View

Khorasani F, Ghaderi F, Bastani P, Sarbakhsh P, Berghmans B . The Effects of home-based stabilization exercises focusing on the pelvic floor on postnatal stress urinary incontinence and low back pain: a randomized controlled trial. Int Urogynecol J. 2020; 31(11):2301-2307. DOI: 10.1007/s00192-020-04284-7. View

Bo K . Physiotherapy management of urinary incontinence in females. J Physiother. 2020; 66(3):147-154. DOI: 10.1016/j.jphys.2020.06.011. View

10.

Kaya D, Ergun N, Hayran M . Effects of different segmental spinal stabilization exercise protocols on postural stability in asymptomatic subjects: randomized controlled trial. J Back Musculoskelet Rehabil. 2012; 25(2):109-16. DOI: 10.3233/BMR-2012-0318. View

11.

Abdel-Fattah M, Barrington J, Youssef M . The standard 1-hour pad test: does it have any value in clinical practice?. Eur Urol. 2004; 46(3):377-80. DOI: 10.1016/j.eururo.2004.04.018. View

12.

Bo K, Sherburn M . Evaluation of female pelvic-floor muscle function and strength. Phys Ther. 2005; 85(3):269-82. View

13.

Kaya S, Akbayrak T, Toprak Celenay S, Dolgun A, Ekici G, Beksac S . Reliability and validity of the Turkish King's Health Questionnaire in women with urinary incontinence. Int Urogynecol J. 2015; 26(12):1853-9. DOI: 10.1007/s00192-015-2786-6. View

14.

Stanton R, Reaburn P, Humphries B . The effect of short-term Swiss ball training on core stability and running economy. J Strength Cond Res. 2004; 18(3):522-8. DOI: 10.1519/1533-4287(2004)18<522:TEOSSB>2.0.CO;2. View

15.

Dumoulin C, Cacciari L, Hay-Smith E . Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018; 10:CD005654. PMC: 6516955. DOI: 10.1002/14651858.CD005654.pub4. View

16.

Nipa S, Sriboonreung T, Paungmali A, Phongnarisorn C . The Effects of Pelvic Floor Muscle Exercise Combined with Core Stability Exercise on Women with Stress Urinary Incontinence following the Treatment of Nonspecific Chronic Low Back Pain. Adv Urol. 2022; 2022:2051374. PMC: 9467742. DOI: 10.1155/2022/2051374. View

17.

Kharaji G, ShahAli S, Ebrahimi-Takamjani I, Sarrafzadeh J, Sanaei F, Shanbehzadeh S . Supervised versus unsupervised pelvic floor muscle training in the treatment of women with urinary incontinence - a systematic review and meta-analysis. Int Urogynecol J. 2023; 34(7):1339-1349. PMC: 9944784. DOI: 10.1007/s00192-023-05489-2. View

18.

Bo K, Morkved S, Frawley H, Sherburn M . Evidence for benefit of transversus abdominis training alone or in combination with pelvic floor muscle training to treat female urinary incontinence: A systematic review. Neurourol Urodyn. 2009; 28(5):368-73. DOI: 10.1002/nau.20700. View

19.

Toprak Celenay S, Balaban M, Kaya D . Lateral abdominal muscle thickness and contractile function in women with and without stress urinary incontinence. Int Urogynecol J. 2023; 35(2):303-309. DOI: 10.1007/s00192-023-05636-9. View

20.

Bush H, Pagorek S, Kuperstein J, Guo J, Ballert K, Crofford L . The Association of Chronic Back Pain and Stress Urinary Incontinence: A Cross-Sectional Study. J Womens Health Phys Therap. 2013; 37(1):11-18. PMC: 3688274. DOI: 10.1097/JWH.0b013e31828c1ab3. View