A randomised interventional parallel study to evaluate the effect of different frequencies of pelvic floor muscle exercises with core stabilisation using three-dimensional ultrasound: the PELSTAB study
Abstrakt
INTRODUCTION AND HYPOTHESIS: The primary objective was to compare high- and low-frequency pelvic floor muscle training (PFMT) with the impact on urinary incontinence episode frequency over 1 week (IEF/week). The secondary objective was to compare the two groups with regard to pelvic floor muscle function, morphometry, incontinence quality of life, and patient global impression.
METHODS: This was a randomised parallel controlled study. The setting was regional gynaecological and urological outpatient clinics.
The subjects consisted of a sample of 86 women with stress urinary incontinence (SUI). Group A underwent high-frequency PFMT and group B underwent low-frequency PFMT for 12 weeks.
We recorded the IEF/week. The International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) was used.
Pelvic floor muscle function was evaluated using a perineometer. Pelvic floor muscle morphometry was evaluated with 3D/4D ultrasound.
The Urinary Incontinence Quality of Life Scale (I-QoL) was used. RESULTS: Significant differences between group A and B after treatment (p<0.001) were noted in favour of group A in IEF/week (group A 10.2+-7.0/2.3+-3.0 vs group B 9.3+-4.7/6.3+-4.9), in the ICIQ-UI SF (group A 9.7+-3.0/3.7 +- 3.6 vs group B 9.9+-3.2/9.4+-3.4).
Significant differences between groups A and B after treatment were noted in favour of group A for pelvic floor muscle function in terms of maximal voluntary contraction and its duration, and also for pelvic floor muscle morphometry in terms of a reduction of the hiatal area during rest, contraction, and the Valsalva manoeuvre. CONCLUSIONS: High-frequency PFMT for 12 weeks significantly decreased IEF/week in comparison with low-frequency PFMT.
In the high-frequency exercise group, women had significantly better pelvic floor muscle function, morphometry and quality of life than the low-frequency exercise group.