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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

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Abstract

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.

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Acknowledgements

The authors are grateful to all patients who participated in this study.

Author information

Authors and Affiliations

  1. Department of Physiatry, Balneology, and Medical Rehabilitation, Institution - Faculty of Medicine, PJ Safarik University, Kosice, Slovakia

    Magdaléna Hagovská

  2. Urogynecology and Physiotherapy in gynecology and urology, Institution - Clinic Centrum s.r.o., Kosice, Slovakia

    Magdaléna Hagovská & Peter Urdzík

  3. Department of Urology, Institution - Jessenius Faculty of Medicine, Martin, Comenius University Bratislava, Bratislava, Slovakia

    Ján Švihra

  4. Department of Gynecology and Obstetrics, Institution - Faculty of Medicine, PJ Safarik University, Kosice, Slovakia

    Peter Urdzík

  5. Institute of Physiotherapy, Balneology and Medical Rehabilitation, Faculty of Health Sciences, University of Ss. Cyril and Methodius in Trnava, Trnava, Slovakia

    Eva Vaská

Authors
  1. Magdaléna Hagovská
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  2. Ján Švihra
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Contributions

P.U. is responsible for the provision and selection of suitable probands; J.S. and M.H. are responsible for study design and methodology; M.H. is responsible for data collection and intervention; E.V. is responsible for preparing educational materials for exercise; P.U., J.S. and M.H. have access to the final trial dataset. M.H. paid for English corrections. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Ján Švihra.

Ethics declarations

Ethics approval

The protocol was approved by the Ethics Committee of the self-governing region with the number 3545/2020/ODDZ-06621 on 28 February 2020.

All participants gave written informed consent before data collection began.

Conflicts of interest

The authors have no conflicts of interest to declare.

Source(s) of support: VEGA 1/0540/21

Correlation of a combination of biochemical and clinical markers in the diagnosis and prognosis of the clinical outcome of cancer.

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Hagovská, M., Švihra, J., Urdzík, P. et al. 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. Int Urogynecol J 34, 2049–2060 (2023). https://doi.org/10.1007/s00192-023-05473-w

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  • DOI: https://doi.org/10.1007/s00192-023-05473-w

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