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Courtaut García CI, Mateos Noblejas M, Romero Morales C, Martínez Pascual B. Thickness of the abdominal wall and pelvic floor dysfunctions in men who practice crossfit vs no crossfit: An observational study. PLoS One 2024; 19:e0296595. [PMID: 39074071 DOI: 10.1371/journal.pone.0296595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/23/2024] [Indexed: 07/31/2024] Open
Abstract
INTRODUCTION The objective of this study is to compare the thickness of the transverse abdominis, internal oblique, external oblique, rectus abdominis, and rectus abdominis distance, the quality of life (SF-36), the presence of chronic pelvic pain (CPPQ-Mohedo), and sexual dysfunction (IIEF) in men who practice CrossFit® versus men who do not. DESIGN, SETTING, PARTICIPANTS, AND MAIN OUTCOME MEASURES Sixty-four healthy men with an average age of 37.19 were recruited at a private sports club and divided into two groups for this cross-sectional observational study. Additionally, participants completed the CPPQ-M, IIEF, and SF-36 questionnaires. RESULTS Significant differences were found in the thickness of the internal oblique at rest (p = 0.018, d = 0.61), which was greater in the CrossFit® group. In the SF-36 quality of life questionnaire (p = 0.05, d = 0.50), the CrossFit® group also obtained a higher score. CONCLUSION CrossFit® improves the quality of life and self-esteem of the participants, in addition to increasing the thickness of the internal oblique. Neither more chronic pelvic pain nor more erectile dysfunction was observed in the CrossFit® group.
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Affiliation(s)
| | | | - Carlos Romero Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Beatriz Martínez Pascual
- Faculty of Physical Activity and Sports Sciences, Department of Physiotherapy, Podiatry and Dance, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
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Audrain A, Cornu JN, Kerdelhue G, Combret Y, Steenstrup B. Do pelvic floor muscle function parameters differ in women according to continence status? A systematic review. THE FRENCH JOURNAL OF UROLOGY 2024; 34:102592. [PMID: 38377645 DOI: 10.1016/j.fjurol.2024.102592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/18/2024] [Accepted: 01/28/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Current literature highlights the difficulty in identifying which pelvic floor muscle (PFM) functions are correlated with urinary incontinence (UI). AIM In this study, we compared parameters of PFM function (strength, endurance, tone, control, reaction, and/or coordination) according to continence status in women (presence or absence, type and/or severity of urinary incontinence). EVIDENCE ACQUISITION A systematic review was conducted following the 2020 PRISMA guidelines. Three databases (Pubmed, Web of Science, and LiSSa) were searched from inception to December 31, 2021. Assessment of risk of bias was performed using the Joanna Briggs Institute critical appraisal checklist. EVIDENCE SYNTHESIS The initial research yielded 4733 studies. Forty-two studies met the inclusion criteria, including 4015 participants. No statistical association was found between PFM function and the presence or absence of UI, the different type of UI or the different levels of severity of UI. The heterogeneity in methodologies and analyzes of the results only with the P-value are important limitations of this review. CONCLUSION It appears that muscle function is not always associated with presence or absence of UI. No association is found between PFM function and type or severity of UI. These results reinforce the need to carry out a bio-psycho-social evaluation of UI that does not only focus on PFM functions. As such, the results reported herein can be considered a resource for more specific research.
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Affiliation(s)
| | | | - Gaëtan Kerdelhue
- Department of Biomechanical Informatics, Rouen University Hospital, Rouen, France
| | - Yann Combret
- Physiotherapy Department, Le Havre Hospital, La Havre, France; ERPHAN, Paris-Saclay University, UVSQ, Versailles, France
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Dominguez-Antuña E, Diz JC, Suárez-Iglesias D, Ayán C. Prevalence of urinary incontinence in female CrossFit athletes: a systematic review with meta-analysis. Int Urogynecol J 2023; 34:621-634. [PMID: 35635565 PMCID: PMC9150382 DOI: 10.1007/s00192-022-05244-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Studies on the prevalence of urinary incontinence (UI) among CrossFit practitioners are on the rise. This systematic review with meta-analysis was aimed at determining the prevalence of UI among CrossFit practitioners. METHODS A systematic review of the literature was performed by searching MEDLINE/PubMed, Scopus, and SPORTDiscus through January 2021. The search strategy included the keywords CrossFit, urine incontinence, exercise, high impact and pelvic floor dysfunction. The inclusion criterion was any study with a sample of CrossFit practitioners and results separated from the other fitness modalities analysed. The subjects were women with no restriction of age, parity, experience or frequency of training. Quality assessment of the studies included was conducted using the Oxford Centre of Evidence-Based Medicine scale and the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. RESULTS Thirteen studies (6 comparative and 7 non-comparative) were included for the systematic review, all using a cross-sectional design. The level of evidence was 4, with their quality ranging from poor (n = 10) to fair (n = 3). A total of 4,823 women aged 18 to 71 were included, 91.0% participated in CrossFit, and 1,637 presented UI, which indicates a prevalence of 44.5%. Also, 55.3% and 40.7% presented mild or moderate UI respectively. Stress UI was the most common type reported (81.2%). CONCLUSIONS The factors that increased the likelihood of UI were age, body mass index and parity. Exercises based on jumps were commonly associated with urine leakage. CrossFit practitioners presented higher UI than control groups.
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Affiliation(s)
| | - José Carlos Diz
- Unidad de Cuidados Intensivos, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.,Departamento de Didácticas Especiais, Universidade de Vigo, Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Pontevedra, Spain
| | - David Suárez-Iglesias
- VALFIS Research Group, Institute of Biomedicine (IBIOMED), Faculty of Physical Activity and Sports Sciences, University of León, León, Spain.
| | - Carlos Ayán
- Departamento de Didácticas Especiais, Universidade de Vigo, Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Pontevedra, Spain
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Urinary Incontinence in Elite Female Athletes. Curr Urol Rep 2023; 24:51-58. [PMID: 36418531 DOI: 10.1007/s11934-022-01133-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW To summarize the current understanding on the epidemiology, pathophysiology, and management strategies of urinary incontinence (UI) in female athletes, highlighting findings specific to nulliparous elite athletes. RECENT FINDINGS UI occurs in about 20-50% of female athletes of all ages and parity status, around 40% for younger nulliparous athletes, and is more prevalent in high-impact sports. Possible contributing factors to UI in female elite athletes include pelvic floor laxity and bladder neck descent, pelvic floor muscle fatigue, low energy availability, and hypermobility syndrome. In female elite athletes, urinary symptoms negatively affect quality of life, although the effects of symptoms on exercise participation are not well understood. Current management strategies are primarily conservative and centered on behavioral modifications and pelvic floor muscle physiotherapy. UI in female elite athletes appears to be multifactorial. Clarifying how individual factors influence UI in this population will inform athlete counseling, prevention, and treatment strategies.
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De Marchi T, Ferlito JV, Turra AC, Flamia S, de Bispo Magro F, Pavelecini Donida ML, Dilkin M, da Silva D, Massia Ribas V, Leal Junior ECP. Pilates Method and/or Photobiomodulation Therapy Combined to Static Magnetic Field in Women with Stress Urinary Incontinence: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. J Clin Med 2023; 12:jcm12031104. [PMID: 36769752 PMCID: PMC9917687 DOI: 10.3390/jcm12031104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 02/04/2023] Open
Abstract
This clinical trial aims to provide evidence about the effectiveness of the Pilates method on stress urinary incontinence (SUI), as well as to elucidate the effects of photobiomodulation therapy associated with static magnetic field (PBMT/sMF) alone or associated with the Pilates Method on Pelvic floor muscle (PFM) in women affected by SUI. For that, a three-arm, parallel randomized, double-blinded, placebo-controlled trial was conducted (NCT05096936). We recruited thirty-three women diagnosed with SUI, randomly allocated to three groups: placebo PBMT/sMF plus method Pilates, PBMT/sMF active plus method Pilates and only PBMT/sMF active. The evaluation consisted of anamnesis and physical examination, muscle strength, completion of the ICIQ-SF questionnaire, and urinary loss. The evaluation of muscle strength and filling the ICIQ-SF were performed on the first and last days, while the Pad test was applied in baseline, one month, two months, and three months of intervention. We observed an increase in strength (p < 0.01), tone (p < 0.01), and quality of life (p < 0.01), in addition to a decrease in urinary lost (p < 0.01) for all groups comparing the pre and post-intervention. The PBMT/sMF alone, the Pilates, and the combination of the two therapies proved to be effective in improving the signs and symptoms of women with SUI.
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Affiliation(s)
- Thiago De Marchi
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 03155-000, SP, Brazil
- Correspondence: or
| | - João Vitor Ferlito
- Oxidative Stress and Antioxidant Laboratory, Postgraduate Program in Biotechnology, University of Caxias do Sul, Caxias do Sul 95070-560, RS, Brazil
- School Clinic of Physical Therapy, University Center CNEC of Bento Gonçalves (UNICNEC), Bento Gonçalves 95700-000, RS, Brazil
| | - Ariane Cristina Turra
- School Clinic of Physical Therapy, University Center CNEC of Bento Gonçalves (UNICNEC), Bento Gonçalves 95700-000, RS, Brazil
| | - Sheila Flamia
- School Clinic of Physical Therapy, University Center CNEC of Bento Gonçalves (UNICNEC), Bento Gonçalves 95700-000, RS, Brazil
| | - Franciele de Bispo Magro
- School Clinic of Physical Therapy, University Center CNEC of Bento Gonçalves (UNICNEC), Bento Gonçalves 95700-000, RS, Brazil
| | - Maribel Luiza Pavelecini Donida
- School Clinic of Physical Therapy, University Center CNEC of Bento Gonçalves (UNICNEC), Bento Gonçalves 95700-000, RS, Brazil
| | - Michele Dilkin
- School Clinic of Physical Therapy, University Center CNEC of Bento Gonçalves (UNICNEC), Bento Gonçalves 95700-000, RS, Brazil
| | - Djéssica da Silva
- School Clinic of Physical Therapy, University Center CNEC of Bento Gonçalves (UNICNEC), Bento Gonçalves 95700-000, RS, Brazil
| | - Vanessa Massia Ribas
- Physiotherapy Department, University Center CNEC of Bento Gonçalves (UNICNEC), Bento Gonçalves 95700-000, RS, Brazil
| | - Ernesto Cesar Pinto Leal Junior
- Laboratory of Phototherapy and Innovative Technologies in Health (LaPIT), Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 03155-000, SP, Brazil
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Strenuous physical activity, exercise, and pelvic organ prolapse: a narrative scoping review. Int Urogynecol J 2023:10.1007/s00192-023-05450-3. [PMID: 36692525 DOI: 10.1007/s00192-023-05450-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023]
Abstract
INTRODUCTION AND HYPOTHESIS High-intensity physical activity and exercise have been listed as possible risk factors for pelvic organ prolapse (POP). The aim of the present study is to conduct a literature review on the prevalence and incidence of POP in women who engage in regular physical activity. In addition, we review the effects of a single exercise or a single session of exercise on pelvic floor support. Finally, the effect of exercises on POP in the early postpartum period is reviewed. METHODS This is a narrative scoping review. We searched PubMed and Ovid Medline, the Physiotherapy Evidence Database (PEDro), and the Cochrane Database of Systematic Reviews up to May 2022 with the following MeSH terms: "physical activity" AND "exercise" AND "pelvic floor" AND "pelvic organ prolapse". RESULTS Eight prevalence studies were retrieved. Prevalence rates of symptomatic POP varied between 0 (small study within different sports) and 23% (Olympic weightlifters and power lifters). Parity was the only factor associated with POP in most studies. Three studies evaluated the pelvic floor after a single exercise or one session of exercise and found increased vaginal descent or increased POP symptoms. One prospective cohort study reported the development of POP after 6 weeks of military parashot training, and one randomized trial reported increased POP symptoms after transverse abdominal training. There is scant knowledge on exercise and POP in the postpartum period. CONCLUSIONS Prevalence of POP in sports varies widely. Experimental and prospective studies indicate that strenuous exercise increased POP symptoms and reduced pelvic floor support.
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Assessment of the Elastographic and Electromyographic of Pelvic Floor Muscles in Postmenopausal Women with Stress Urinary Incontinence Symptoms. Diagnostics (Basel) 2021; 11:diagnostics11112051. [PMID: 34829398 PMCID: PMC8618737 DOI: 10.3390/diagnostics11112051] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/01/2021] [Accepted: 11/04/2021] [Indexed: 12/03/2022] Open
Abstract
Background. Shear wave elastography is an effective method for studying the condition of various musculoskeletal soft tissues. The primary aim of this study was the objective elastographic and electromyographic assessment of the pelvic floor during the rest and contraction of the pelvic floor muscles (PFM) in postmenopausal women. Methods. This was a prospective observational study that was carried out at the University Hospital in Wroclaw, Poland, between January 2017 and December 2019. Patients. The target group of the study included postmenopausal women with stress urinary incontinence. The primary outcomes were the features of the elastographic assessment of the pelvic floor during rest and contraction of the PFM obtained using shear wave elastography. Results. Based on the inclusion and exclusion criteria for the study, 14 patients took part in the measurements. There was a significant difference between the elastographic assessment of the pelvic floor during rest and contraction of the PFM at all locations in front of the urethra. No statistically significant correlation was found between the results of elastography and the bioelectrical activity of PFM. Conclusion. The elasticity of the periurethral structures is higher during active pelvic floor muscle contraction than at rest, it seems that shear wave elastography is an effective test that objectively assesses the strength of PFM contraction.
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