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Rodríguez-Longobardo C, López-Torres O, Guadalupe-Grau A, Gómez-Ruano MÁ. Pelvic Floor Muscle Training Interventions in Female Athletes: A Systematic Review and Meta-analysis. Sports Health 2024; 16:766-775. [PMID: 37688407 PMCID: PMC11346234 DOI: 10.1177/19417381231195305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023] Open
Abstract
CONTEXT Athletes are almost 3 times more at risk of experiencing urinary incontinence (UI) than sedentary women, with prevalence rates varying from 10.9% in low-impact sports such as cycling to 80% when engaging in high-impact sports such as trampoline gymnastics. To treat UI, pelvic floor muscle (PFM) training (PFMT) is recommended as a first line of treatment. OBJECTIVE The aim of the present study was to perform a meta-analysis of the available literature on the efficacy of PFMT interventions in young, nulliparous female athletes. DATA SOURCES A literature research was conducted using PubMed, Sport Discus, and Web of Science. STUDY SELECTION The inclusion criteria were studies with PFMT intervention in female athletes or recreationally active women. Interventions could be carried out for treatment or prevention of pelvic floor dysfunctions. STUDY DESIGN Systematic review with meta-analysis. LEVEL OF EVIDENCE Level 5. DATA EXTRACTION A descriptive analysis of the articles included in the systematic review was carried out. Meta-analyses could be performed on 6 of the included articles, evaluating the maximal voluntary contraction (MVC) of the PFMs, the amount of urinary leakage (AUL), and the vaginal resting pressure (VRP). Random-effects model and standardized mean differences (SMD) ± 95% CI were reported. RESULTS The meta-analysis showed that PFMT produced a significant increase in MVC (SMD, 0.60; 95% CI, 0.11 to 1.08; P = 0.02) and a significant reduction of AUL (SMD, -1.13; 95% CI, -1.84 to -0.41; P < 0.01) in female athletes. No effects were shown in VRP (SMD, -0.05; 95% CI, -1.27 to 1.17; P = 0.93). CONCLUSION PFMT is shown to be effective in increasing PFM strength and reducing urine leakage in female athletes, being a powerful tool to prevent and treat pelvic floor dysfunction in this population.
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Affiliation(s)
- Celia Rodríguez-Longobardo
- Social Sciences of Physical Activity, Sport and Leisure Department, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Olga López-Torres
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Amelia Guadalupe-Grau
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Miguel Ángel Gómez-Ruano
- Social Sciences of Physical Activity, Sport and Leisure Department, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
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Petter Rodrigues M, Bérubé MÈ, Charette M, McLean L. Conservative interventions for female exercise-induced urinary incontinence: a systematic review. BJU Int 2024. [PMID: 39043585 DOI: 10.1111/bju.16474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
OBJECTIVE To systematically review and synthesise what is known about the effectiveness of non-pharmaceutical conservative interventions for the management of urinary incontinence (UI) experienced by women during physical exercise. METHODS A systematic search was performed in the following databases in September 2023: the Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica dataBASE (EMBASE), Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), and Physiotherapy Evidence Database (PEDro). Studies were deemed eligible if population consisted of females who reported symptoms of UI while participating in physical exercise, and the interventions involved any non-pharmaceutical conservative treatment to manage symptoms during exercise. The primary outcome was severity of UI signs and symptoms. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO identifier: CRD42022379138). RESULTS Of the 3429 abstracts screened, 19 studies were retained. Pelvic floor muscle training (PFMT) and intravaginal devices were the most commonly investigated modalities. Only two randomised controlled trials (RCTs), both among volleyball players, compared PFMT with no PFM exercise, showing a reduction in pad weight gain after the intervention in the experimental groups only. PFMT with and without biofeedback randomised among soldiers demonstrated a reduction in the frequency of urine leakage episodes in both groups, while supervised and unsupervised PFMT randomised among athletes from different sports showed pad weight gain reduction in the supervised group only. Seven single-arm studies suggested that PFMT alone or combined with other modalities may reduce UI severity in active women based on questionnaires, bladder diaries, and self-reported symptoms. A single-arm and a crossover study found pessary use beneficial in reducing urine leakage based on questionnaires and pad weight gain, respectively. When comparing pessary, tampon, and no intervention, two repeated-measures studies found tampons may reduce leakage more than pessaries in CrossFit exercisers and women performing aerobic exercises. A vaginal sponge also reduced pad weight gain during aerobic exercises. Other modalities (i.e., an intraurethral device, photobiomodulation, and combined therapies) were investigated using case series or single case studies. While all interventions showed some evidence of effectiveness, the results must be interpreted with caution due to methodological limitations and high risk of bias. In particular, despite a high reliance on pad tests as a primary outcome, we identified inconsistencies in how pad tests were administered and interpreted. CONCLUSION Only the effectiveness of PFMT to reduce urine leakage during exercise has been evaluated through RCTs, with some evidence of effectiveness. We identified a clear need for higher quality studies, with better reporting on the interventions, and more judicious use and interpretation of outcome measures.
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Affiliation(s)
| | - Marie-Ève Bérubé
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Marylène Charette
- Population Health, Interdisciplinary School of Health Science, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Linda McLean
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Saulicz M, Saulicz A, Saulicz E. Self-Assessment of Lower Urinary Tract Condition in Female Competitive Cyclists. Healthcare (Basel) 2024; 12:1163. [PMID: 38921278 PMCID: PMC11202815 DOI: 10.3390/healthcare12121163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/25/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
During cycling, prolonged compression by the bicycle saddle on the anatomical structures located in the perineum area occurs. An additional factor that may have a negative impact on organs located in the pelvic area may be a prolonged sitting position resulting in increased intraabdominal pressure. This situation has the potential to adversely affect pelvic floor function. Therefore, the aim of this study was to assess the incidence of lower urinary tract symptoms (LUTSs) in female competitive road cyclists and cross-country cyclists. The study included 76 female competitive road cyclists and cross-country cyclists and 76 women not practising competitive sport. The Core Lower Urinary Tract Symptom Score (CLSS) questionnaire was used to assess the lower urinary tract condition. Female competitive cyclists had a statistically significantly higher LUTSs score (95% CI: 3.12-4.2 vs. 2.31-3.16; p < 0.05) compared to women not practising competitive sports. Female cyclists had a statistically significantly higher overall CLSS score (95% CI: 3.99-5.61 vs. 2.79-3.97; p < 0.05). Female cyclists had a statistically significantly higher incidence and severity of urinary frequency (p < 0.05 and p < 0.02), urge (p < 0.001 and p < 0.02) and stress incontinence (p < 0.001 and p < 0.001), and pain in the bladder (p < 0.01 and p < 0.01), while physically inactive women recorded a statistically higher incidence of slow urinary stream (p < 0.01 and p < 0.04). A statistically significant association was recorded between the years of cycling and the number of hours per week spent on training and the number of symptoms and their severity. The number of natural births experienced by women involved in competitive cycling significantly affects the severity of LUT symptoms. Compared to women not practising competitive sports, competitive female cyclists are found to have a higher prevalence of LUTSs and a greater degree of severity. LUTSs in competitive female cyclists are negatively influenced by years of competitive career and weekly number of training hours and the number of natural births experienced.
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Affiliation(s)
- Mariola Saulicz
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
| | - Aleksandra Saulicz
- School of Public Health & Social Work, Queensland University of Technology (QUT), Kelvin Grove, QLD 4059, Australia
| | - Edward Saulicz
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
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Bø K, Lillegård RH, Skaug KL. Pelvic Floor Muscle Training on Stress Urinary Incontinence in Power- and Weightlifters: a Pilot Study. Int Urogynecol J 2024; 35:1291-1298. [PMID: 38758455 PMCID: PMC11245411 DOI: 10.1007/s00192-024-05801-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/06/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Stress urinary incontinence (SUI) is defined as involuntary leakage of urine on physical effort and is prevalent among power- and weightlifters. However, there is scant knowledge on treatment options for this population. The aim of this pilot study was to evaluate the potential outcomes and feasibility of a pelvic floor muscle training (PFMT) program on SUI in nulliparous female power- and weightlifters. METHODS This was a case-series study, including one weightlifter and two powerlifters aged 21-32 years. The participants conducted 12 weeks of PFMT at home, with weekly follow-up by a physiotherapist. Change in total score of the International Consensus of Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF) was the primary outcome. Secondary outcome was perceived change assessed by the Patient Global Impression of Improvement (PGI-I) Scale and impact on sport participation. PFM strength, endurance, and resting pressure was measured using vaginal manometry. Feasibility was evaluated as adherence to training and self-efficacy (Self Efficacy Scale for Practicing Pelvic Floor Exercises). RESULTS One athlete reduced their ICIQ-UI-SF score and experienced improvement in symptoms. One athlete reported no change, and one reported a worsening of symptoms. All three participants improved PFM strength and endurance, completed the testing, and 12 weeks of PFMT, but adherence varied between 40 and 80%. Participants reported a lack of time and energy and forgetting to perform the exercises, as reasons for low adherence. CONCLUSION There were varying effects of a 12-week PFMT program on SUI in three strength athletes. The results can create the basis for a future randomized controlled trial.
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Affiliation(s)
- Kari Bø
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.
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Giagio S, Innocenti T, Pillastrini P, Gava G, Salvioli S. What is known from the existing literature about the available interventions for pelvic floor dysfunction among female athletes? A scoping review. Neurourol Urodyn 2022; 41:573-584. [PMID: 35094428 PMCID: PMC9305779 DOI: 10.1002/nau.24883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/24/2021] [Accepted: 01/02/2022] [Indexed: 12/29/2022]
Abstract
Background Aim Methods Results Conclusions
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Affiliation(s)
- Silvia Giagio
- Division of Occupational Medicine IRCCS Azienda Ospedaliero‐Universitaria di Bologna Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM) Alma Mater Studiorum University of Bologna Bologna Italy
| | - Tiziano Innocenti
- Department of Health Science, Faculty of Science Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Amsterdam The Netherlands
| | - Paolo Pillastrini
- Division of Occupational Medicine IRCCS Azienda Ospedaliero‐Universitaria di Bologna Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM) Alma Mater Studiorum University of Bologna Bologna Italy
| | - Giulia Gava
- Gynecology and Physiopathology of Human Reproduction IRCCS Azienda Ospedaliero ‐Universitaria di Bologna Bologna Italy
- Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy
| | - Stefano Salvioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health Campus of Savona University of Genova Genova Italy
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Pires T, Pires P, Moreira H, Gabriel R, Reis A, Viana S, Viana R. Leg stiffness and muscle power vs manometer in sportswomen with symptoms of stress urinary incontinence. Clin Biomech (Bristol, Avon) 2021; 90:105471. [PMID: 34610505 DOI: 10.1016/j.clinbiomech.2021.105471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Pelvic floor muscle training can cure or alleviate stress urinary incontinence. This study aimed to evaluate maximum voluntary contractions of the pelvic floor muscle in sportswomen and verify the association with leg stiffness and muscle power, both maximal and submaximal. METHODS The sample consisted of 41 sportswomen between 18 and 42 years of age. Pelvic floor muscle strength was measured by the manometer. The sportswomen were instructed to perform 3 maximum voluntary contractions of the perineum, held for 3 seconds. Maximal and submaximal leg stiffness and muscle power were measured with a force platform, in two conditions: 1st condition was the sub-maximal, double leg hop test, which was performed allowing sportswomen to self-select their preferred frequency and 2nd condition was the maximal double leg hop test, which was performed asking athletes to maximize hop height and minimize contact time on the top of the force platform for 6 consecutive hops. FINDINGS Maximal and submaximal leg stiffness values increase with increasing age, weight, height, and body mass index, showing positive and significant (p <0.05) or close correlations. There are strong positive correlations between maximal and submaximal leg stiffness (r = 0.759) and between maximal and submaximal muscle power. Maximum voluntary contractions values decrease with increasing leg stiffness: the correlation is significant with maximal leg stiffness. INTERPRETATION Maximum voluntary contractions values decrease with increasing leg stiffness and increase with increasing muscle power values. If the training program aims to increase muscle power, it may also increase maximum voluntary contractions.
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Affiliation(s)
- Telma Pires
- University of Trás-os-Montes and Alto Douro - Vila Real, Portugal.
| | - Patrícia Pires
- University of Trás-os-Montes and Alto Douro - Vila Real, Portugal
| | - Helena Moreira
- University of Trás-os-Montes and Alto Douro - Vila Real, Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Portugal
| | - Ronaldo Gabriel
- University of Trás-os-Montes and Alto Douro - Vila Real, Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Portugal
| | - Arsénio Reis
- University of Trás-os-Montes and Alto Douro - Vila Real, Research in INESC TEC, Portugal
| | - Sara Viana
- Hospital de S. João - Porto/University of Fernando Pessoa - Porto, Portugal
| | - Rui Viana
- Hospital de S. João - Porto/University of Fernando Pessoa - Porto, Portugal
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Abstract
Objective: The aim is to verify the effectiveness of the pelvic floor muscle training (PFMT) program in pregnant women, by analyzing the amount of urine leakage. Design: Experimental study. Location: Care units in the Vila Real district, Portugal. Participants: Forty-three pregnant women divided into an experimental group (EG) (n = 22) and a control group (CG) (n = 21). Interventions: Both groups were evaluated in a predelivery stage (initial) and 6 months after delivery (final). The EG was given a PFMT exercise protocol with a duration of 6 weeks, applicable in classes and at home, another PFMT protocol for 9 weeks. Main measurements: The strength of the pelvic floor muscle was measured by the Oxford Grading Scale and the amount of urine was assessed with a Pad test. Quality of life was measured by the King's Health Questionnaire and self-efficacy by the Broome Pelvic Muscle Self-Efficacy Scale. Results: The loss of urine, significantly reduced from 0.86 ± 0.83 to 0.50 ± 0.67 in the EG (P = .021), whereas in the CG no significant change was observed. The degree of muscle contraction increased by 4.82 ± 0.39 in EG and 3.95 ± 0.67 in CG. The quality of life observed significant improvements in both groups (P < .05). As for self-efficacy, for the EG it improved significantly – initial (P = .001), final (P = .031), and for the CG the values remained the same. Conclusions: This PFMT protocol reduced urinary incontinence in pregnant women. The program allowed significant improvement in the quantity of urinary leakage and an increase in the strength of the pelvic floor muscle.
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Prevalence of Urinary Incontinence in High-Impact Sport Athletes: A Systematic Review and Meta-Analysis. J Hum Kinet 2020; 73:279-288. [PMID: 32774559 PMCID: PMC7386138 DOI: 10.2478/hukin-2020-0008] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to systematize the scientific evidence that assessed the prevalence of urinary incontinence in female athletes and determine which modality is most predisposed to stress urinary incontinence. From September to December 2018, a systematic literature search of current interventional studies of stress urinary incontinence of the last ten years was performed using PubMed, EMBASE, Scopus and Web of Science databases. The methodological quality was assessed by the Downs and Black scale, while the data collected from the studies were analyzed through meta-analysis. Nine studies met the eligibility criteria, meaning they included reports of urinary incontinence in different sports. The meta-analysis showed 25.9% prevalence of urinary incontinence in female athletes in different sports, as well as 20.7% prevalence of stress urinary incontinence. The most prevalent high impact sport was volleyball, with the value of 75.6%. The prevalence of urinary incontinence can be high in female athletes, with high-impact sports potentially increasing the risk for stress urinary incontinence. Further research is needed regarding the potential risk factors related to the onset of urinary incontinence.
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Pires T, Pires P, Moreira H, Gabriel R, Viana S, Viana R. Assessment of pelvic floor muscles in sportswomen: Quality of life and related factors. Phys Ther Sport 2020; 43:151-156. [PMID: 32200260 DOI: 10.1016/j.ptsp.2020.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/20/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To evaluate Maximum Voluntary Contraction (MVC) of the Pelvic Floor Muscles (PFM) in sportswomen, to observe the urinary symptoms and their impact on the Quality of Life (QoL). DESIGN Observational cross-sectional study. SETTING Gyms and teams in the North of Portugal. PARTICIPANTS Sportswomen (n = 197). MAIN OUTCOME MEASURES The measurement was performed using a manometer. The sportswomen were instructed to perform 3 MVC of the perineum, held for 3 s. The Kings Health Questionnaire (KHQ) was used to evaluate urinary symptoms and the QoL of the sportswomen. RESULTS Age significantly influenced (p < 0.05) the QoL in all domains. An increase in BMI was also significantly associated with a decrease in the QoL. MVC values had a highly significant effect on the overall QoL and all domains, including a reduction in urinary symptoms. The weekly time of physical activity was associated with a better QoL in symptomatology. The practice of high-impact activities decreased the QoL (compared to low-impact activities). The vaginal resting pressure values ranged from 1.60 to 59.80 (24.34 ± 11.00). CONCLUSIONS Age, BMI and high-impact sports appear to be the leading factors that promote the onset of SUI, which in turn decrease the QoL in sportswomen. There was a positive association between MVC and weekly time of physical activity in the QoL.
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Affiliation(s)
- Telma Pires
- Department Sports Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
| | - Patrícia Pires
- Department Sports Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
| | - Helena Moreira
- Department Sports Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
| | - Ronaldo Gabriel
- Department Sports Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
| | - Sara Viana
- Department of Health Sciences, University of Fernando Pessoa, Porto, Portugal.
| | - Rui Viana
- Department of Health Sciences, University of Fernando Pessoa, Porto, Portugal.
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Abstract
More women participate in sports than ever before and the proportion of women athletes at the Olympic Games is nearly 50%. The pelvic floor in women may be the only area of the body where the positive effect of physical activity has been questioned. The aim of this narrative review is to present two widely held opposing hypotheses on the effect of general exercise on the pelvic floor and to discuss the evidence for each. Hypothesis 1: by strengthening the pelvic floor muscles (PFM) and decreasing the levator hiatus, exercise decreases the risk of urinary incontinence, anal incontinence and pelvic organ prolapse, but negatively affects the ease and safety of childbirth. Hypothesis 2: by overloading and stretching the PFM, exercise not only increases the risk of these disorders, but also makes labor and childbirth easier, as the PFM do not obstruct the exit of the fetus. Key findings of this review endorse aspects of both hypotheses. Exercising women generally have similar or stronger PFM strength and larger levator ani muscles than non-exercising women, but this does not seem to have a greater risk of obstructed labor or childbirth. Additionally, women that specifically train their PFM while pregnant are not more likely to have outcomes associated with obstructed labor. Mild-to-moderate physical activity, such as walking, decreases the risk of urinary incontinence but female athletes are about three times more likely to have urinary incontinence compared to controls. There is some evidence that strenuous exercise may cause and worsen pelvic organ prolapse, but data are inconsistent. Both intra-abdominal pressure associated with exercise and PFM strength vary between activities and between women; thus the threshold for optimal or negative effects on the pelvic floor almost certainly differs from person to person. Our review highlights many knowledge gaps that need to be understood to understand the full effects of strenuous and non-strenuous activities on pelvic floor health.
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Affiliation(s)
- Kari Bø
- Department of Sports Medicine, Norwegian School of Sport Sciences, PB 4014, Ullevål Stadion, 0806, Oslo, Norway.
- Akershus University Hospital, Lørenskog, Norway.
| | - Ingrid Elisabeth Nygaard
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, USA
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Rial Rebullido T, Chulvi-Medrano I, Faigenbaum AD, Stracciolini A. Pelvic Floor Dysfunction: An Urgent Matter for Female Athletes. Strength Cond J 2019. [DOI: 10.1519/ssc.0000000000000510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Dornowski M, Makar P, Sawicki P, Wilczyńska D, Vereshchaka I, Ossowski Z. Effects of low- vs high-volume swimming training on pelvic floor muscle activity in women. Biol Sport 2019; 36:95-99. [PMID: 30899144 PMCID: PMC6413572 DOI: 10.5114/biolsport.2018.78909] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/13/2018] [Accepted: 10/22/2018] [Indexed: 11/17/2022] Open
Abstract
This study examined the effects of different training loads on pelvic floor muscle (PFM) activity in swimming. Twelve female swimmers were included in this study (23.71±1.44 y.o.; 167±5.89 cm; 62.05±8.89 kg). They took part in an experiment with two different stages of load in swimming training. For the pelvic floor muscle assessment the Glazer Protocol was used. To assess swimming technique, David Pyne's Stroke Mechanics Test was used. A statistically significant increase in surface electromyography (sEMG) values appeared in the fifth R (rest after contraction) in the quick flick stage of the measurement protocol of PFM at the third measurement time (7.71±4.49 μV) compared to the first measurement time (6.25±4.43 μV) with p≤0.05. Increasing the training load may cause unwanted changes in the level of electrical activity of pelvic floor muscles.
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Affiliation(s)
- Marcin Dornowski
- Department of Sport, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Piotr Makar
- Department of Sport, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Piotr Sawicki
- Department of Sport, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Dominika Wilczyńska
- Department of Sport, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Inna Vereshchaka
- Department of Sport, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
| | - Zbigniew Ossowski
- Department of Sport, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
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Gonçalves MLC, Fernandes S, Batista de Sousa J. Do moderate aerobic exercise and strength training influence electromyographic biofeedback of the pelvic floor muscles in female non-athletes? J Phys Ther Sci 2018; 30:313-319. [PMID: 29545703 PMCID: PMC5851372 DOI: 10.1589/jpts.30.313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 11/28/2017] [Indexed: 11/25/2022] Open
Abstract
[Purpose] To assess the influence of moderate physical exercise on pelvic floor muscle
electromyographic (EMG) biofeedback signal in female non-athletes. [Subjects and Methods]
A prospective, non-randomized study of 90 adult females (age ≥18 years) divided into three
groups: Intervention (I), which began physical exercise upon study enrollment; Moderate
Exercise (ME), comprising those who already engaged in physical activity; and Sedentary
(S), comprising those who had a sedentary lifestyle. All participants underwent EMG
biofeedback of the pelvic floor muscles upon study enrollment (T1) and at the end of the
third subsequent month (T2). [Results] Mean age was 35.7 (SD: 7.5) years, with no
significant difference between groups. T1 values in groups I and S were significantly
lower than in group ME. There was no statistically significant difference between groups S
and I. On comparison between groups at T2, values were highest in group I (18.5 µV vs.
15.3 µV in group S, vs. 16.1 µV in group ME). There was no significant difference between
groups S and ME. On age-adjusted analysis, group I exhibited the greatest change between
T1 and T2 (I, 4.7 µV; ME, 2.1 µV; S, 1.5 µV). [Conclusion] Females who exercise exhibit
better pelvic floor muscle function than those who do not engage in physical activity.
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Affiliation(s)
- Maria Lucia Campos Gonçalves
- Graduate Program in Medical Sciences, Universidade de Brasília (UnB): Campus Universitário Darcy Ribeiro, Asa Norte, School of Medicine, sala B2, 70910-900, Brasília, DF, Brazil
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Carvalhais A, Natal Jorge R, Bø K. Performing high-level sport is strongly associated with urinary incontinence in elite athletes: a comparative study of 372 elite female athletes and 372 controls. Br J Sports Med 2017. [PMID: 28642223 DOI: 10.1136/bjsports-2017-097587] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the prevalence of urinary incontinence (UI) in female elite athletes compared with controls and to investigate potential risk factors for UI among elite athletes. METHODS This cross-sectional study included 372 elite athletes (athletes group, AG) and 372 age-matched controls (control group, CG). The median age was low (19 years) and the vast majority were nulliparous. Potential risk factors, including clinical, demographic and sports practice characteristics, were collected by using a questionnaire. The International Consultation on Urinary Incontinence Questionnaire-Urinary Incontinence-Short Form was applied to estimate the prevalence of UI. OR with 95% CIs were used to estimate the association with UI. The final model was adjusted for constipation, family history of UI and history of urinary infection. RESULTS The prevalence of UI was 29.6% and 13.4% in AG and CG, respectively (p<0.001). The following prevalences were obtained: AG: 19.6% and CG: 3.5% (p<0.001) for stress UI, AG: 3.8% and CG: 5.4% (p=0.292) for urgency UI and AG: 5.9% and CG: 0.8% (p<0.001) for mixed UI. After adjustment, performing high-level sport (adjusted (adj) OR=3.31; 95% CI 2.20 to 4.97), family history of UI (adj OR=1.54; 95% CI 1.04 to 2.29), history of urinary infection (adj OR=1.53; 95% CI 1.05 to 2.23) and constipation (adj OR=1.79; 95% CI 1.07 to 2.98) were associated with UI. CONCLUSION The prevalence of UI among Portuguese female elite athletes is high and the odds of UI were three times higher than in controls. Also, constipation, family history of UI and history of urinary infections were significantly associated with UI.
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Affiliation(s)
- Alice Carvalhais
- Department of Physiotherapy, CESPU, North Polytechnic Institute of Health, Paredes, Portugal.,Faculty of Sport, University of Porto, Porto, Portugal.,Institute of Science and Innovation in Mechanical and Industrial Engineering, Porto, Portugal
| | - Renato Natal Jorge
- Institute of Science and Innovation in Mechanical and Industrial Engineering, Porto, Portugal.,Faculty of Engineering, Department of Mechanical Engineering, University of Porto, Porto, Portugal
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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15
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García-Sánchez E, Rubio-Arias J, Ávila-Gandía V, Ramos-Campo D, López-Román J. Effectiveness of pelvic floor muscle training in treating urinary incontinence in women: A current review. Actas Urol Esp 2016; 40:271-8. [PMID: 26614435 DOI: 10.1016/j.acuro.2015.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 09/03/2015] [Accepted: 09/03/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To analyse the content of various published studies related to physical exercise and its effects on urinary incontinence and to determine the effectiveness of pelvic floor training programmes. METHOD We conducted a search in the databases of PubMed, CINAHL, the Cochrane Plus Library, The Cochrane Library, WOS and SPORTDiscus and a manual search in the Google Scholar metasearcher using the search descriptors for documents published in the last 10 years in Spanish or English. The documents needed to have an abstract or complete text on the treatment of urinary incontinence in female athletes and in women in general. RESULTS We selected 3 full-text articles on treating urinary incontinence in female athletes and 6 full-text articles and 1 abstract on treating urinary incontinence in women in general. The 9 studies included in the review achieved positive results, i.e., there was improvement in the disease in all of the studies. CONCLUSIONS Physical exercise, specifically pelvic floor muscle training programmes, has positive effects on urinary incontinence. This type of training has been shown to be an effective programme for treating urinary incontinence, especially stress urinary incontinence.
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16
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Almeida MBA, Barra AA, Saltiel F, Silva-Filho AL, Fonseca AMRM, Figueiredo EM. Urinary incontinence and other pelvic floor dysfunctions in female athletes in Brazil: A cross-sectional study. Scand J Med Sci Sports 2015; 26:1109-16. [DOI: 10.1111/sms.12546] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- M. B. A. Almeida
- Health Sciences Program; Instituto de Previdência Social do Estado de Minas Gerais (IPSEMG); Belo Horizonte MG Brazil
| | - A. A. Barra
- Health Sciences Program; Instituto de Previdência Social do Estado de Minas Gerais (IPSEMG); Belo Horizonte MG Brazil
| | - F. Saltiel
- Rehabilitation Sciences Program; Universidade Federal de Minas Gerais (UFMG); Belo Horizonte MG Brazil
| | - A. L. Silva-Filho
- Obstetrics and Gynecology Department; UFMG; Belo Horizonte MG Brazil
| | | | - E. M. Figueiredo
- Rehabilitation Sciences Program; Universidade Federal de Minas Gerais (UFMG); Belo Horizonte MG Brazil
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17
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Ferreira S, Ferreira M, Carvalhais A, Santos PC, Rocha P, Brochado G. Reeducation of pelvic floor muscles in volleyball athletes. Rev Assoc Med Bras (1992) 2014. [DOI: 10.1590/1806-9282.60.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: to verify the effectiveness of the pelvic floor muscles rehabilitation program (PFMRP) in female volleyball athletes, analyzing the amount and frequency of urinary leakage. Methods: experimental study. The sample consisted of 32 female athletes from Famalicão Athletic Volleyball Club (Portugal). The athletes were selected by convenience and distributed randomly into two groups: experimental group (EG = 16 athletes) and the control group (CG = 16 athletes). The EG underwent PFMRP for three months. The PFMRP was the awareness and identification of the pelvic floor muscles (PFM), pre-timed PFM contraction prior to occasions of increased intra-abdominal pressure, and 30 daily contractions of MPP at home. The CG had only access to the pamphlet. The assessment instruments included the questionnaires, the Pad Test (amount of urinary leakage) and frequency record of urinary leakage (7-day diary) before and after PFMRP. Results: the amount of urine leakage decreased in 45.5% of athletes under PFMRP intervention, and in 4.9% of athletes in CG, with statistical differences between the groups (p < 0.001). The reduction in the frequency of urinary leakage was 14.3% in EG, and 0.05% in CG, a statistically significant difference between the groups (p < 0.001). Conclusion: PFMRP in this study was effective to reduce stress urinary incontinence in female volleyball athletes. The program allowed significant improvement of symptoms of quantity and frequency of urinary leakage.
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18
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19
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[Sport and urinary incontinence in women]. ACTA ACUST UNITED AC 2014; 42:597-603. [PMID: 24996876 DOI: 10.1016/j.gyobfe.2014.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 04/14/2014] [Indexed: 11/21/2022]
Abstract
Women are more attentive to their physical appearance and a quarter of French women use to practice a regular physical activity. Benefits of sport on general health are recognized. However, sport may be the cause of various diseases when it is poorly chosen or improperly performed. In literature, intensive exercise is a risk factor for urinary incontinence, defined as "the complaint of any involuntary leakage of urine". It is essentially stress urinary incontinence, occurring because of the phenomenon of intrabdominal hyperpressure, inherent with certain activities, and excess capacity of sphincters. Some sports are more risky than others, and high-level sportswomen are the most exposed. Health professionals must invest in information, screening, prevention, counseling and treatment track athletes So, the general practitioner and the doctor of sports play a vital role in informing, screening, prevention, therapeutic and monitoring of sportswomen. Better information is needed because according to the severity of incontinence and its impact, there are simple, effective, more or less invasive treatment options. The aim of this study was to establish an inventory of scientific knowledge and to improve the management of these patients.
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20
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Goldstick O, Constantini N. Urinary incontinence in physically active women and female athletes. Br J Sports Med 2013; 48:296-8. [PMID: 23687004 DOI: 10.1136/bjsports-2012-091880] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A literature review was performed on the topic of urinary incontinence during physical activity and sports. This paper reviews the prevalence, risk factors, pathophysiology and treatment modalities of urinary incontinence in physically active women and female athletes. Urinary incontinence affects women of all ages, including top female athletes, but is often under-reported. The highest prevalence of urinary incontinence is reported in those participating in high impact sports. Pelvic floor muscle training is considered the first-line treatment, although more research is needed to determine optimal treatment protocols for exercising women and athletes. Trainers, coaches and other athletes' caregivers should be educated and made aware of the need for proper urogynaecological assessment.
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Affiliation(s)
- Orly Goldstick
- Pediatric and Adolescent Gynecology Clinic, Clalit Health Services, , Haifa, Israel
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21
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Da Roza T, de Araujo MP, Viana R, Viana S, Jorge RN, Bø K, Mascarenhas T. Pelvic floor muscle training to improve urinary incontinence in young, nulliparous sport students: a pilot study. Int Urogynecol J 2012; 23:1069-73. [DOI: 10.1007/s00192-012-1759-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 03/18/2012] [Indexed: 11/28/2022]
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22
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Rocha CS, Lanferdini FJ, Kolberg C, Silva MF, Vaz MA, Partata WA, Zaro MA. Interferential therapy effect on mechanical pain threshold and isometric torque after delayed onset muscle soreness induction in human hamstrings. J Sports Sci 2012; 30:733-42. [DOI: 10.1080/02640414.2012.672025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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