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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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Sorrigueta-Hernández A, Padilla-Fernandez BY, Marquez-Sanchez MT, Flores-Fraile MC, Flores-Fraile J, Moreno-Pascual C, Lorenzo-Gomez A, Garcia-Cenador MB, Lorenzo-Gomez MF. Benefits of Physiotherapy on Urinary Incontinence in High-Performance Female Athletes. Meta-Analysis. J Clin Med 2020; 9:jcm9103240. [PMID: 33050442 PMCID: PMC7601720 DOI: 10.3390/jcm9103240] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: High performance female athletes may be a risk group for the development of urinary incontinence due to the imbalance of forces between the abdomen and the pelvis. Pelvic floor physiotherapy may be a useful treatment in these patients. Objectives: (1) To identify the scientific evidence for pelvic floor (PF) dysfunctions that are associated with urinary incontinence (UI) in high-performance sportswomen. (2) To determine whether pelvic floor physiotherapy (PT) corrects UI in elite female athletes. Materials and methods: Meta-analysis of published scientific evidence. The articles analyzed were found through the following search terms: (A) pelvic floor dysfunction elite female athletes; (B) urinary incontinence elite female athletes; (C) pelvic floor dysfunction elite female athletes physiotherapy; (D) urinary incontinence elite female athletes physiotherapy. Variables studied: type of study, number of individuals, age, prevalence of urinary incontinence described in the athletes, type of sport, type of UI, aspect investigated in the articles (prevalence, response to treatment, etiopathogenesis, response to PT treatment, concomitant health conditions or diseases. Study groups according to the impact of each sport on the PF: G1: low-impact (noncompetitive sports, golf, swimming, running athletics, throwing athletics); G2: moderate impact (cross-country skiing, field hockey, tennis, badminton, baseball) and G3: high impact (gymnastics, artistic gymnastics, rhythmic gymnastics, ballet, aerobics, jump sports (high, long, triple and pole jump)), judo, soccer, basketball, handball, volleyball). Descriptive analysis, ANOVA and meta-analysis. Results: Mean age 22.69 years (SD 2.70, 18.00–29.49), with no difference between athletes and controls. Average number of athletes for each study was 284.38 (SD 373,867, 1–1263). The most frequent type of study was case-control (39.60%), followed by cross-sectional (30.20%). The type of UI was most often unspecified by the study (47.20%), was stress UI (SUI, 24.50%), or was referred to as general UI (18.90%). Studies on prevalence were more frequent (54.70%), followed by etiopathogenesis (28.30%) and, lastly, on treatment (17.00%). In most cases sportswomen did not have any disease or concomitant pathological condition (77.40%). More general UI was found in G1 (36.40%), SUI in G2 (50%) and unspecified UI in G3 (63.64%). In the meta-analysis, elite athletes were found to suffer more UI than the control women. In elite female athletes, in general, physiotherapy contributed to gain in urinary continence more than in control women (risk ratio 0.81, confidence interval 0.78–0.84)). In elite female athletes, former elite female athletes and in pregnant women who regularly engage in aerobic activity, physiotherapy was successful in delivering superior urinary continence compared to the control group. The risk of UI was the same in athletes and in the control group in volleyball female athletes, elite female athletes, cross-country skiers and runners. Treatment with PT was more effective in control women than in gymnastics, basketball, tennis, field hockey, track, swimming, volleyball, softball, golf, soccer and elite female athletes. Conclusions: There is pelvic floor dysfunction in high-performance athletes associated with athletic activity and urinary incontinence. Eating disorders, constipation, family history of urinary incontinence, history of urinary tract infections and decreased flexibility of the plantar arch are associated with an increased risk of UI in elite female athletes. Pelvic floor physiotherapy as a treatment for urinary incontinence in elite female athletes, former elite female athletes and pregnant athletes who engage in regular aerobic activity leads to a higher continence gain than that obtained by nonathlete women.
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Affiliation(s)
- Alba Sorrigueta-Hernández
- Section of Urology, Department of Surgery, University of Salamanca, 37007 Salamanca, Spain; (A.S.-H.); (M.-C.F.-F.); (M.-B.G.-C.); (M.-F.L.-G.)
- Department of Physiotherapy, University of Salamanca, 37007 Salamanca, Spain;
| | | | - Magaly-Teresa Marquez-Sanchez
- Multidisciplinary Renal Research Group of the Institute for Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain;
| | - Maria-Carmen Flores-Fraile
- Section of Urology, Department of Surgery, University of Salamanca, 37007 Salamanca, Spain; (A.S.-H.); (M.-C.F.-F.); (M.-B.G.-C.); (M.-F.L.-G.)
| | - Javier Flores-Fraile
- Section of Urology, Department of Surgery, University of Salamanca, 37007 Salamanca, Spain; (A.S.-H.); (M.-C.F.-F.); (M.-B.G.-C.); (M.-F.L.-G.)
- Correspondence:
| | | | | | - Maria-Begoña Garcia-Cenador
- Section of Urology, Department of Surgery, University of Salamanca, 37007 Salamanca, Spain; (A.S.-H.); (M.-C.F.-F.); (M.-B.G.-C.); (M.-F.L.-G.)
| | - Maria-Fernanda Lorenzo-Gomez
- Section of Urology, Department of Surgery, University of Salamanca, 37007 Salamanca, Spain; (A.S.-H.); (M.-C.F.-F.); (M.-B.G.-C.); (M.-F.L.-G.)
- Multidisciplinary Renal Research Group of the Institute for Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain;
- Urology Service of the University Hospital of Salamanca, 37007 Salamanca, Spain
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