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Effects of PFM rehabilitation on PFM function and morphology in older women

Authors

  • Stéphanie J. Madill,

    Corresponding author
    1. School of Physical Therapy, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
    • Correspondence to: Ste'phanie J. Madill, PhD, School of Physical Therapy, University of Saskatchewan, 1121 College Drive, Saskatoon, Saskatchewan, Canada S7N 0W3.

      E-mail: stephanie.madill@usask.ca

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  • Stéphanie Pontbriand-Drolet,

    1. Centre de Recherche de L'institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montréal, Québec, Canada
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  • An Tang,

    1. Abdominal Radiology, Department of Medical Imaging, Université de Montréal, Montréal, Québec, Canada
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  • Chantale Dumoulin

    1. Centre de Recherche de L'institut Universitaire de Gériatrie de Montréal, Université de Montréal, École de Réadaptation, Université de Montréal, Montréal, Québec, Canada
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  • Heinz Koelbl led the peer-review process as the Associate Editor responsible for the paper.
  • Conflict of interest: none.

Abstract

Aims

The purpose of this study was to examine the effect of a pelvic floor muscle (PFM) rehabilitation program on incontinence symptoms, PFM function, and morphology in older women with SUI.

Methods

Women 60 years old and older with at least weekly episodes of SUI were recruited. Participants were evaluated before and after a 12-week group PFM rehabilitation intervention. The evaluations included 3-day bladder diaries, symptom, and quality of life questionnaires, PFM function testing with dynamometry (force) and electromyography (activation) during seven tasks: rest, PFM maximum voluntary contraction (MVC), straining, rapid-repeated PFM contractions, a 60 sec sustained PFM contraction, a single cough and three repeated coughs, and sagittal MRI recorded at rest, during PFM MVCs and during straining to assess PFM morphology.

Results

Seventeen women (68.9 ± 5.5 years) participated. Following the intervention the frequency of urine leakage decreased and disease-specific quality of life improved significantly. PFM function improved significantly: the participants were able to perform more rapid-repeated PFM contractions; they activated their PFMs sooner when coughing and they were better able to maintain a PFM contraction between repeated coughs. Pelvic organ support improved significantly: the anorectal angle was decreased and the urethrovescial junction was higher at rest, during contraction and while straining.

Conclusions

This study indicated that improvements in urine leakage were produced along with improvements in PFM co-ordination (demonstrated by the increased number of rapid PFM contractions and the earlier PFM activation when coughing), motor-control, pelvic organ support. Neurourol. Urodynam. 32:1086–1095, 2013. © 2013 Wiley Periodicals, Inc.

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