Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women.

Rehabilitation Teaching and Research Unit, Department of Medicine, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington South, Wellington, New Zealand.
Cochrane database of systematic reviews (Online) (Impact Factor: 5.94). 02/2008; DOI: 10.1002/14651858.CD007471
Source: PubMed

ABSTRACT About a third of women have urinary incontinence and up to a tenth have faecal incontinence after childbirth. Pelvic floor muscle training is commonly recommended during pregnancy and after birth both for prevention and treatment of incontinence.
To determine the effect of pelvic floor muscle training compared to usual antenatal and postnatal care on incontinence.
We searched the Cochrane Incontinence Group Specialised Register (searched 24 April 2008) and the references of relevant articles.
Randomised or quasi-randomised trials in pregnant or postnatal women. One arm of the trials needed to include pelvic floor muscle training (PFMT). Another arm was either no pelvic floor muscle training or usual antenatal or postnatal care. The pelvic floor muscle training programmes were divided into either: intensive; or unspecified if training elements were lacking or information was not provided. Reasons for classifying as intensive included one to one instruction, checking for correct contraction, continued supervision of training, or choice of an exercise programme with sufficient exercise dose to strengthen muscle.
Trials were independently assessed for eligibility and methodological quality. Data were extracted then cross checked. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook. Three different populations of women were considered separately: women dry at randomisation (prevention); women wet at randomisation (treatment); and a population-based approach in women who might be one or the other (prevention or treatment). Trials were further divided into: those which started during pregnancy (antenatal); and after delivery (postnatal).
Sixteen trials met the inclusion criteria. Fifteen studies involving 6181 women (3040 PFMT, 3141 controls) contributed to the analysis. Based on the trial reports, four trials appeared to be at low risk of bias, two at low to moderate risk, and the remainder at moderate risk of bias.Pregnant women without prior urinary incontinence who were randomised to intensive antenatal PFMT were less likely than women randomised to no PFMT or usual antenatal care to report urinary incontinence in late pregnancy (about 56% less; RR 0.44, 95% CI 0.30 to 0.65) and up to six months postpartum (about 30% less; RR 0.71, 95% CI 0.52 to 0.97).Postnatal women with persistent urinary incontinence three months after delivery and who received PFMT were less likely than women who did not receive treatment or received usual postnatal care (about 20% less; RR 0.79, 95% CI 0.70 to 0.90) to report urinary incontinence 12 months after delivery. It seemed that the more intensive the programme the greater the treatment effect. Faecal incontinence was also reduced at 12 months after delivery: women receiving PFMT were about half as likely to report faecal incontinence (RR 0.52, 95% CI 0.31 to 0.87).Based on the trial data to date, the extent to which population-based approaches to PFMT are effective is less clear (that is, offering advice on PFMT to all pregnant or postpartum women whether they have incontinence symptoms or not). It is possible that population-based approaches might be effective when the intervention is intensive enough.There was not enough evidence about long-term effects for either urinary or faecal incontinence.
There is some evidence that PFMT in women having their first baby can prevent urinary incontinence in late pregnancy and postpartum. In common with older women with stress incontinence, there is support for the widespread recommendation that PFMT is an appropriate treatment for women with persistent postpartum urinary incontinence. It is possible that the effects of PFMT might be greater with targeted rather than population-based approaches and in certain groups of women (for example primiparous women; women who had bladder neck hypermobility in early pregnancy, a large baby, or a forceps delivery). These and other uncertainties, particularly long-term effectiveness, require further testing.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Adhesive capsulitis is a common painful condition characterized by severe loss of mobility and shoulder pain. Patients with this disease have a painful restriction of both active and passive mobility and an overall loss of shoulder movement in all planes. This experimental design study investigated the effect of combination of taping neuromuscular and stretching exercises program compared to ultrasounds and stretching exercises program. A total of 40 patients aged between 40 and 60 years were involved in the study. Patients were divided in two groups: first group subjected of neuromuscular taping +stretching exercises program for 4 weeks (experimental group 20 patients) and a second group subjected of a daily program of physical therapy + stretching exercises (control group 20 patients). They were evaluated using visual analogue scales for pain, goniometric measure for passive and active range of motion, SPADI index for shoulder function and patient satisfaction. Analysis showed statistically significant improvement in both the experimental and control groups. In addition, the mean improvement in VAS was significantly greater after first week in the experimental group than in the control group. The study showed that the combination of taping with stretching exercises program leads to better outcomes in rehabilitation of patients with frozen shoulder especially when an immediate effect is needed. Keywords: Adhesive exercises, taping neuromuscular, ultrasound, laser, stretching exercises.
    The 2th International Scientific Forum, ISF 2014, Tirana, Albania; 12/2014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Urinary incontinence is a significant health problem with considerable social and economic impact. Women experience UI twice as often as men. Various factors may affect the development of UI.According to existing studies and literature few women go to consult a therapist who specializes in urinary incontinence in our country.Talking about this kind of problems it is a taboo for most women, especially for women living in small cities or rural area. For them it is difficult to even consider a therapist for such personal problems. Most of the cases women blame their self’s for these problems.Purpose of the study: The purpose of the study was to investigate the effects of Combined Pelvic Floor Muscle Exercise (PFME) in patient with Urinary Incontinence.Methodology:40 patient (women) aged over 18 years old were involved in a randomized control trial . The patients were randomly allocated into two groups, the control group and the experimental group. The experimental group practiced PFME at home, the control group didn’t practice PFME at home . Assessment of UI was conducted at baseline and three months.Results: Statistical analysis of the data showed that PFME gives good results in controlling involuntary loss of urine. Conclusion.Physiotherapy is an effective treatment and less cost. To have this method of treatment introduced to patients will have a great impact in Improving their QOL. This treatment isn’t very recognized in Albania. One of the best ways to introduce this method will be from the family doctors and from maternity staff who treats the most effected patients, future mothers.
    The Journal of MacroTrends in Health and Medicine. 12/2014; Vol 2(Issue 1):148.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cancer in general in Albania is an increasing problem and cervical cancer is the third most common gynecologic cancer among all women. Refer to European Code Against cancer an important action for women to help to prevent cervical cancer is to take part in organised cancer screening programmes. The study aims to identify in women health beliefs about cervical cancer. This is a transversal and analytical study with a sample of 210 healthy women from Vlora city with different socio-economic and educational levels. A self-administered questionnaire that assesses the health beliefs components about cervical cancer was the data collection instrument. The results highlighted low risk perception relative to cervical cancer. Most of women believe that cervical cancer as dangerous as all the other cancers and uncertainties about the chances to recover from it exist among them. Misunderstandings and high sensitivity relate to cervical screening. Relationship between perceived benefits, emotional, economic barriers and Pap test uptake was found. Large numbers of women never screened. The results indicated that to improve the women's attitudes to health, to encourage adherence to cervical screening and to avoid misconceptions due to lack of information conversations with health operators and the designing of effective prevention strategies based on health beliefs are fundamental.
    2nd INTERNATIONAL SCIENTIFIC FORUM, ISF 2014, Tirana,Albania; 12/2014

Full-text (2 Sources)

Available from
Jun 5, 2014