Open AccessPrenatal high-low impact exercise program supported by pelvic floor muscle education and training decreases the life impact of postnatal urinary incontinence
Author(s) -
Anna Szumilewicz,
Agnieszka Kuchta,
Monika Kranich,
Marcin Dornowski,
Zbigniew Jastrzębski
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000018874
Subject(s) - medicine , urinary incontinence , pelvic floor muscle , pelvic floor , physical therapy , pregnancy , urinary system , biofeedback , obstetrics , urology , surgery , biology , genetics
Background: Pregnancy and high impact exercise may cause postnatal urinary incontinence. We aimed to evaluate the life impact of postnatal urinary incontinence in women attending prenatal, high-low impact exercise program, supported by pelvic floor muscle education and training, in comparison to controls. Methods: It was a quasiexperimental trial among 260 postpartum Caucasian women (age 29 ± 4 years; mean ± standard deviation). The training group (n = 133) attended a high-low impact exercise and educational program from the 2nd trimester of pregnancy until birth, 3 times a week. We educated this group to contract and relax pelvic floor muscles with surface electromyography biofeedback and instructed how to exercise postpartum. Control women (n = 127) did not get any intervention. All women reported on the life impact of urinary incontinence 2 months and 1 year postpartum using the Incontinence Impact Questionnaire (IIQ). Results: Training group started regular pelvic floor muscle exercises substantially earlier postpartum than controls ( P < .001). Significantly less training women reported the life impact of urinary incontinence both 2 months ( P = .03) and 1 year postpartum ( P = .005). Two months after birth, for the symptomatic women the IIQ scores were significantly lower in the training than in the control women (median [Me] = 9.4 vs Me = 18.9; P = .002). Between the 1st and 2nd assessments the number of women affected by incontinence symptoms decreased by 38% in the training group and by 20% in the controls. Conclusion: High-low impact activities supported by pelvic floor muscle exercises and education should be promoted among pregnant, physically active women. Such activities may help women to continue high-intensity exercise with the simultaneous prevention of postnatal urinary incontinence. Thy study was registered at ISRCTN under the title “Pelvic floor muscle training with surface electromyography” (DOI 10.1186/ISRCTN92265528).