International Urogynecology Journal

, Volume 28, Issue 12, pp 1807–1815 | Cite as

Physical activity and pelvic floor muscle training in patients with pelvic organ prolapse: a pilot study

  • Mifuka Ouchi
  • Kumiko Kato
  • Momokazu Gotoh
  • Shigeyuki SuzukiEmail author
Original Article


Introduction and hypothesis

The details of the physical activity in patients with mild to moderate pelvic organ prolapse (Pmoderate pelvic organ prolapse (POP) remain under-studied. The purpose of the present study was to investigate objective physical activity levels and the changes in pelvic floor muscle(PFM) strength, symptoms and quality of life (QOL) between before and after PFM training (PFMT) in patients with POP.


In a prospective pilot study, 29 patients with stage II or III POP completed approximately 16 weeks of PFMT. A reliable activity monitor was used to measure physical activity parameters including step counts, activity and total calories expended, and duration at each intensity level. Maximum vaginal squeeze pressure, POP symptoms and QOL were assessed. Changes in these outcome measures were compared before and after PFMT.


The step counts per day (mean ± SD) of women with POP was 7,272.9 ± 3,091.7 before PFMT and 7,553.4 ± 2,831.0 after PFMT. There was no significant change between before and PFMT. PFM strength was significantly increased after PFMT. POP-related symptoms including stress urinary incontinence, frequency, postmicturition dribble and interference with emptying the bowels were significantly improved. The QOL scores for general health, physical limitations, emotion, and severity measures were significantly improved after PFMT.


Although PFMT changed PFM strength symptoms, and QOL, there were no changes for any physical activity parameters before and after PFMT. This is probably because the physical activity levels in patients with mild to moderate POP were almost same as in age-matched healthy women.


Physical activity Pelvic floor muscle training Pelvic organ prolapse 



The author thanks the members of Suzuki laboratory for advice and constructive criticism of this project.

Compliance with ethical standards

Conflict of interest



  1. 1.
    Bump RC, Mattiasson A, Bø K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175:10–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24:1783–90. doi: 10.1007/s00192-013-2169-9.CrossRefPubMedGoogle Scholar
  3. 3.
    Brown WJ, Miller YD. Too wet to exercise? Leaking urine as a barrier to physical activity in women. J Sci Med Sport. 2001;4:373–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Nygaard I, Handa V, Brubaker L, et al. Physical activity in women planning sacrocolpopexy. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18:33–7. doi: 10.1007/ s00192-006-0116-8.CrossRefPubMedGoogle Scholar
  5. 5.
    Stüpp L, Resende AP, Oliveira E, et al. Pelvic floor muscle training for treatment of pelvic organ prolapse: an assessor-blinded randomized controlled trial. Int Urogynecol J. 2011;22:1233–9. doi: 10.1007/s00192-011-1428-x.CrossRefPubMedGoogle Scholar
  6. 6.
    Abrams P, Andersson KE, Birder L, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29:213–40.Google Scholar
  7. 7.
    Bø K. Can pelvic floor muscle training prevent and treat pelvic organ prolapse? Acta Obstet Gynecol Scand. 2006;85:263–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014;383:796–806. doi: 10.1016/S0140-6736(13)61977-7.CrossRefPubMedGoogle Scholar
  9. 9.
    Braekken IH, Majida M, Engh M, Bø K. Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol. 2010;203:170. e1-7Google Scholar
  10. 10.
    Braekken IH, Hoff Braekken I, Majida M, et al. Morphological changes after pelvic floor muscle training measured by 3-dimensional ultrasonography: a randomized controlled trial. Obstet Gynecol. 2010;115:317–24.CrossRefPubMedGoogle Scholar
  11. 11.
    Hung H-C, Hsiao S-M, Chih S-Y, et al. Effect of pelvic-floor muscle strengthening on bladder neck mobility: a clinical trial. Phys Ther. 2011;91:1030–8. doi: 10.2522/ptj.20100186.CrossRefPubMedGoogle Scholar
  12. 12.
    Miller JM, Ashton-Miller JA, DeLancey JO. A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc. 1998;46:870–4.CrossRefPubMedGoogle Scholar
  13. 13.
    Kumahara H, Schutz Y, Ayabe M, et al. The use of uniaxial accelerometry for the assessment of physical-activity-related energy expenditure: a validation study against whole-body indirect calorimetry. Br J Nutr. 2004;91:235–43.CrossRefPubMedGoogle Scholar
  14. 14.
    Crouter SE, Schneider PL, Karabulut M, et al. Validity of 10 electronic pedometers for measuring steps, distance, and energy cost. Med Sci Sports Exerc. 2003;35:1455–60.CrossRefPubMedGoogle Scholar
  15. 15.
    Tudor-Locke C, Bassett DR. How many steps/day are enough? Preliminary pedometer indices for public health. Sport Med. 2004;34:1–8. doi: 10.2165/00007256-200434010-00001.CrossRefGoogle Scholar
  16. 16.
    Kubota A, Nagata J, Sugiyama M, et al. How many days of pedometer monitoring predict weekly physical activity in Japanese adults? [in Japanese]. Nihon Koshu Eisei Zasshi. 2009;56:805–10.PubMedGoogle Scholar
  17. 17.
    Tudor-Locke C, Burkett L, Reis JP, et al. How many days of pedometer monitoring predict weekly physical activity in adults? Prev Med. 2005;40:293–8. doi: 10.1016/j.ypmed.2004.06.003.CrossRefPubMedGoogle Scholar
  18. 18.
    Digesu GA, Khullar V, Cardozo L, et al. P-QOL: a validated questionnaire to assess the symptoms and quality of life of women with urogenital prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2005;16:176–81. doi: 10.1007/s00192-004-1225-x.CrossRefPubMedGoogle Scholar
  19. 19.
    Takeyama M, Ikeda S, Kobayashi M, et al. Validation of the prolapse quality-of life questionnaire (P-QOL) in Japanese version in Japanese women [in Japanese]. J Japanese Cont Soc. 2014;25:327–36.Google Scholar
  20. 20.
    Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology. 2006;130:1480–91. doi: 10.1053/j.gastro.2005.11.061.CrossRefPubMedGoogle Scholar
  21. 21.
    Matsushita M, Sawada S, Nakagata T, et al. Characteristics of the number of steps in the National Health and nutrition survey [in Japanese]. Nihon Koshu Eisei Zasshi. 2014;61:686–92.Google Scholar
  22. 22.
    Bogner HR, Gallo JJ, Sammel MD, et al. Urinary incontinence and psychological distress in community-dwelling older adults. J Am Geriatr Soc. 2002;50:489–95.Google Scholar
  23. 23.
    Nygaard I, Girts T, Fultz NH, et al. Is urinary incontinence a barrier to exercise in women? Obstet Gynecol. 2005;106:307–14. doi: 10.1097/01.AOG.0000168455.39156.0f.CrossRefPubMedGoogle Scholar
  24. 24.
    Nygaard I, Handa VL, Brubaker L, et al. Changes in physical activity after abdominal sacrocolpopexy for advanced pelvic organ prolapse. Am J Obstet Gynecol. 2008;198:570.e1-5.Google Scholar
  25. 25.
    Stach-Lempinen B, Nygård CH, Laippala P, et al. Is physical activity influenced by urinary incontinence? BJOG. 2004;111:475–80.CrossRefPubMedGoogle Scholar
  26. 26.
    Homma Y, Yamaguchi O, Hayashi K. Epidemiologic survey of lower urinary tract symptoms in Japan. Urology. 2006;68:560–4. doi: 10.1016/j.urology.2006.03.035.CrossRefPubMedGoogle Scholar
  27. 27.
    Farage MA, Miller KW, Berardesca E, et al. Psychosocial and societal burden of incontinence in the aged population: a review. Arch Gynecol Obstet. 2008;277:285–90. doi: 10.1007/s00404-007-0505-3.CrossRefPubMedGoogle Scholar
  28. 28.
    Hagen S, Stark D, Glazener C, et al. A randomized controlled trial of pelvic floor muscle training for stages I and II pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:45–51. doi: 10.1007/s00192-008-0726-4.CrossRefPubMedGoogle Scholar
  29. 29.
    Li C, Gong Y, Wang B. The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis. Int Urogynecol J. 2016;27:981-92. doi: 10.1007/s00192-015-2846-y.
  30. 30.
    Hirakawa T, Suzuki S, Kato K, et al. Randomized controlled trial of pelvic floor muscle training with or without biofeedback for urinary incontinence. Int Urogynecol J. 2013;24:1347–54.CrossRefPubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2017

Authors and Affiliations

  • Mifuka Ouchi
    • 1
  • Kumiko Kato
    • 2
  • Momokazu Gotoh
    • 3
  • Shigeyuki Suzuki
    • 4
    Email author
  1. 1.School of Rehabilitation SciencesHealth Sciences University of HokkaidoTobetsuJapan
  2. 2.Department of Female UrologyJapanese Red Cross Nagoya First HospitalNagoyaJapan
  3. 3.Department of UrologyNagoya University Graduate School of MedicineNagoyaJapan
  4. 4.Program in Physical and Occupational TherapyNagoya University Graduate School of MedicineHigashi-kuJapan

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