Abstract
Introduction and hypothesis
It is uncertain how reliable a personal belief is about the ability to do pelvic floor muscle (PFM) contractions early postdelivery and how instructional feedback affects pelvic floor muscle contraction (PFMC) performance. We hypothesize that many women do not have a reliable idea about PFMC and that instructional feedback can help improve their control.
Methods
Prospective observational study in 958 women (median 30 years) early postdelivery PFMC was evaluated with visual observation: an inward movement of the perineum was accepted as sign of good contraction. The women who could not show PFMC three consecutive times got verbal instructions, and re-evaluation was afterward.
Results
In 500 women, no inward movement of the perineum was observed: 275 women (29 %) showed no movement at all, and 225 women (24 %) showed some movement but no inward displacement. In 33.4 %, the personal conviction to be able or not to perform PFMC proved false. After verbal instructions, 74 % improved their PFMC.
Conclusions
The belief of doing correct PFM contraction was false in at least one of five postpartum women. Verbal instructions have a positive effect on performing PFMC in 73.6 % of women.
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Abbreviations
- PFM:
-
Pelvic floor muscles
- PFMC:
-
Pelvic floor muscle contraction
- PFMT:
-
Pelvic floor muscle training
- UI:
-
Urinary incontinence
References
Bortolini M, Drutz H, Lovatsis D (2010) Vaginal delivery and pelvic floor dysfunction: current evidence and implications for future research. Int Urogynecol J 21(8):1025–1030
Sangsawang B, Sangsawang N (2013) Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J 24(6):901–912
Buckley BS, Lapitan MCM (2010) Prevalence of urinary incontinence in men, women, and children—current evidence: findings of the Fourth International Consultation on Incontinence. Urology 76(2):265–270
Thom DH, Rortveit G (2010) Prevalence of postpartum urinary incontinence: a systematic review. Acta Obstet Gynecol 89(12):1511–1522
Mascarenhas T, Coelho R, Oliveira M (2003) Impact of urinary incontinence on quality of life during pregnancy and after childbirth. 33th annual meeting of the International Continence Society, Florence, Italy
Subak LL, Brown JS, Kraus SR (2006) The “costs” of urinary incontinence for women. Obstet Gynecol 107(4):908
Kegel AH (1948) Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gynecol 56(2):238
Whitford HM, Alder B, Jones M (2007) A cross-sectional study of knowledge and practice of pelvic floor exercises during pregnancy and associated symptoms of stress urinary incontinence in North-East Scotland. Midwifery 23(2):204
Hilde G, Stær-Jensen J, Engh ME (2012) Continence and pelvic floor status in nulliparous women at midterm pregnancy. Int Urogynecol J 23(9):1257–1263
Chiarelli P, Cockburn J (1999) The development of a physiotherapy continence promotion program using a customer focus. Aust J Physiother 45:111–119
Talasz H, Himmer-Perschak G, Marth E (2008) Evaluation of pelvic floor muscle function in a random group of adult women in Austria. Int Urogynecol J 19(1):131–135
Haylen BT, de Ridder D, Freeman RM (2010) An international urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29(1):4–20
Chiarelli P, Murphy B, Cockburn J (2003) Women’s knowledge, practises, and intentions regarding correct pelvic floor exercises. Neurourol Urodyn 22(3):246–249
Henderson JW, Wang S, Egger MJ (2013) Can women correctly contract their pelvic floor muscles without formal instruction? Female Pelvic Med Reconstr Surg 19(1):8–12
Herderschee R, Hay-Smith EJC, Herbison GP (2011) Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev 6(7)
Bump RC, Hurt WG, Fantl JA (1991) Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol 165(2):322–327
Hay-Smith J, Mørkved S, Fairbrother K (2009) Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 8(4)
Bø K, Sherburn M (2005) Evaluation of female pelvic-floor muscle function and strength. Phys Ther 85(3):269–282
Acknowledgments
The authors thank all pelvic floor therapists and women who participated in this study.
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Vermandel, A., De Wachter, S., Beyltjens, T. et al. Pelvic floor awareness and the positive effect of verbal instructions in 958 women early postdelivery. Int Urogynecol J 26, 223–228 (2015). https://doi.org/10.1007/s00192-014-2483-x
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DOI: https://doi.org/10.1007/s00192-014-2483-x