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The Effects of home-based stabilization exercises focusing on the pelvic floor on postnatal stress urinary incontinence and low back pain: a randomized controlled trial

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A Commentary to this article was published on 06 May 2020

Abstract

Introduction and hypothesis

Stress urinary incontinence (SUI) and low back pain (LBP) are common postnatal problems. We aimed to compare the effects of stabilization exercises focusing on the pelvic floor on postnatal SUI and LBP.

Methods

This two-arm, single-blind, parallel, randomized controlled trial was done on 80 women (mean age: 30.5, range: 20–45 years), with postnatal SUI and LBP. They were randomized into two equal control and intervention groups. The control group received no treatment while the intervention group received home-based stabilization exercises focusing on pelvic floor muscles (PFM) 3 days a week for 12 weeks, three sets a day; each set included three different types of exercise each week. Outcome measures were UI severity, assessed by ICIQ-UI-SF, low back pain functional disability, assessed by the Oswestry Disability Index (ODI), LBP severity, assessed by visual analog scale (VAS), and PFM strength and endurance, assessed by vaginal examination. Transverse abdominis (TrA) muscle strength was assessed by manometric biofeedback. All outcomes were measured directly before and after treatment.

Results

In the intervention group, PFM strength, TrA muscle strength, functional disability and pain severity were significantly improved (P < 0.05). Within-group results showed that all outcomes except pain severity (P = 0.06) had directly improved in the intervention group after treatment (P < 0.05), while in the control group only PFM strength and endurance and UI severity had improved (P < 0.05).

Conclusions

Home-based stabilization exercises focusing on the pelvic floor muscles could be effective for postnatal LBP and SUI.

Trial registration

Iranian Registry of Clinical Trials (Code: IRCT2017050618760N4).

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Abbreviations

SUI:

Stress urinary incontinence

LBP:

Low back pain

PFM:

Pelvic floor muscles

PFD:

Pelvic floor disorders

ODI:

Oswestry Disability Index

VAS:

Visual analog scale

TrA:

Transverse abdominis

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Acknowledgments

The authors thank all of the participants, the Physiotherapy Department of Tabriz University of Medical Sciences and Al-Zahra Hospital.

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Authors and Affiliations

  1. Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Daneshgah Ave., Tabriz, Iran

    Fahime Khorasani & Fariba Ghaderi

  2. Iranian Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    Fariba Ghaderi

  3. Department of Gynaecology, Woman’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Parvin Bastani

  4. Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Parvin Sarbakhsh

  5. Pelvic care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands

    Bary Berghmans

Authors
  1. Fahime Khorasani
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  2. Fariba Ghaderi
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  3. Parvin Bastani
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  4. Parvin Sarbakhsh
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Contributions

F Ghaderi: Project development, Data Collection, Manuscript writing and editing

F Khorasani: Project development, Data collection

P Bastani: Data collection

P Sarbakhsh: Statistical Analysis

B Berghmans: Project Development, Manuscript writing and editing, English editing

Corresponding author

Correspondence to Fariba Ghaderi.

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Khorasani, F., Ghaderi, F., Bastani, P. et al. The Effects of home-based stabilization exercises focusing on the pelvic floor on postnatal stress urinary incontinence and low back pain: a randomized controlled trial. Int Urogynecol J 31, 2301–2307 (2020). https://doi.org/10.1007/s00192-020-04284-7

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  • DOI: https://doi.org/10.1007/s00192-020-04284-7

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