Pre-rehabilitation of the pelvic floor before radiation therapy for cervical cancer: a pilot study

Abstract

Introduction and hypothesis

The objective was to evaluate pelvic floor muscle (PFM) function regarding strength, activation and incontinence, approximately 1 month before and after radiation therapy in women with cervical cancer.

Methods

This was a pilot study of 49 women with cervical cancer at stages I to III. These women attended an educational session with a physical therapist who taught them to perform preventive pelvic floor muscle exercises (PFMEs; slow and fast contractions and the “knack”) at home before, during and after radiation therapy. The women received instructions for performing PFME prior to radiation therapy. The modified Oxford scale, electromyography (EMG), the International Consultation on Incontinence Questionnaire Short Form to assess urinary incontinence and two questions for faecal and gas incontinence were used.

Results

Twenty-eight women (57%; mean age = 44 years, range 27–66) completed the study, 21 (43%) were lost to follow-up. There was no significant change from baseline to post-radiation therapy in muscle strength, EMG records and incontinence (p > 0.05). The median of PFM strength was equal at baseline and after intervention (median = 2; IQR = 1).

Conclusions

The results of this study suggest that pre-rehabilitation teaching PFMEs might be a protective factor for preserving PFM strength and preventing incontinence 1 month after radiation therapy. It is a feasible intervention.

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Funding

1° Concurso de Investigacion Interno de la Universidad Bernardo O’Higgins (Ref. UBO/VRIP 170202) and Concurso de Investigacion Interno de la Universidad San Sebastian (PI0073–2016-0003-IE).

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Authors

Contributions

C. Sacomori: protocol/project development, data collection or management, data analysis, manuscript writing/editing; P. Araya-Castro: protocol/project development, data collection or management, manuscript writing/editing; P. Diaz-Guerrero: protocol/project development, delivered the intervention, manuscript editing; I.A. Ferrada: recruited participants, data collection or management, manuscript editing; A.C. Martínez-Varas: recruited participants, tabulated data, data collection or management, manuscript editing; K. Zomkowski: manuscript writing and editing.

Corresponding author

Correspondence to Paulina Araya-Castro.

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The authors declare that they have no conflicts of interest.

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Sacomori, C., Araya-Castro, P., Diaz-Guerrero, P. et al. Pre-rehabilitation of the pelvic floor before radiation therapy for cervical cancer: a pilot study. Int Urogynecol J 31, 2411–2418 (2020). https://doi.org/10.1007/s00192-020-04391-5

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Keywords

  • Cervical cancer
  • Radiotherapy
  • Brachytherapy
  • Pelvic floor
  • Muscle strength
  • Pre-rehabilitation