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Effectiveness of Different Hypopressive Exercises in Pelvic Floor Dysfunction

Not Applicable
Completed
Conditions
Pelvic Floor Disorders
Interventions
Other: Hypopressive exercises
Other: Hypopressive exercises plus pelvic floor muscle contraction
Other: Hypopressive maneuver plus pelvic floor muscle contraction
Other: Hypopressive maneuver
Registration Number
NCT04336150
Lead Sponsor
University of Alcala
Brief Summary

The purpose of the study is to compare the efficacy of different modalities of hypopressive exercises and biofeedback with ultrasound in women with pelvic floor dysfunctions, considering the efficacy of the treatment as improving the specific quality of life related to pelvic floor dysfunctions and improvement of the muscular properties of the pelvic floor muscles.

Detailed Description

Female 18-65 years old

Inclusion Criteria:

Women diagnosed with pelvic floor dysfunction by their doctor. With minimum strength of the pelvic floor muscles of 3 according to Modified Oxford Score

Exclusion Criteria:

Women who are pregnant or women who have had a vaginal or caesarean birth in the past six months.

Women whose PFD is severe and the first indication is surgical (POP-Q grade III-IV prolapses).

Women with only urinary incontinence or fecal urgency. Women with pain in the pelvic-perineal region of 3 cm in the visual analog scale, where a score of 0 cm means no pain, and a score of 10cm, the maximum pain that the participant can imagine.

Women who have received pelvic floor physiotherapy treatment in the last 12 months.

Women who are unable to voluntarily contract the pelvic floor muscles, quantified by the Modified Oxford Score by a score less than or equal to 2.

Women with any pathology that may affect the treatment (neurological, gynecological or urological), or with recurrent urinary infection or hematuria.

Women with cognitive limitations to understand the information, answer the questionnaires, consent and / or participate in the study.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
120
Inclusion Criteria
  • Women diagnosed with pelvic floor dysfunction by their doctor.
  • With minimum strength of the pelvic floor muscles of 3 according to Modified Oxford Score
Exclusion Criteria
  • Women who are pregnant or women who have had a vaginal or caesarean birth in the past six months.
  • Women whose PFD is severe and the first indication is surgical (POP-Q grade III-IV prolapses).
  • Women with only urinary incontinence or fecal urgency.
  • Women with pain in the pelvic-perineal region of 3 cm in the visual analog scale, where a score of 0 cm means no pain, and a score of 10cm, the maximum pain that the participant can imagine.
  • Women who have received pelvic floor physiotherapy treatment in the last 12 months.
  • Women who are unable to voluntarily contract the pelvic floor muscles, quantified by the Modified Oxford Score by a score less than or equal to 2.
  • Women with any pathology that may affect the treatment (neurological, gynecological or urological), or with recurrent urinary infection or hematuria.
  • Women with cognitive limitations to understand the information, answer the questionnaires, consent and / or participate in the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Hypopressive exercisesEHypopressive exercisesHypopressive exercises described according to Dr. Caufriez 1. Anatomical and physiological explanation of the abdomen-pelvic cavity (perineal organs, bone, ligament and muscle structures of the entire abdomen-pelvic cavity). 2. Hypopressive exercises according to the original method described by Dr. Caufriez, which is based on performing the hypopressive maneuver in 33 postures that he described (1,2).
Hypopressive exercises&PFM contractionHypopressive exercises plus pelvic floor muscle contractionHypopressive exercises + active pelvic floor muscle contraction: 1. Anatomical and physiological explanation of the abdomen-pelvic cavity (perineal organs, bone, ligament and muscle structures of the entire abdomen-pelvic cavity). 2. Hypopressive exercises according to the original method described by Dr.Caufriez, which is based on performing the hypopressive maneuver in 33 postures he described, plus the active contraction of the pelvic floor muscles (PFM) during the hypopressive maneuver.
Hypopressive maneuver&PFM contractionHypopressive maneuver plus pelvic floor muscle contractionHypopressive maneuver + pelvic floor muscles contraction: 1. Anatomical and physiological explanation of the abdomen-pelvic cavity (perineal organs, bone, ligament and muscle structures of the entire abdomen-pelvic cavity). 2. Hypopressive maneuver plus active contraction of the pelvic floor muscles with transabdominal ultrasound biofeedback.
Hypopressive maneuverHypopressive maneuverHypopressive maneuver: 1. Anatomical and physiological explanation of the abdomen-pelvic cavity (perineal organs, bone, ligament and muscle structures of the entire abdomen-pelvic cavity). 2. Hypopressive maneuver with transabdominal ultrasound biofeedback.
Primary Outcome Measures
NameTimeMethod
Change in life impact of pelvic floor dysfunction5 assessments to evaluate change from baseline: at baseline, after the intervention period (2 months from baseline), 3 months, 6 months and 12 months after the intervention.

It will be assessed by the PFIQ-7 Spanish version. The PFIQ-7 consists of 3 scales of 7 questions each taken from the Urinary Impact Questionnaire, the Pelvic Organ Prolapse Impact Questionnaire, and the Colorectal-Anal Impact Questionnaire. The 3 scales are scored from 0 (least impact) to 100 (greatest impact) and an overall summary score (0 to 300).

Change in symptoms and quality of life: PFDI-205 assessments to evaluate change from baseline: at baseline, after the intervention period (2 months from baseline), 3 months, 6 months and 12 months after the intervention.

It will be assessed by PFDI-20 that is both a symptom inventory and a measure of the degree of bother and distress caused by pelvic floor symptoms. The PFDI-20 includes 20 questions and 3 scales. Each of the 3 scales is scored from 0 (least distress) to 100 (greatest distress). The sum of the scores of these 3 scales serves as the overall summary score of the PFDI-20 and ranges from 0 - 300 and the higher the score, the worse quality of life. The 3 scales include questions taken from the following widely used outcome measures: Urinary Distress Inventory - 6 questions, Pelvic Organ Prolapse Distress Inventory - 6 questions, and Colorectal-Anal Distress Inventory - 8 questions collecting data about UI, POP and colorectal and anal symptoms.

Secondary Outcome Measures
NameTimeMethod
Change in pelvic floor muscle strength by dinamometry5 assessments to evaluate change from baseline after the intervention period (2 months from baseline), 3 months, 6 months and 12 months after the intervention.

It will be measured by dynamometry (measured in GRAMS).

Change in pelvic floor muscle strength by manual scale5 assessments to evaluate change from baseline after the intervention period (2 months from baseline), 3 months, 6 months and 12 months after the intervention.

It will be measured by Modified Oxford Scale to rate pelvic floor muscle contraction on a scale of 0-5: 0 = no contraction; 1 = minor muscle; 'flicker'; 2 = weak muscle; contraction; 3 = moderate muscle contraction; 4 = good muscle contraction and 5 = strong muscle contraction. T)

Change in pelvic floor muscle pasive tone5 assessments to evaluate change from baseline after the intervention period (2 months from baseline), 3 months, 6 months and 12 months after the intervention.

It will be measured by dinamometry (measured in GRAMS)

Cahnge in the displacement of the base of the bladder during voluntary contraction of the pelvic floor5 assessments to evaluate change from baseline after the intervention period (2 months from baseline), 3 months, 6 months and 12 months after the intervention.

It will be measured by Ultrasound

Trial Locations

Locations (1)

María

🇪🇸

Alcalá de Henares, Madrid, Spain

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