Urinary Incontinence Clinical Trial
Official title:
Can Women Correctly Contract Their Pelvic Floor Muscles After to Receive Verbal Instructions and Vaginal Palpation? Protocol of a Randomized Controlled Clinical Trial
The pelvic floor muscle training (PFMT) is a conservative treatment, currently considered as first line for women with stress urinary incontinence (SUI). However, in practice, about 30 to 50% of women are unable to perform the correct contraction of the pelvic floor muscles (PFMs). When requested to perform the muscle contraction, the contraction of the gluteal muscles, hip adductors, or abdominal muscles is observed initially, rather of contraction of the levator anus muscle. Some factors make it difficult to perform the contraction of the PFM, such as its location on the pelvic floor, and its small size, followed by a lack of knowledge of the pelvic region, as well as its functions. Associated with these factors is the use of the muscles adjacent to the PFM, as previously mentioned. In order for women to benefit from a PFMT program for the treatment of SUI, the awareness phase of PFM can't be omitted, since the literature is unanimous in stating that pelvic exercises improve the recruitment capacity of the musculature, its tone and reflex coordination during the effort activities.
Research Questions: The objectives of this study is to test the hypothesis that the provision
of verbal instructions about the anatomy and function of PFMs associated with the use of body
techniques awareness and vaginal palpation helps in learning the correct contraction and
improves the function of the PFMs.
Design: A single-centered, double-blind (investigator and outcome assessor) randomised
controlled trial with two physiotherapy intervention groups.
Measurements: The primary outcome measure will be the EMG activity of the PFMs, gluteus
maximus, hip adductor, and the group formed by the abdominal transverse (TrA) and internal
oblique (IO) muscles during rest and maximal voluntary contractions (MVCs). The secondary
outcome measure will be the PFM function (vaginal palpation and visual observation), posture
assessment (software SAPO), and self-efficacy scale for practising PFM exercises.
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