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Pelvic Floor Muscle Training in Pregnancy to Prevent Urinary Incontinence

pregnant yoga

If pelvic floor muscle training (PFMT) is instructed as part of a general exercise class during pregnancy, can this (PFMT) prevent urinary incontinence? A recent post on our site described the systematic review by Bo and colleagues in which the researchers suggested that fitness instructors and coaches should be trained in effective pelvic floor muscle training approaches. A recent article describes such an approach in which a Physical Activity and Sports Sciences graduate instructed in a general exercise class for pregnant women and the class also included PFMT. Nulliparous women completed participation in a pregnancy exercise class (n=63) or a control group (n=89), and in the exercise group, pelvic floor muscle exercises were included. The classes took place 3x/week, for 55-60 minutes each session, for up to 22 weeks, and 8-12 women were in each group class.

Within each exercise class, a typical prenatal program was followed consisting of an 8 minute warm-up, 30 minutes of aerobic training including 10 minutes of strength training, 10 minutes of PFMT and a 7 minute cool-down period. A heart rate monitor and a Borg Rating of Perceived Exertion Scale was used and the women were asked to exercise at a 12-14 on the Borg scale. For pelvic floor muscle training, women were instructed in the anatomy and function of the PFM and in the role of the PFM in urinary incontinence. Although the participants were not formally assessed for correct contractions, the women were instructed in methods of confirming a correct contraction at home such as stopping the flow of urine, self-palpation, or using a mirror to confirm contraction. The PFM exercises started with 1 set of 8 contractions, and the class included both long (6 seconds) and short (1 second) contractions. The participants worked up to a total of 100 exercise contractions that included a combination of short and long contractions, and they were also encouraged to complete the same number of exercises on days outside of class.

Women in the control group received "usual care" including care from a midwife and instruction in pelvic floor muscle health. The outcome tool completed by both groups included the International Consultation on Incontinence Questionnaire- Urinary Incontinence Short Form (ICIQ-UI SF) which was completed prior to and directly following intervention. At the end of the intervention, a significant difference was observed in the women in the exercise group (EG), as 95% of the EG denied leakage, whereas 61% of the control group denied leakage. Of those reporting leakage in the exercise group, the amount of leakage reported was small, and in the control group, amount leaked ranged from small to large. The key points of interest in this study include that first, participation in an exercise group that includes pelvic floor muscle training can prevent urinary incontinence in pregnancy, Secondly, although pelvic muscle function assessment is optimal, participants who did not have PFM contraction confirmed still had positive outcome from the treatment. And because most studies of PFMT are conducted by a physical therapist, this study is unique in its design of having a Physical Activity and Sports Science graduate conduct the intervention.

To learn more about training the pelvic floor, find out which course in the Pelvic Floor Series is right for you. If you have not been trained yet in internal pelvic muscle assessment, the Pelvic Floor Level 1 (PF1) continuing education course is a great place to start. This course fills up many months ahead of time, so check the dates on our website for the best course for you!

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Upcoming Continuing Education Courses

Pregnancy Rehabilitation - Seattle, WA (SOLD OUT)

Feb 22, 2020 - Feb 23, 2020
Location: Pacific Medical Centers

Manual Therapy Techniques for the Pelvic Rehab Therapist - Pasadena, CA

Feb 22, 2020 - Feb 23, 2020
Location: Huntington Hospital

Pelvic Floor Level 2B - Alexandria, VA (SOLD OUT)

Feb 28, 2020 - Mar 1, 2020
Location: Inova Physical Therapy Center

Pelvic Floor Level 2B - Fort Worth, TX (SOLD OUT)

Feb 28, 2020 - Mar 1, 2020
Location: University of North Texas Health Science Center

Pediatric Functional Gastrointestinal Disorders - Charlotte, NC

Feb 28, 2020 - Mar 1, 2020
Location: Novant Health

Rehabilitative Ultrasound Imaging: Orthopedic Topics - Raleigh, NC

Feb 28, 2020 - Feb 29, 2020
Location: Rex Hospital

Pelvic Floor Series Capstone - Phoenix, AZ (SOLD OUT)

Mar 6, 2020 - Mar 8, 2020
Location: 360 Sports Medicine & Aquatic Rehabilitation Centers

Pelvic Floor Level 1 - Salida, CO (SOLD OUT)

Mar 6, 2020 - Mar 8, 2020
Location: Heart of the Rockies Regional Medical Center

Pelvic Floor Level 1 - Columbia, MO

Mar 6, 2020 - Mar 8, 2020
Location: University of Missouri-Smiley Lane Therapy Services

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Mar 6, 2020 - Mar 8, 2020
Location: Princeton Healthcare System

Pelvic Floor Level 1 - New Orleans, LA (SOLD OUT)

Mar 6, 2020 - Mar 8, 2020
Location: Ochsner Health System

Mobilization of the Myofascial layer: Pelvis and Lower Extremity- Grand Rapids, MI

Mar 6, 2020 - Mar 8, 2020
Location: Spectrum Health System

Bowel Pathology and Function -Salt Lake City, UT

Mar 7, 2020 - Mar 8, 2020
Location: Veterans Administration - Salt Lake City

Postpartum Rehabilitation - Washington, DC (SOLD OUT)

Mar 7, 2020 - Mar 8, 2020
Location: GWUH Outpatient Rehabilitation Center

Pelvic Floor Level 1 - Virginia Beach, VA (SOLD OUT)

Mar 13, 2020 - Mar 15, 2020
Location: Sentara Therapy Center - Princess Anne

Pelvic Floor Level 2A - Philadelphia, PA (SOLD OUT)

Mar 13, 2020 - Mar 15, 2020
Location: Thomas Jefferson University

Pelvic Floor Level 1 - Manchester, NH (SOLD OUT)

Mar 13, 2020 - Mar 15, 2020
Location: Franklin Pierce University

Meeks Method for Osteoporosis - Minneapolis, MN

Mar 14, 2020 - Mar 15, 2020
Location: Park Nicollet Clinic--St. Louis Park

Pelvic Floor Level 2A - Minneapolis, MN (SOLD OUT)

Mar 20, 2020 - Mar 22, 2020
Location: Allina Hospitals and Clinics

Nutrition Perspectives for the Pelvic Rehab Therapist - San Diego, CA

Mar 20, 2020 - Mar 22, 2020
Location: Comprehensive Therapy Services

Pelvic Floor Level 1 - Birmingham, AL (SOLD OUT)

Mar 20, 2020 - Mar 22, 2020
Location: Shelby Baptist Medical Center

Mobilization of Visceral Fascia: The Urinary System - Carlsbad, CA

Mar 20, 2020 - Mar 22, 2020
Location: Tri-City Medical Center

Pelvic Floor Level 1 - Bellingham, WA (SOLD OUT)

Mar 20, 2020 - Mar 22, 2020
Location: PeaceHealth- St. Joseph Medical Center

Pelvic Floor Level 1 - Los Angeles, CA (SOLD OUT)

Mar 20, 2020 - Mar 22, 2020
Location: Mount Saint Mary’s University

Breastfeeding Conditions - Phoenix, AZ

Mar 21, 2020 - Mar 22, 2020
Location: Banner Physical Therapy and Rehabilitation

Breathing and the Diaphragm: Orthopedic Therapists - Sterling Heights, MI

Mar 27, 2020 - Mar 29, 2020
Location: Henry Ford Macomb Hospital

Breathing and the Diaphragm: Pelvic and Orthopedic Therapists - Sterling Heights, MI

Mar 27, 2020 - Mar 29, 2020
Location: Henry Ford Macomb Hospital

Pelvic Floor Level 1 - Corvallis, OR (SOLD OUT)

Mar 27, 2020 - Mar 29, 2020
Location: Albany Sport & Spine Physical Therapy

Breast Cancer Rehabilitation - Alexandria, VA

Mar 28, 2020 - Mar 29, 2020
Location: Inova Physical Therapy Center