E-Posters-Rehabilitation in Women Undergoing Pelvic Floor Reconstructive Surgery: A Double-blind, Randomised, Controlled Clinical Trial

Rehabilitation in Women Undergoing Pelvic Floor Reconstructive Surgery: A Double-blind, Randomised, Controlled Clinical Trial - Corlia Brandt, BSc, MSc, PhD

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This study aimed to determine the outcomes of a pelvic floor muscle training (PFMT) protocol, core training protocol, and a control group on the abdominal and pelvic floor muscles (PFM) and quality of life (QOL) in women undergoing corrective surgery for pelvic organ prolapse (POP). The study included women over 18 years old scheduled for corrective surgery who were able to execute a home program and were literate. Women with neuro-musculoskeletal disorders, pregnancy, over 75 years old, with stage IV POP, or with a history of more than 2 previous surgical corrections were excluded.<br /><br />The outcomes measures included levator hiatus at rest, during Valsalva, and during contraction, thickness of perineal body and puborectalis muscle, movement and endurance of muscles, muscle activity, pain, and exercise adherence. The measuring instruments used were a demographic questionnaire, prolapse-specific quality of life questionnaire, ultrasound, electromyography, PERFECT scale, visual faces scale, Sahrmann scale, pressure biofeedback unit, and training diary.<br /><br />The results showed that group 2, which underwent the core training protocol including PFMT, had a statistically significant improvement in the median quality of life score compared to group 1 (the PFMT protocol) from baseline to three months.<br /><br />The study was the first to investigate the effect of rehabilitation on different components of abdominal and PFM function and was conducted on South African women with POP. The results indicated that rehabilitation affected different components of abdominal and PFM function, contrary to previous studies that only focused on PFM strength. The study supports the hypothesis of motor control and rehabilitation, suggesting that specific training should be targeted at the affected component of abdominal or PFM function. The holistic approach of motor control also led to a significant improvement in QOL, which was not observed in previous studies focusing on isolated PFM training post-operatively. The authors suggest that including larger sample sizes may yield more significant results.<br /><br />This study was conducted by the Department of Obstetrics and Gynaecology at the University of the Free State.

Keywords

pelvic floor muscle training

core training protocol

control group

abdominal muscles

pelvic floor muscles

quality of life

women

corrective surgery

pelvic organ prolapse

outcomes measures