Sunday, June 12, 2016

June Pelvic PT Distance Journal club recording

Does PFM contraction affect urethral closure pressure? and overflow PFM exercises.

Next call July 13

Pelvic floor muscle training to improve urinary incontinence in young, nulliparous sport students: a pilot study

Da Roza t, de Araujo MP, Viana R, Viana S, Jorge RN, Bo K, Mascarenhas T: Int Urogynecol J, 2012; 23:1069-1073.
Ann Dunbar PT, DPT, MS, WCS
June 8, 2016

Introduction: Urinary incontinence (UI) is thought of as a problem with aging however, studies demonstrate young, physically fit nulliparous women also experience UI. Factors that contribute to incontinence in this population of women are not well understood. Studies suggest weak connective tissue, high-intensity and high-impact activities, heavy training, and possible pelvic floor muscle (PFM) fatigue. Though RCTs demonstrate benefit of pelvic floor muscle training (PFMT) for SUI, none assess the intervention for nulliparous sports women.

Influence of voluntary pelvic floor muscle contraction and pelvic floor muscle training on urethral closure pressures: a systematic literature review

Zubieta M, Carr RL, Drake MJ, Bo K: Int Urogynecolo J, 2015.  DOI 10.1007/s00192-015-28856-9; Online ISSN 1433-3023.
Ann Dunbar PT, DPT, MS, WCS
June 8. 2016

Introduction:  Though pelvic floor m training (PFMT) is effective for treatment of stress urinary incontinence (SUI) (Level I evidence), how this works is not clear. Several theories are presented including (1) PFM morphology is altered; (2) PFMT prevents bladder and urethral descent with activities increasing intra-abdominal pressure; (3) PFMT increases strength of a voluntary pre-PFM contraction and appears to reduce downward movement of bladder neck with cough (ie the Knack) ;  PFMT facilitates unconscious, automatic firing of PFM, increasing maximal urethral closure pressure (MUCP) during increases in intra-abdominal pressure.