EP26.05: Ultrasound screening of pelvis floor muscle in different training methods

Pelvic floor muscle training is the first-line treatment for urinary incontinence. The aim of this study to apply this complex approach in the treatment of incontinence, to combine pelvic floor muscle training (cPFMT) with trunk stabiliser muscle training. Young nulliparous women (n = 55; 21,27 ± 1,46 years) were enrolled into the study. The participants were divided into three groups: supine (SUG; n = 22), sitting (SIG; n = 19) and control (COG; n = 14) groups. The 8 weeks cPFMT program was performed. The objective outcome measures were the vaginal surface EMG (for the conditioning ability of pelvic floor muscle (PFM) such as maximal isometric contraction till fatigue, maximal isometric contraction holding time, dynamic endurance, number of maximal fast contractions, relaxation values) and the ultrasound (for recording TRA and pelvic floor muscle thickness). The data were analysed with t-test for independent samples and repeated measures ANOVA (p < 0,05 were adopted). 18 subjects reported occasional urinary leakage before the training. After the competing the program in case of 7 subjects (4 from SUG, 3 from SIG) the urinary leakage disappeared, in case of 6 subjects (2 from SUG, 4 from SIG) the signs improved and, in case of 4 subjects from COG the urinary leakage unchanged. During the fatigue isometric contractions of PFM the TRA and pelvic muscle thickness were increased in SUG (p = 0,675) and also in SIG (p = 0,300), in COG the reduction was significant (p = 0,01). Young women might be also affected by asymptomatic urinary leakage. The slow-twitch fibres of PFM can be trained effectively in both the horizontal (SUG) and in the vertical body positions (SIG) by cPFMT. The authors suggest that during a PFM training the isometric tasks might be performed either in supine or sitting positions, but the dynamic endurance tasks of PFM should be performed at the beginning of the training only in supine position.