Table 1.
Characteristics of the selected studies
| Author (Year) | Study Design | Aim | CG | Sample | Inclusion Criteria | Age, years | N (total) | N (EG) | Assessment | Intervention | Duration, weeks | Results |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Piernicka (2021) 28 | Randomized controlled trial | To test the hypothesis that a high-impact aerobics program, combined with PFMT does not impair PFM function in young active women | Yes | Sport students | Nulliparous women without diagnosed urinary tract problems Women who did not have a good QoL based on IIQ Classified as physically active in IPAQ |
22.0 ± 2 | 32 | 13 | Biofeedback EMG QoL IIQ |
PFMT | 6 | Post MVC: increase of 5% EG and 2% CG EG increase mean EMG in contractions and present lower EMG values in relaxations |
| Szumilewicz (2019) 39 | Randomized controlled trial | To assess how well future female exercise professionals contract the PFM, and whether a biofeedback session is necessary to train them to contract PFM | Yes | Future exercise professionals | Nulliparous students Health condition that allowed for physical activity Available to implement a 6-week training program Ready to comply with the requirements of the study |
23.0 ± 3 | 84 | 53 | Biofeedback EMG Self-elaborated questionnaire |
PFMT with or without biofeedback | 6 | Pretest: 17% could not activate the PF and 45% presented correct technique Posttest: both intervention groups presented better technique score by 0.6 (90% confidence limits ± 0.5) relative to the CG, and 65% of the intervention groups presented the correct technique |
| da Roza (2012) 7 | Pre-post test pilot study | To evaluate the effect of a comprehensive PFMT program on UI symptoms in young nulliparous sport students | No | Sport students | Nulliparous Incontinent Performing high levels of physical activity classified according to the IPAQ-SF |
20.0 ± 0.8 | 7 | 7 | Vaginal palpation MVC (perineometry) ICIQ-SF QoL |
PFMT | 8 | VRP: pre 38.4 ± 15.7, post 55.8 ± 9.0 (P = 0.04) MVC: pre 73.4 ± 24.9, post 89.8 ± 19.1 (P = 0.04) FUL: pre 1.6 ± 1.5, post 0.1 ± 0.4 (P = 0.02) AUL pre 2.6 ± 1.5, post 0.3 ± 0.8 (P = 0.02) Impact on QOL: pre 2.9 ± 3.8, post 0.9 ± 2.3 (P = 0.07). ICIQ-SF score: pre 4.08 ± 6.0, post 0.75 ± 2.6 (P = 0.03) |
| Ferreira (2014) 10 | Randomized controlled trial | To verify the effectiveness of the PFMRP in female volleyball athletes, analyzing the amount and frequency of urinary leakage | Yes | Volleyball athletes | Nulliparous female volleyball athletes Symptoms of stress UI Age between 13 and 30 years Amount of urinary leakage >1 g |
19.3 | 32 | 16 | Pad test Questionnaires 7-day diary urinary leaking |
PFMT | 12 | Decrease in AUL: EG 45.5%, CG 4.9% Reduction in FUL: EG 14.3%, CG 0.05% P < 0.01 between groups |
| Pires (2020) 29 | Randomized controlled trial | To investigate the effects of PFMT in elite female volleyball athletes and whether it is an effective therapy for stress UI | Yes | Volleyball athletes | Age ≥18 years Elite female volleyball athletes Nulliparous Able to provide informed consent |
22.3 | 14 | 7 | MVC Pad test King’s Health Questionnaire |
PFMT | 16 | EG improved MVC (P < 0.01) and reduced urine loss (P = 0.03) Urine loss pre-post 71.4-42.9% Significant differences between groups in the variation from the initial to final phases |
| Alvarez Saez (2016) 1 | Quasi-experimental study | To test the effects of an HT program on body composition and PFM function parameters in a group of female rugby players | No | Rugby players | Nulliparous No contraindications to physical activity Not pregnant No hypertension |
23.4 ± 2.7 | 8 | 8 | Isolation TA test with biofeedback MVC during 10 seconds with a perionometer PFM tone with perionometer (2 isometric contraction of 10 seconds each) |
HT | 8 | MVC pre-post: 1165.29 (510.85)-1453.14 (529.69) (P = 0.02) PF tonicity pre-post: 212.57 (114.74) 329.00 (92.82) (P = 0.02) |
| Rivalta (2010) 33 | Case study | To test the use of combined PF rehabilitation treatment techniques in 3 young female athletes affected by UI | No | Volleyball athletes | 30.6 | 3 | 3 | 48-hour voiding diary PC test: PFM function and strength |
Biofeedback Electrical stimulation PFMT PFMT with vaginal cones |
12 | PC-test values pre-post (graded by the modified Oxford Grading Scale from 0 to 5) Patient 1: 2-5 Patient 2: 1-5 Patient 3: 2-5 After intervention, women stopped using UI requiring devices. No urinary leaking was reported during physical activity |
|
| Sousa (2015) 38 | Randomized controlled trial | To evaluate the effect of a comprehensive PFMT protocol on UI symptoms in young nulliparous athletes using a biomechanical model | Yes | Physically active females | Nulliparous Age ≥18 years Regular physical activity Consent to participate in the study Incontinent |
21.8 ± 3.6 | 7 | 7 | CONTILIFE PFM contraction (self-efficacy Scale of Broome) IPAQ-SF Pad Test PFM strength (perionometer) |
PFMT with or without supervision of a physical therapist | 8 | Pad-test pre-post supervised groups (P = 0.05) Supervised group: improvements in QoL, in self-efficacy of the PFM contractions, increase in PFM strength and decrease in leakage of urine by Pad-test |
AUL, amount of urinary leakage; CG, control group; EG, experimental group; EMG, electromyography; FUL, functional urethral length; HT, hypopressive technique; IIQ, Incontinence Impact Questionnaire; IPAQ, International Physical Activity Questionnaire; IPAQ-SF, IPAQ-short form; MVC, maximal voluntary contraction; PC, puborectalis; PF, pelvic floor; PFM, pelvic floor muscle; PFMRP, PFM rehabilitation program; PFMT, PFM training; QoL, quality of life; TA, transversus abdominis; UI, urinary incontinence; VRP, vaginal resting pressure.