Table 4.
Characterization of selected studies on the effects of pelvic floor muscle training (PFMT) on the fecal incontinence prevention (A) and treatment (B).
| Reference | Main Objective | Participants | Intervention | Outcome |
|---|---|---|---|---|
| (A) Pelvic floor muscle training (PFMT) in fecal incontinence prevention | ||||
| Bø et al. (2011) Norway [44] A randomized controlled trial study |
The effectiveness of PFM exercises conducted during general fitness classes in pregnant women for mitigating postpartum incontinence. | 84 pregnant women Exp.: 42 (aged 31.2 ± 3.7 years) Con.: 42 (aged 30.3 ± 4.4 years) |
Exp.: 1 h general fitness classes with PMFT (3 × 8–12 PFM contractions, hold 6–8 s); 2–3 times a week per 12 weeks + 30 min additional home exercises Con.: w/o interventionAssessment: SI, ICIQ–UI SH, |
No efficacy of PFMT conducted during general fitness classes in reduction of FI symptoms assessed 6–8 weeks after childbirth. |
| Stafne (2012) Norway [45] A randomized controlled trial study |
Comparison of the effectiveness of general exercise course including PFMT with standard care in the prevention of UI and FI in late pregnancy | 761 pregnant women Exp.: 396 (aged 30.5 ± 4.4 years) Con.: 365 (aged 30.4 ± 4.3 years) |
Exp.: general exercise with PFMT (1 h, once a week under physiotherapist supervision + 45 min at home, twice a week per 12 weeks) Con.: standard care w/o exercise Assessment: SI, St. M.S, questionnaire about PFMT |
Pregnant women who regularly participated in the training program reported UI and FI less frequently in late pregnancy. |
| (B) Pelvic floor muscle training (PFMT) in fecal incontinence treatment | ||||
| Johannessen (2017) Norway [46] A randomized controlled trial study |
Assessment of the effectiveness of individualized PFM training in the treatment of FI in the postpartum period | 109 women with FI 1 year postpartum Exp.: 54 (aged 29.7 ± 4.3 years) Con.: 55 (aged 30.6 ± 3.8 years) |
Exp.: individually adapted home PFMT program: 3 sets of 8–10 maximum PFM contractions per day, 3 s long with progression to 10 or 12 s with 3 fast contraction at the end, for 6 months Con.: written information about PFMT, training was not obligatory. Assessment: St. M.S, EaU, manometry, VPFMC |
Both interventions reduced the symptoms of FI, howeverregular, individualized PFMT in the postpartum period reduced them significantly more, which has been described as a clinically significant effect. |
| Mathé et al. (2016) France [62] A retrospective observational study |
Comparison of the effectiveness of early PFMT and/or standard rehabilitation for FI symptoms after vaginal deliveries complicated by ≥3rd degree of perineal tears | 167 women with ≥3rd degree of perineal tears after vaginal delivery Con.: 83 (age: 29.5 ± 4.7 years) Exp.: 84 (age: 30.6 ± 4.1 years) |
Con.: standard rehabilitation, PFMT from 6–8 weeks of puerperium + BF as supports + education Exp.: early rehabilitation, PFMT after 30 days postpartum (6–10 series of PFMT twice a day) + standard rehabilitation (as in the group Con.) Assessment: Modified version of the Jorge and Wexner questionnaire |
The implementation of early rehabilitation significantly reduces FI, GI, and UI in women after childbirth complicated by massive perineal damage, this result was significantly better than that obtained after standard rehabilitation. |
Exp., experimental group; Con., control group; PFMT, pelvic floor muscle training; FI, fecal incontinence; UI, urinary incontinence; GI, gas incontinence; PFM, pelvic floor muscles; SI, severity index; ICIQ-UI SH, International Consultation of Incontinence Questionnaire Urinary Incontinence Short Form; St. M.S, St. Mark’s score; VPFMC, voluntary pelvic floor muscle contractions; EaU, endoanal ultrasound; BF, biofeedback.