2. Objective
The objective of this review was to determine the effectiveness of PFMT on POP with regards to prevention and treatment from existing research and studies. We wanted to examine common recommendations and training programs and what effects they had.
3. Method
3.1 Research design
This was a literature review. The method was used to enable gathering, validations and comparisons of research results in order to investigate and evaluate the effects of PFMT.
3.2 Inclusion criteria
Studies that were included were:
- Studying patient groups with POP as main condition
- Studying individuals with POP mainly related to pregnancy
- Studies that used PFMT as main intervention
- Quantitative studies
- Randomized controlled trials
- Written in English or Swedish
- Available free online
3.3 Exclusion criteria
Studies that were excluded were:
- Studying individuals with POP mainly related to genetic disorders or obesity
- Trials mainly studying the effects of PFMT on pelvic floor dysfunctions other than POP (e.g. UI)
- Articles older than 10 years
3.4 Search method
Included databases were PubMed, Cinahl, Cochrane and PEDro. A primary search was conducted in March 2014. Additional searches were conducted during June and July 2014. Keywords were used in addition to search filters, in order to narrow down the search (see Table II).
Table II. Database, MeSH term, search limitations, search hits and selected studies overview
| Database | MeSH terms | Limits | Hits | Selected studies (first author, year) |
| Cinahl | Pelvic organ prolapse
Exercise Prevention |
Published between 1999 and 2014 | 9 | Braekken, 2010.2
Total: 1 |
| Pelvic organ prolapse quantitative | 12 | –
Total: 0 |
||
| Pelvic organ prolapse exercise | 19 | Braekken, 2010.1
Total: 1 |
||
| Pelvic floor
Exercise Pregnancy |
40 | –
Total: 0 |
||
| Cochrane | Pelvic organ prolapse
Exercise Prevention |
– | 1 | –
Total: 0 |
| PEDro | Pelvic floor training
Prolapse |
Published between 1999 and 2014
Clinical trial |
15
|
Kashyap, 2013
Total: 1 |
| PubMed | Pelvic organ prolapse
Exercise Prevention |
Free full text online
Published between 1999 and 2014 |
2 | –
Total: 0 |
| Pelvic organ prolapse
Physical therapy |
19 | Bernardes, 2012
Total: 1 |
||
| Pelvic floor
Exercise Pregnancy |
20 | –
Total: 0 |
||
| Pelvic floor muscle training prolapse | – | 120 | Hagen, 2014
Total: 1 |
|
| Pelvic floor training
Prolapse |
110 | Frawley, 2009
Total: 1 |
||
| Total: 367 | Total: 6 |
MeSH; Medical subject heading
3.5 Search result
During the literature search 367 records were screened. There were ten studies included in the final stage of selection. There was one pilot study that was followed by a large-scale multi- center study and was therefore excluded. One article was excluded because it did not follow the criteria for language. One article was excluded as it did not look at POP related outcome factors primarily. Finally, one was excluded because of lacking accessibility. Ultimately six randomized controlled trials were selected after being checked for relevance and availability. Five out of six studies were assessor blinded. All included studies were published between 2008 and 2013. The search however included articles published 1 January 1999 and more recent.
3.6 Quality assessment
All articles were assessed with Physiotherapy evidence database (PEDro) scale, with a minimum level of 4 out of 10 (see table III).
Table III Quality assessment according to PEDro
| First author, year | (1) | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | PEDro score |
| Bernardes, 2012 | (x) | x | x | x | x | 4/10 | ||||||
| Braekken, 2010.1 | (x) | x | x | x | x | x | x | x | x | 8/10 | ||
| Braekken, 2010.2 | (x) | x | x | x | x | x | x | x | x | 8/10 | ||
| Frawley, 2012 | (x) | x | x | x | x | x | x | 6/10 | ||||
| Hagen, 2014 | (x) | x | x | x | x | x | x | x | 7/10 | |||
| Kashyap, 2013 | (x) | x | x | x | x | x | x | x | 7/10 |
PEDro; Physiotherapy evidence database
**See appendix 2 for detailed overview of the PEDro scoring system
3.7 Ethical considerations
Written and informed consent was given and discussed in the following articles, Bernades, Braekken (2010.1 and 2010.2), Hagen and Kashyap. The only article that did not mention if informed consent was given was the article by Frawley. However, all studies were approved by ethical committees.
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