4.3 Outcome
Outcome measurements included severity of POP symptoms and bother, morphological changes (i.e. muscle length and thickness) and severity of POP measured by POP-Q. All but one article reported that PFMT had reduced POP symptoms, bother and/or severity, and improved morphological factors.
Table VI. Study, objective, length, number of participants, outcome variables and result overview
| First author, year, country | Objective | Study length | n | Outcome variable | Result | Notes |
| Bernardes, 2012, Brazil | Evaluate efficacy of PFMT and hypopressive exercise for increasing cross-sectional area (CSA) of levator ani in women with POP | 3 months | 58 | Gt1: CSA (mm) | 1.6 (0.4) ./. 2.1 (0.3) | Before ./. after |
| Gt2: CSA (mm) | 1.4 (0.3) ./. 1.8 (0.5) | |||||
| Gc: CSA (mm) | 1.5 (0.3) ./. 1.4 (0.3) | |||||
| Braekken, 2010.1, Norway | Investigate morphological and functional changes after PFMT in women with POP | 6 months | 109 | Gt: Muscle thickness, rest (mm)
Levator hiatus area, rest (cm2) Muscle tightness, rest (mm) Levator hiatus area, Valsalva (cm2) Muscle length, Valsavla (mm) |
9.0 ./. 10.5
23.7 ./. 22.2 121.2 ./. 117.2 29.5 ./. 28.9 142.3 ./. 140.0 |
Before ./. after |
| Gc: Muscle thickness, rest (mm)
Levator hiatus area, rest (cm2) Muscle length, rest (mm) Levator hiatus area, Valsalva (cm2) Muscle length, Valsalva (mm) |
9.4 ./. 9.0
22.6 ./. 22.6 113.9 ./. 115.6 30.3 ./. 30.6 137.9 ./. 141.1 |
|||||
| Braekken, 2010.2, Norway | Investigate efficacy of PFMT in reversing POP and alleviating symptoms | 6 months | 109 | POP stage
Symptoms (frequency) Symptoms (bother) Position bladder/rectum |
See Table VII
32 (78%) ./. 8 (31%) 29 (67%) ./. 11 (42%) See results above |
Gt ./. Gc
|
| Frawley, 2012, Australia | Investigate the effect of a pre- and post-operative PT supervised PFMT program in women undergoing POP surgery or hysterectomy | 12 months | 51 | UDI total score | 54.0 ./. 44.1 | Gt ./. Gc final |
| Hagen, 2014, United Kingdom, New Zealand, Australia | Establish the effectiveness of 1-to-1 individually PFMT for reducing POP symptoms | 12 months | 477 | POP-SS
Improvement prolapse symptoms |
-3.77 ./. -2.09
57% ./. 45% |
Gt ./. Gc final |
| Kashyap, 2013, India | Compare effect of 2 packages of PFMT programs among women attending outpatient departments | 6 months | 140 | POP-SS | -2.99 ./. -1.25 | Gt ./. Gsim final |
CSA; cross-sectional area
Gc; Group controls
Gt; Group training
Gt1; Group training1
Gt2; Group training2
Gsim; Group self-instruction manual
PFIQ-7; Pelvic floor impact questionnaire
POP; Pelvic organ prolapse
POP-SS; Pelvic organ prolapse symptom score
PFMT pelvic floor muscle training
PT; Physiotherapist
UDI; Urinary distress index
*See appendix 1 for a detailed article overview
Table VII. Study, outcome variables, p-value compared within and between intervention groups and POP-Q improvement outcome overview
| First author, year | Outcome | P Intra | P Pan | POP-Q improvement |
| Bernardes, 2012 | Gt1: CSA (cm2) | <.001 | n/a | Used but no data available |
| Gt2: CSA (cm2) | .001 | |||
| Gc: CSA (cm2) | .816 | |||
| Braekken, 2010.1 | Gt: Muscle thickness, rest (mm)
Levator hiatus area, rest (cm2) Muscle length, rest (mm) Levator hiatus area, Valsalva (cm2) Muscle length, Valsalva (mm) |
<.001
.002 .001 .004 .001 |
<.001
.001 .007 .21 .001 |
n/a |
| Gc: Muscle thickness, rest (mm)
Levator hiatus area, rest (cm2) Muscle length, rest (mm) Levator hiatus area, Valsalva (cm2) Muscle length, Valsalva (mm) |
.065
.870 .441 .512 .106 |
|||
| Braekken, 2010.2 | POP stage
Improvement symptoms (bulging or heaviness) frequency and bother |
n/a | –
.000* |
Gt: 19%
Gc: 8%* |
| Frawley, 2010 | Gt: UDI total score | .46 | /.46 | n/a |
| Hagen, 2014 | Reduction POP-SS score
Improvement prolapse symptoms |
n/a | .0053
.0125 |
Gt: 27%
Gc: 20% |
| Kashyap, 2013 | POP-SS score (Gt (-2.99) and Gsim (-1.25)) | n/a | .0002 | n/a |
CSA; Cross-sectional area
Gc; Group controls
Gt; Group training
Gt1; Group training1
Gt2; Group training2
Gsim; Group self-instruction manual
POP; Pelvic organ prolapse
P intra; comparison development within one group
P pan; comparison development between all groups
POP-SS; Pelvic organ prolapse symptom scale
UDI; Urinary distress index
*No improvements in POP stage I (controls and training)
To make an appointment with Anna Wallin specialist in women’s health please call the clinic on 020 8546 6464.