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Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction

Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a nonin...

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Autores principales: Pedraza, Rodrigo, Nieto, Javier, Ibarra, Sergio, Haas, Eric M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4071781/
https://www.ncbi.nlm.nih.gov/pubmed/25006337
http://dx.doi.org/10.1155/2014/487436
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author Pedraza, Rodrigo
Nieto, Javier
Ibarra, Sergio
Haas, Eric M.
author_facet Pedraza, Rodrigo
Nieto, Javier
Ibarra, Sergio
Haas, Eric M.
author_sort Pedraza, Rodrigo
collection PubMed
description Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1) initial baseline phase; (2) rapid contraction phase; (3) tonic contraction and endurance phase; and (4) late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1) down-training; (2) accessory muscle isolation; (3) discrimination training; (4) muscle strengthening; (5) endurance training; and (6) electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course.
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spelling pubmed-40717812014-07-08 Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction Pedraza, Rodrigo Nieto, Javier Ibarra, Sergio Haas, Eric M. Adv Urol Research Article Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1) initial baseline phase; (2) rapid contraction phase; (3) tonic contraction and endurance phase; and (4) late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1) down-training; (2) accessory muscle isolation; (3) discrimination training; (4) muscle strengthening; (5) endurance training; and (6) electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course. Hindawi Publishing Corporation 2014 2014-06-11 /pmc/articles/PMC4071781/ /pubmed/25006337 http://dx.doi.org/10.1155/2014/487436 Text en Copyright © 2014 Rodrigo Pedraza et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Pedraza, Rodrigo
Nieto, Javier
Ibarra, Sergio
Haas, Eric M.
Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction
title Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction
title_full Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction
title_fullStr Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction
title_full_unstemmed Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction
title_short Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction
title_sort pelvic muscle rehabilitation: a standardized protocol for pelvic floor dysfunction
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4071781/
https://www.ncbi.nlm.nih.gov/pubmed/25006337
http://dx.doi.org/10.1155/2014/487436
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