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Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review

BACKGROUND: Pelvic floor muscle training is recommended as first line treatment for urinary incontinence in women based on three proposed theorized mechanisms: ‘Enhanced Pelvic Floor Muscle Strength,’ ‘Maximized Awareness of Timing,’ and ‘Strengthened Core Muscles’. The purpose of this scoping revie...

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Autores principales: Sheng, Ying, Carpenter, Janet S., Ashton-Miller, James A., Miller, Janis M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103460/
https://www.ncbi.nlm.nih.gov/pubmed/35562699
http://dx.doi.org/10.1186/s12905-022-01742-w
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author Sheng, Ying
Carpenter, Janet S.
Ashton-Miller, James A.
Miller, Janis M.
author_facet Sheng, Ying
Carpenter, Janet S.
Ashton-Miller, James A.
Miller, Janis M.
author_sort Sheng, Ying
collection PubMed
description BACKGROUND: Pelvic floor muscle training is recommended as first line treatment for urinary incontinence in women based on three proposed theorized mechanisms: ‘Enhanced Pelvic Floor Muscle Strength,’ ‘Maximized Awareness of Timing,’ and ‘Strengthened Core Muscles’. The purpose of this scoping review was to systematically map evidence for and against theorized mechanisms through which pelvic floor muscle training interventions work to reduce urinary incontinence in women. METHODS: The scoping review is based upon a comprehensive search of relevant literature published from 1990 to 2020 in PubMed, CINAHL, PsycINFO, ClinialTrials.gov, reference lists from review articles, and hand searches of articles by known researchers in the field. We included English-language, peer-reviewed articles on pelvic floor muscle training as an intervention for adult women if they provided empirical evidence to testing the theorized intervention mechanisms. Two independent reviewers screened articles for inclusion and extracted data to describe details of each study (author, year, country, design, sampling), measures of pelvic floor muscle strength and urinary incontinence, statistical analysis of linkage between changes in the measures, and pelvic floor muscle training regimens. Data were summarized to facilitate the integration of diverse evidence to draw conclusions on supporting or refuting the three proposed theorized mechanisms for managing urinary incontinence in women. RESULTS: Of the 278 articles identified with the search, 13 (4.7%) met inclusion criteria. There was weak to no evidence for the mechanism of enhanced pelvic floor muscle strength, equivocal support for maximized awareness of timing, and no evidence for strengthened core muscles. CONCLUSIONS: This review revealed extremely limited data supporting the proposed theorized mechanisms underlying pelvic floor muscle training programs to manage urinary incontinence in women. Such evidence is needed to help women and clinicians understand how, why and when a woman benefits from pelvic floor muscle training. Future studies should specifically state and report statistical analysis that relates the theorized mechanisms to the training outcomes observed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-022-01742-w.
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spelling pubmed-91034602022-05-14 Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review Sheng, Ying Carpenter, Janet S. Ashton-Miller, James A. Miller, Janis M. BMC Womens Health Research Article BACKGROUND: Pelvic floor muscle training is recommended as first line treatment for urinary incontinence in women based on three proposed theorized mechanisms: ‘Enhanced Pelvic Floor Muscle Strength,’ ‘Maximized Awareness of Timing,’ and ‘Strengthened Core Muscles’. The purpose of this scoping review was to systematically map evidence for and against theorized mechanisms through which pelvic floor muscle training interventions work to reduce urinary incontinence in women. METHODS: The scoping review is based upon a comprehensive search of relevant literature published from 1990 to 2020 in PubMed, CINAHL, PsycINFO, ClinialTrials.gov, reference lists from review articles, and hand searches of articles by known researchers in the field. We included English-language, peer-reviewed articles on pelvic floor muscle training as an intervention for adult women if they provided empirical evidence to testing the theorized intervention mechanisms. Two independent reviewers screened articles for inclusion and extracted data to describe details of each study (author, year, country, design, sampling), measures of pelvic floor muscle strength and urinary incontinence, statistical analysis of linkage between changes in the measures, and pelvic floor muscle training regimens. Data were summarized to facilitate the integration of diverse evidence to draw conclusions on supporting or refuting the three proposed theorized mechanisms for managing urinary incontinence in women. RESULTS: Of the 278 articles identified with the search, 13 (4.7%) met inclusion criteria. There was weak to no evidence for the mechanism of enhanced pelvic floor muscle strength, equivocal support for maximized awareness of timing, and no evidence for strengthened core muscles. CONCLUSIONS: This review revealed extremely limited data supporting the proposed theorized mechanisms underlying pelvic floor muscle training programs to manage urinary incontinence in women. Such evidence is needed to help women and clinicians understand how, why and when a woman benefits from pelvic floor muscle training. Future studies should specifically state and report statistical analysis that relates the theorized mechanisms to the training outcomes observed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-022-01742-w. BioMed Central 2022-05-13 /pmc/articles/PMC9103460/ /pubmed/35562699 http://dx.doi.org/10.1186/s12905-022-01742-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Sheng, Ying
Carpenter, Janet S.
Ashton-Miller, James A.
Miller, Janis M.
Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review
title Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review
title_full Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review
title_fullStr Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review
title_full_unstemmed Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review
title_short Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review
title_sort mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103460/
https://www.ncbi.nlm.nih.gov/pubmed/35562699
http://dx.doi.org/10.1186/s12905-022-01742-w
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