Does a Kegel Exercise Program Prior to Resistance Training Reduce the Risk of Stress Urinary Incontinence?

This comparative pre-post intervention study investigated the feasibility and benefits of Kegel exercises amongst incontinent women, prior to commencing resistance training (RT), to reduce the risk of stress urinary incontinence (SUI) compared to a group of women without prior Kegel exercises (KE). Incontinence severity index (ISI) score, pelvic floor muscle strength (PFMS), and body composition (such as body mass index (BMI), fat, and muscle mass), were obtained pre and post intervention. Results demonstrated that RT reduced SUI to a significantly greater extent only if preceded by KE as was observed in the Kegel exercise plus RT group (KE + RT) over time. The improvements in total ISI in both the KE + RT and RT groups were large (d = 1.50 and d = 1.17 respectively). A two-way ANOVA indicated a statistically significant improvement in average PFMS within the KE + RT group over time and between the two groups. A positive correlation was found between the average strength of pelvic floor muscles and SUI. Participants in KE + RT group demonstrated a significant increase in muscle mass (p ≤ 0.001) and concomitant reduction in fat mass (p = 0.018). This study determined a dedicated program of KE preceding a RT program improved average pelvic floor muscle strength and was effective in reducing SUI among incontinent women.

Effectiveness of supervised Kegel exercises using bio-feedback versus unsupervised Kegel exercises on stress urinary incontinence: a quasi-experimental study.

INTRODUCTION AND HYPOTHESIS: The objective was to investigate and compare the efficacy of supervised Kegel exercises with bio-feedback on stress urinary incontinence (SUI) and pelvic floor muscle strength (PFMS) compared with unsupervised Kegel exercises. METHOD: Matched-group quasi-experimental study of 29 female participants divided into two groups (supervised and non-supervised) was conducted over 12 weeks. Baseline measurements of PFMS were undertaken by a women's health physiotherapist and a Kegel exercise regime bespoke designed for each participant. The supervised group visited the physiotherapist monthly for bio-feedback training (BT); the unsupervised group continued at home with their individualised Kegel exercises. Data were collected via a perineometer (Peritron™) and self-reporting responses to questionnaires. All participants received a final PFMS measurement on completion of the study. RESULTS: Overall Incontinence Severity index (ISI) score was significantly lower in the supervised group post-intervention. Wilcoxon signed-rank tests indicated that supervised Kegel exercises significantly reduced frequency (p= 0.002) and severity (p= 0.020) of overall ISI. Analysis of PFMS were not significantly different, despite an increase in maximum voluntary contraction or pelvic floor muscle strength (PFMS) (p= 0.032) in the supervised group. Of the questionnaires, results of Wilcoxon signed-rank tests indicated that "total bother" was significantly reduced (p= 0.005) in the supervised group. The correlation analysis between PFMS and ISI did not reveal any significant results. CONCLUSIONS: The study confirmed that supervised BT is more effective in reducing SUI than unsupervised Kegel exercises, and that this reduction in ISI score did not correlate with the improvement in PFMS.

Prevalence of urinary incontinence in women powerlifters: a pilot study.

INTRODUCTION AND HYPOTHESIS: Increased intra-abdominal pressure is associated with urinary incontinence (UI) as is increasing age, obesity, and participating in sport at an elite level. We aimed to determine the prevalence of UI in competitive women powerlifters and establish if commonly cited risk factors affect the incidence of UI. METHODS: The authors developed a 17-item questionnaire to investigate the prevalence of UI and the relationship of UI with age, body mass, resistance training experience, and competition grade in competitive women powerlifters. The questionnaire was distributed through three major powerlifting federations in Australia for 16 months. The data of 134 competitive women powerlifters were collected anonymously using Qualtrics, and were analysed using multivariate analysis. RESULTS: In combination, the age of lifters, resistance training experience, body weight categories, and competition grade accounted for a significant 28% of the variability in the Incontinence Severity Index (ISI) (p < 0.01). However, the ISI was not significantly different among age groups, body weight categories, or competition grade. Approximately, 41% of women powerlifters had experienced UI at some stage in life, and 37% of women powerlifters currently experienced UI during training, competition, or maximum effort lifts. However, the rate of UI experienced during daily life activities was approximately 11%. CONCLUSIONS: This study showed that competitive women powerlifters experience a higher rate of UI during lifting-related activities than in daily life and that the rate of UI correlates positively with age, body weight categories, resistance training experience, and competition grade.