Current evidence for hypopressive exercises in healthy women: A systematic review.

BACKGROUND: Hypopressive exercises have been mainly used in the treatment of pelvic floor dysfunctions. Recently it has started to spread among healthy women. However, no comprehensive review is available in this population. PURPOSE: Assess the current evidence of the effects of hypopressive exercises on healthy women. METHODS: This study was registered on PROSPERO (CRD42020203103). The search was performed in Scielo, Pubmed, Lilacs, Embase, Scopus, Pedro, Trip Database, Web of Science, and Google Scholar. The last search was performed on November 1st, 2021. Inclusion criteria were randomized controlled trials and single-arm trials, healthy women, acute or late effects of hypopressive exercises, and pre and post-training analysis. Exclusion criteria included non-original research, conference proceedings, dissertations and theses. Downs and Black checklist were used to assess the methodological quality. Study design, participants characteristics, description of the intervention, follow-up period, variables, instruments, and outcomes were extracted and recorded. RESULTS: From the 410 studies, five were selected. The variable of major interest was waist circumference, which showed a decrease with exercise. It also seemed to have plausible positive effects on height, lower back mobility, abdominal and pelvic floor muscle contraction, respiratory flow and apnea, and hemodynamic responses. CONCLUSION: This study suggests that the current literature on the effects of hypopressive exercise on healthy women is very limited. Despite the plausible positive effects identified, we cannot recommend its practice due to the serious methodological problems. Therefore, more studies are needed to elucidate the benefits and adverse effects of hypopressive exercises.

Is age rating enough to investigate changes in breathing motion pattern associated with aging of physically active women?

The most common way to analyze the effect of aging on breathing is to divide subjects into age groups. However, in addition to the fact that there is no consensus in the literature regarding age group division, such design critically influences the interpretation of the effects attributed to aging. Thus, this study aimed to investigate the feasibility to distinguish different age groups from the 3D kinematic variables of breathing motion (i.e., markers' coordinate as a function of time allowing the calculation of compartmental volume variations) and to analyze whether the aging could influence these variables. Seventy-three physically active women aged 19-80 years performed quiet breathing and vital capacity maneuvers. To record the thoracoabdominal breathing motion, the 3D coordinates of 32 retroreflective markers positioned on the trunk were used to estimate the volume variation of the superior thorax, inferior thorax, and abdomen. The percentage of contribution and the correlation coefficient were calculated to analyze the breathing motion pattern from the estimated volumes. The k-means cluster analysis was performed to analyze the age group classification. Linear regression was performed to investigate whether age can predict changes in the breathing motion pattern. The results showed that physically active women could not be classified into age groups from breathing motion. Despite significant p values of the linear regression, the high variability of the data suggested that age itself is not enough to predict the changes in breathing motion pattern when non-sedentary women are considered.

Comparison of marker models for the analysis of the volume variation and thoracoabdominal motion pattern in untrained and trained participants.

Respiratory assessment and the biomechanical analysis of chest and abdomen motion during breathing can be carried out using motion capture systems. An advantage of this methodology is that it allows analysis of compartmental breathing volumes, thoraco-abdominal patterns, percentage contribution of each compartment and the coordination between compartments. In the literature, mainly, two marker models are reported, a full marker model of 89 markers placed on the trunk and a reduced marker model with 32 markers. However, in practice, positioning and post-process a large number of markers on the trunk can be time-consuming. In this study, the full marker model was compared against the one that uses a reduced number of markers, in order to evaluate (i) their capability to obtain respiratory parameters (breath-by-breath tidal volumes) and thoracoabdominal motion pattern (compartmental percentage contributions, and coordination between compartments) during quiet breathing, and (ii) their response in different groups such as trained and untrained, male and female. Although tests revealed strong correlations of the tidal volume values in all the groups (R2 > 0.93), the reduced model underestimated the trunk volume compared with the 89 marker model. The highest underestimation was found in trained males (bias of 0.43 L). The three-way ANOVA test showed that the model did not influence the evaluation of compartmental contributions and the 32 marker model was adequate to distinguish thoracoabdominal breathing pattern in the studied groups. Our findings showed that the reduced marker model could be used to analyse the thoracoabdominal motion in both trained and untrained populations but performs poorly in estimating tidal volume.