Effect of exercise on female pelvic floor morphology and muscle function: a systematic review.

INTRODUCTION AND HYPOTHESIS: The objective was to synthesize the scientific evidence on the relationship of exercise with morphology and muscle function parameters of the female pelvic floor. The design was a systematic review. METHODS: Searches were performed in MEDLINE, PubMed, CINAHL, Web of Science, SCOPUS, SportDiscuss, and Google Scholar up to April 2021. Observational and experimental studies evaluating the morphology and/or function of the pelvic floor muscles (PFMs) in women were eligible. Studies reporting exercise or sports disciplines as exposure/intervention were included. RESULTS: Twenty-five studies were included. Compared with the control group, women performing vigorous and high-impact exercises exhibited lower maximum voluntary contraction of the PFM and those performing moderate exercise had better maximum voluntary contraction. Exercise practitioners had a larger hiatal area at rest, during contraction, and during Valsalva, and greater bladder neck descent than the control group. CONCLUSIONS: The results of this review demonstrate an inverse relationship of PFM maximum voluntary contraction with exercise intensity. Qualitative synthesis showed that the studies found favorable outcomes for the control group in terms of hiatal area during contraction and Valsalva and bladder neck displacement.

Urine Loss during a Volleyball Competition: Comparison between Amateur and Professional Athletes.

BACKGROUND: High-impact sports can cause dysfunction to the female pelvic floor that leads to the occurrence of stress urinary incontinence. OBJECTIVE: To identify and compare the presence of urine loss between professional and amateur female volleyball athletes during a competition. METHODS: A cross-sectional and comparative study was conducted on 75 volleyball athletes, including 30 amateurs and 45 professional athletes. Female athletes 18 years of age or older were included. Urine loss during the competition was evaluated by self-report and measured by a pad test (in grams). Day-to-day urinary incontinence was identified using the Urinary Distress Inventory 6 (UDI-6). Before the beginning of the game, the instruments were applied by individual interview for data collection and the pad was positioned. After the game, the pad was removed and weighed again. Descriptive and inferential statistics were used, with a significance level of 5%. RESULTS: Half of the professional (50.0%) and amateur (55.6%) athletes have symptoms of urine loss during a competition. Objective urine loss was higher among professional athletes (4.5 ± 1.4 g) compared to amateur athletes (3.8 ± 1.4 g). There was a significant difference (P < .001) in objective urine loss between symptomatic (mean = 5.41, standard deviation [SD] = 0.8) and asymptomatic professional athletes (mean = 3.40, SD = 1.3). CONCLUSION: Self-report of urinary incontinence during the competition was common among professional and amateur athletes. However, objective urine loss was significantly higher among professional athletes.

Anthropometric indicators as predictors of pelvic floor muscle distress in young women.

AIM: To identify anthropometric indicators that could predict pelvic floor muscle distress (PFMD) in young women. METHOD: A cross-sectional study was conducted, whose sample consisted of 54 women aged between 18 and 35 years. The Pelvic Floor Distress Inventory was used to assess the PFMD. The anthropometric indicators evaluated were body mass index (BMI) being measured the weight and height, body fat percentage (skinfolds), waist circumference (WC), waist-to-hip ratio (WHR), and relative fat mass (RFM), which is calculated from height and WC. Descriptive and inferential statistics (Spearman correlation, simple linear regression, and receiver operating characteristic curve) were used, with a significance level of 5%. RESULTS: The PFMD and the anthropometric indicators BMI (r = .43), body fat percentage (r = .42), WC (r = .46), WHR (r = .49), and RFM (r = .48) showed a positive and moderate correlation (P < .01). In all, 24%, 23%, 20%, and 18% of the PFMD can be credited to RFM, WC, WHR, and body fat percentage, respectively. The cut-off point for RFM was 38.44 for the symptom of pressure in the lower abdomen and 36.24 for symptom of stress urinary incontinence and incomplete emptying of the bladder. CONCLUSION: Anthropometric indicators of body fat percentage, WC, WHR, and RFM can be predictors of PFMD in young women minimally symptomatic.