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Pelvic floor exercises in postpartum women

Summary of an article comparing different pelvic floor exercises with Kegels in postpartum women.

Who

15 women 6 months to 2 years (median 15 months) postpartum median age 32 (ranging between 28 and 39) years.

Design

Cross-sectional study comparing 10 exercises to the traditional pelvic floor muscle contractions (Kegels) in postpartum women. Exercises: bird dog, bridge, clam, crunch, tucked squat, untucked squat, leg lift, plank, plie, thigh adduction (instructions).

Outcome measures

  • pelvic floor muscle strength
  • pelvic floor muscle length
  • levator hiatus area
  • (digital examination, perineometry, transperineal ultrasound)

Main results

  • Exercising status:
    • not at all 27%
    • occasionally 13%
    • once per week 20%
    • 2-3 times per week 33%
    • 4-5 times per week 7%.
  • Types of exercises usually performed:
    • “cardio” 60%
    • lifting weights 27%
    • yoga 27%
    • group exercise class 13%
  • Pelvic floor muscle strength:
    • Kegel exercise evoked 24.3cm H2O squeeze pressure, 0.46cm of shortening of the pelvic floor muscle and 0.13cm2 levator hiatus narrowing when compared with the resting state.
    • Bird dog, crunch, and plank generated similar peak squeeze pressures to Kegel. Leg lift generated higher (double) peak squeeze pressure than Kegel.
    • Bridge, clam, tucked and untucked squat, plié, and thigh adduction generated lower squeeze pressures than Kegels.
  • Levator hiatus area:
    • Bird dog, tucked and untacked squats, leg lifts, plank, and thigh adduction shortened levator hiatus similarly to Kegel.
    • Bridge, clam, crunch and plié generated wider levator hiatus area than Kegel.
  • Most women rated other exercises as equally difficult as Kegels, but 47% thought that other exercises are easier (or much easier) to perform than Kegels. 80% of women were more likely (or much more likely) to perfrom the other exercises than Kegels.

Take home message

For a clinician
Bird dog, crunch, plank, tucked and untacked squats, leg lifts, and thigh adduction generated similar response on pelvic floor strength and length to Kegels. These exercises may also be perceived as easier to perform.
For a parent
Bird dog, crunch, plank, tucked and untacked squats, leg lifts, and thigh adduction are similar to Kegels in strengthening pelvic floor muscles.
For an athlete
Bird dog, crunch, plank, tucked and untacked squats, leg lifts, and thigh adduction are similar to Kegels in strengthening pelvic floor muscles.

Original article

Siff LN, Hill AJ, Walters SJ, Walters G, Walters MD. The effect of commonly performed exercises on the levator hiatus area and the length and strength of pelvic floor muscles in postpartum women. Female pelvic medicine & reconstructive surgery. 2020 Jan 1;26(1):61-6.

Exercise instructions

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