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Pelvic floor muscle training by competitive rhythmic gymnasts at regular training sessions did not reduce urinary
Marte Charlotte Dobbertin Gram1, Morten Wang Fagerland1, Kari Bø2
1Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Question:
What is the effect of an expanded warm-up program including pelvic floor muscle training (PFMT) compared with usual warm-up on bother and prevalence of urinary incontinence (UI) among rhythmic gymnasts? What is the self-perceived effect of PFMT, including its progression over time, assessed via the global rating of change?
Design:
A cluster-randomised controlled trial with concealed allocation and intention-to-treat analysis.
Participants:
Gymnasts had to be ≥ 12 years of age and training in rhythmic gymnastics ≥ 3 days/week. Twenty-three rhythmic gymnastics clubs were randomised to an experimental group (12 clubs, 119 gymnasts) or a control group (11 clubs, 86 gymnasts).
Intervention:
The experimental group performed one set of 8 to 12 near-maximum pelvic floor muscle contractions and exercises for the knees, lower back and hip/groin as warm-up before each training session for 8 months. The control group continued rhythmic gymnastics training as usual without PFMT or additional lower back and lower limb exercises.
Outcome Measures:
Primary outcomes were bother from UI (score 0 to 21) and prevalence of UI, each measured by the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI-SF). The secondary outcome measure was the self-perceived effect and its progress over time, assessed using the global rating of change (-5 to 5).
Results:
The difference between the groups in the ICIQ-UI-SF total score (ie, UI bother) was clearly negligible (MD -0.48, 95% CI -1.27 to 0.31). The prevalence of UI reduced from 46 to 41% in the experimental group and increased from 32 to 34% in the control group; despite this, the risk difference at 8 months was negligible (RD 0.07) and the confidence interval spanned mainly negligible effects (95% CI -0.08 to 0.21). Experimental group participants rated their global change at a mean of 2.1 (SD 1.7).
Conclusion:
Eight months of warm-up before rhythmic gymnastics training sessions that included one set of 8 to 12 near-maximum PFM contractions did not reduce UI bother. The effect on UI prevalence was also likely to be negligible, despite experimental group participants perceiving benefit from the intervention.
Registration:
ClinicalTrials.gov NCT05506579.
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