Risk Factors and the Efficacy of Corrective Interventions for Abnormal Pelvic Floor Muscle Contractions

Pelvic floor dysfunction (PFD) is a prevalent, symptom-driven disorder that escalates with age and significantly impairs women's quality of life. As the first-line treatment for PFD, pelvic floor muscle training (PFMT) relies heavily on the patient's ability to execute a correct and isolated pelvic floor muscle contraction (PFMC). Many women inadvertently perform "COMMOV"-defined as contractions involving other muscles (C-O-M) or extraneous movements (MOV)-when attempting PFMC. These compensatory contractions represent the most frequent errors during PFMC efforts. This study aims to explore risk factors for COMMOV in middle-aged and elderly Chinese women and evaluate the efficacy of verbal correction (VC) and pelvic floor stimulation (PFMS) in mitigating these errors.

A total of 1292 women aged ≥ 40 years were recruited from two tertiary care centers: Wuxi Maternal and Child Health Hospital and Yangpu Hospital, Tongji University. Participants completed comprehensive assessments including: demographic questionnaires, clinical symptoms surveys, PFM information questionnaires, Mini-Mental State Examination (MMSE), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). All participants underwent three sequential pelvic floor muscle evaluations (PFME) with recording of PFMC scores and COMMOV occurrences. After the initial PFME, participants failing to demonstrate a correct isolated PFMC received verbal correction (VC). Those still unable to perform a proper PFMC after the second PFME underwent pelvic floor magnetic stimulation (PFMS), followed by final evaluation.

848 women performed with COMMOV at first attempt. Contractions of rectus abdominis (RA), gluteus maximus (Glut Max) and breath holding were the most common. Aged ≥ 61, information received about PFM, PFMC was practiced before assessment, higher MMSE score and mild anxiety were protective factors for COMMOV. Single, divorced, of windowed, feelings of nervousness during PFME were risk factors for COMMOV. VC reduced the prevalence of COMMOV from 65.63% to 33.98%. PFMS also reduced the prevalence of COMMOV from 33.98% to 7.51%.

COMMOV are prevalent among middle-aged and elderly Chinese women. The occurrence of COMMOV is associated with several factors. VC and PFMS can prevent COMMOV and assist in performing correct and independent PFMCs. Attending to risk factors for COMMOV during the execution of PFMC, along with the corresponding medical interventions, can help middle-aged and elderly women carry out correct and efficient PFMT. These findings provide valuable strategic recommendations for enhancing PFM treatment strategies.