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Proprioceptive Trunk-Based Physiotherapy for Stress Urinary Incontinence: Case Report in a Rhythmic Gymnast
Gabriela Martínez-Roig1, Irene Sandoval-Hernández2, Marta María Córdoba-Peláez3
1Cofrentes Thermal Spa, Cofrentes, 46625 Valencia, Spain.
Background:
Pelvic floor dysfunction (PFD) encompasses the set of clinical alterations characterised by a loss of muscular control or an incoordination in the activity of the muscles that make up this region. In the female population, the prevalence of urinary incontinence (UI) is between 24% and 45%, making it the most common PFD. Stress urinary incontinence (SUI) occurs when there is an increase in intra- abdominal pressure, such as when coughing, sneezing or lifting heavy objects, causing involuntary urine leakage. It is common for elite gymnasts to experience an increase in intra-abdominal pressure, exacerbating the onset of SUI.
Case Description:
25-year-old patient who started practising rhythmic gymnastics at the age of 9. In the anamnesis, the patient reported that for about 8 years she had been experiencing SUI during training and competitions. The patient refers that factors such as fatigue or stressful situations influence her presentation.
Objective:
The main objective of this clinical case is the improvement of UI symptomatology during sports practice, through the use of the proprioceptive trunk.
Intervention:
The physiotherapy intervention was carried out over six weeks with a frequency of three sessions per week and was structured under an active, guided treatment approach. The sessions lasted approximately 30 minutes. In the first phase of the intervention the aim was to improve the patient's proprioception and pelvic floor activation; in the second phase, the aim was to strengthen the core musculature and the scapulohumeral region, while ensuring the maintenance of proper body posture; finally, the final phase consisted of the application of the intervention to functionality within the sporting context.
Conclusions:
In this patient with SUI, an improvement has been observed in the symptomatology that she presented at the beginning of the intervention, achieving significant advances both at an objective level, with the self-reported questionnaires and the voiding diary, and at a subjective level in her sensations when practising sport.
