An International Classification of Function, Disability and Health (ICF)-based investigation of movement impairment in women with pelvic organ prolapse.
Corlia Brandt, Elizabeth C Janse van Vuuren
PMID 30863798WHAT IT FOUND
Women awaiting pelvic organ prolapse surgery showed poor pelvic floor and abdominal muscle function, with low endurance and incorrect activation.
Pelvic floor and abdominal measures correlated moderately, suggesting clinicians should assess and treat both muscle groups together rather than the pelvic floor alone.
Key findings
01Pelvic floor muscle endurance was poor, with a mean hold time of 4.04 seconds out of a possible 10 seconds.
02Fifty-six per cent of participants could not perform the local stabiliser function of the abdominal muscles correctly, and 73% could not activate them for more than 10 seconds under low load.
03Moderate to strong correlations were found between local stabiliser functions of the pelvic floor and abdominal muscles, as well as between their global stabiliser and mobiliser functions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
There was no control group of women without pelvic organ prolapse, so it is impossible to say whether these muscle impairments cause the prolapse, result from it, or are simply common in this population. The sample was drawn from women already scheduled for surgery, which may mean their impairment was more severe than in women managed conservatively. The study was cross-sectional, so it cannot show that these muscle deficits led to the prolapse or that treating them would help. Other core muscles such as the gluteus maximus and external obliques were not assessed, so compensatory strategies may have been missed. The high unemployment rate and low physical activity levels in this South African sample mean the findings may not generalise to more active populations.
Declared interests
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The easy way to misread this
Do not read the correlations between pelvic floor and abdominal muscle function as evidence that treating both will improve prolapse. This was an observational study of women already scheduled for surgery, with no control group and no treatment intervention, so it describes what these women looked like but does not show that correcting these impairments changes outcomes.