Pelvic floor rehabilitation in patients with levator ani muscle avulsion
Objective: To determine if physiotherapy treatment applied to patients with levator ani muscle (LAM) avulsion identified after a vaginal delivery, reduces the LAM hiatus area. Material and Methods: A prospective observational study of 52 nulliparous (26 in the experimental and 26 in the control grou...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
IMR Press
2020-06-01
|
| Series: | Clinical and Experimental Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/CEOG/47/3/10.31083/j.ceog.2020.03.5252 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849324869439717376 |
|---|---|
| author | J.A. García-Mejido C. Suarez-Serrano E.M. Medrano-Sanchez M.J. Bonomi Barby A. Armijo Sánchez J.A. Sainz |
| author_facet | J.A. García-Mejido C. Suarez-Serrano E.M. Medrano-Sanchez M.J. Bonomi Barby A. Armijo Sánchez J.A. Sainz |
| author_sort | J.A. García-Mejido |
| collection | DOAJ |
| description | Objective: To determine if physiotherapy treatment applied to patients with levator ani muscle (LAM) avulsion identified after a vaginal delivery, reduces the LAM hiatus area. Material and Methods: A prospective observational study of 52 nulliparous (26 in the experimental and 26 in the control group). We included patients with LAM avulsion, diagnosed by 3-4D/transperineal ultrasound performed 3 months after delivery. Patients in the experimental group underwent a program of pelvic floor exercises, assisted by biofeedback and lumbopelvic stabilization exercises. Assessment of LAM was carried out at 6 and 9 months postpartum, using 3-4D/transperineal ultrasound, and taking the following measurements: levator hiatus area at rest, during Valsalva and at maximum contraction; LAM area, and thickness of right and left LAM. Results: Patients in the experimental group presented a reduction in the levator hiatus area at rest (17.0, 15.7, 15.9 cm2), during Valsalva (23.0, 20.8, 19.9 cm2) and at maximum contraction (15.6, 14.4 and 13.5 cm2), in comparison with patients in the control group, who presented a levator hiatus area at rest of 17.4, 17.2 and 16.8 cm2, during Valsalva of 21.0, 20.8 and 20.3 cm2, and at maximum contraction of 16.6, 16.1 and 15.6 cm2, at 1, 6 and 9 months postpartum respectively (P < 0.05). However, no changes were appreciated in the successive examinations regarding LAM area between study groups: experimental 9.5, 8.9, 9.6 cm2 versus 8.9, 9.0, 9.2 cm2 in the control group. Conclusions: Physiotherapy treatment based on pelvic floor exercises with lumbopelvic stabilization exercises in patients with LAM avulsion reduces the levator hiatus area at rest, during Valsalva and at maximum contraction. |
| format | Article |
| id | doaj-art-a490025af45340a9b2effea523390e2b |
| institution | Kabale University |
| issn | 0390-6663 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-a490025af45340a9b2effea523390e2b2025-08-20T03:48:35ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632020-06-0147334134710.31083/j.ceog.2020.03.5252S0390-6663(20)00263-8Pelvic floor rehabilitation in patients with levator ani muscle avulsionJ.A. García-Mejido0C. Suarez-Serrano1E.M. Medrano-Sanchez2M.J. Bonomi Barby3A. Armijo Sánchez4J.A. Sainz5Department of Obstetrics and Gynecology, Valme University Hospital, Seville, SpainDepartment of Physiotherapy, University of Seville, SpainDepartment of Physiotherapy, University of Seville, SpainDepartment of Obstetrics and Gynecology, Valme University Hospital, Seville, SpainDepartment of Obstetrics and Gynecology, Valme University Hospital, Seville, SpainDepartment of Obstetrics and Gynecology, Valme University Hospital, Seville, SpainObjective: To determine if physiotherapy treatment applied to patients with levator ani muscle (LAM) avulsion identified after a vaginal delivery, reduces the LAM hiatus area. Material and Methods: A prospective observational study of 52 nulliparous (26 in the experimental and 26 in the control group). We included patients with LAM avulsion, diagnosed by 3-4D/transperineal ultrasound performed 3 months after delivery. Patients in the experimental group underwent a program of pelvic floor exercises, assisted by biofeedback and lumbopelvic stabilization exercises. Assessment of LAM was carried out at 6 and 9 months postpartum, using 3-4D/transperineal ultrasound, and taking the following measurements: levator hiatus area at rest, during Valsalva and at maximum contraction; LAM area, and thickness of right and left LAM. Results: Patients in the experimental group presented a reduction in the levator hiatus area at rest (17.0, 15.7, 15.9 cm2), during Valsalva (23.0, 20.8, 19.9 cm2) and at maximum contraction (15.6, 14.4 and 13.5 cm2), in comparison with patients in the control group, who presented a levator hiatus area at rest of 17.4, 17.2 and 16.8 cm2, during Valsalva of 21.0, 20.8 and 20.3 cm2, and at maximum contraction of 16.6, 16.1 and 15.6 cm2, at 1, 6 and 9 months postpartum respectively (P < 0.05). However, no changes were appreciated in the successive examinations regarding LAM area between study groups: experimental 9.5, 8.9, 9.6 cm2 versus 8.9, 9.0, 9.2 cm2 in the control group. Conclusions: Physiotherapy treatment based on pelvic floor exercises with lumbopelvic stabilization exercises in patients with LAM avulsion reduces the levator hiatus area at rest, during Valsalva and at maximum contraction.https://www.imrpress.com/journal/CEOG/47/3/10.31083/j.ceog.2020.03.5252pelvic floor muscle traininglevator ani muscle avulsionpostpartum physiotherapy |
| spellingShingle | J.A. García-Mejido C. Suarez-Serrano E.M. Medrano-Sanchez M.J. Bonomi Barby A. Armijo Sánchez J.A. Sainz Pelvic floor rehabilitation in patients with levator ani muscle avulsion Clinical and Experimental Obstetrics & Gynecology pelvic floor muscle training levator ani muscle avulsion postpartum physiotherapy |
| title | Pelvic floor rehabilitation in patients with levator ani muscle avulsion |
| title_full | Pelvic floor rehabilitation in patients with levator ani muscle avulsion |
| title_fullStr | Pelvic floor rehabilitation in patients with levator ani muscle avulsion |
| title_full_unstemmed | Pelvic floor rehabilitation in patients with levator ani muscle avulsion |
| title_short | Pelvic floor rehabilitation in patients with levator ani muscle avulsion |
| title_sort | pelvic floor rehabilitation in patients with levator ani muscle avulsion |
| topic | pelvic floor muscle training levator ani muscle avulsion postpartum physiotherapy |
| url | https://www.imrpress.com/journal/CEOG/47/3/10.31083/j.ceog.2020.03.5252 |
| work_keys_str_mv | AT jagarciamejido pelvicfloorrehabilitationinpatientswithlevatoranimuscleavulsion AT csuarezserrano pelvicfloorrehabilitationinpatientswithlevatoranimuscleavulsion AT emmedranosanchez pelvicfloorrehabilitationinpatientswithlevatoranimuscleavulsion AT mjbonomibarby pelvicfloorrehabilitationinpatientswithlevatoranimuscleavulsion AT aarmijosanchez pelvicfloorrehabilitationinpatientswithlevatoranimuscleavulsion AT jasainz pelvicfloorrehabilitationinpatientswithlevatoranimuscleavulsion |