The comparative effectiveness of pelvic floor muscle training and hypopressive breathing techniques for pelvic organ prolapse: A systematic review and pooled analysis of randomized controlled trials

Jessica R Mitchell; Hanna E Brancaccio; Morgan Blusewicz Spt; David F Lo; Brandon Goodwin; Danielle Carey

doi:10.1016/j.amjsurg.2024.116111

The comparative effectiveness of pelvic floor muscle training and hypopressive breathing techniques for pelvic organ prolapse: A systematic review and pooled analysis of randomized controlled trials

Am J Surg. 2024 Nov 21:116111. doi: 10.1016/j.amjsurg.2024.116111. Online ahead of print.

Authors

Jessica R Mitchell¹, Hanna E Brancaccio², Morgan Blusewicz Spt³, David F Lo⁴, Brandon Goodwin⁵, Danielle Carey⁶

Affiliations

¹ Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA; Futures Forward Research Institute, Toms River, NJ, USA. Electronic address: mitche89@rowan.edu.
² Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA; Futures Forward Research Institute, Toms River, NJ, USA. Electronic address: branca29@rowan.edu.
³ Marist University, College of Physical Therapy, Poughkeepsie, NY, USA. Electronic address: morgan.blusewicz1@marist.edu.
⁴ Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA; Futures Forward Research Institute, Toms River, NJ, USA; American Preventive Screening & Education Association (APSEA), Stratford, NJ, USA; Department of Biology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA. Electronic address: lodavi26@rowan.edu.
⁵ Futures Forward Research Institute, Toms River, NJ, USA; Ocean University Medical Center, Hackensack Meridian Health, Brick Township, NJ, USA. Electronic address: goodwi52@rowan.edu.
⁶ Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA. Electronic address: careyda@rowan.edu.

PMID: 39603917
DOI: 10.1016/j.amjsurg.2024.116111

Abstract

Background: Pelvic floor (PF) disorder affects 25 % of females, often progressing to Pelvic Organ Prolapse (POP). PF muscle training (PFMT) and hypopressive breathing (HB) are conservative techniques used to repair pelvic muscles. This study analyzes the comparative efficacy of PFMT and HB for POP.

Methods: A systematic review was conducted and seven records were included in the pooled analysis, which compared PF outcomes between HB and PFMT.

Results: PFMT (d = 2.14 and d = 1.07) demonstrated a larger effect size compared to HB (d = 1.24 and d = 0.78) for sEMG contractility and the Modified Oxford Scale, respectively. The Pelvic Floor Disability Index (PFDI-20) found a lower effect size of PFMT (d = 0.558) compared to HB (d = 0.961).

Conclusions: PFMT was found to improve PF strength (Oxford) more than HB, while HB had a greater effect on quality of life (PFDI-20). Results were insignificant for contractility.

Keywords: Hypopressive breathing; Pelvic floor; Pelvic floor muscle training; Pelvic organ prolapse.