Cross-sectional survey assessment of physical activity level and frequency of performing pelvic floor muscle exercises

Pelvic floor muscle (PFM) exercises are a non-invasive and effective treatment option for female pelvic floor disorders, but patient adherence is often poor, and predictors of adherence are limited. Our objective was to evaluate the relationship between physical activity level in women and self-reported frequency of performing PFM exercises. Women who responded to a cross-sectional survey through Research Match, a national online volunteer registry, were stratified into low, moderate, and high activity categories based on the International Physical Activity Questionnaire (IPAQ) Short Form. The Pearson Chi -square test was used to evaluate the association between activity level and the self-reported frequency of performing Kegels or PFM exercises. Multivariable logistic regression was used to assess the impact of physical activity level, demographic characteristics (including age, race, ethnicity, insurance status), and urinary symptoms (assessed by the Lower Urinary Tract Research Network -Symptom Index, LURN-SI 29) on performing PFM exercises several times a month or more. A total of 1,720 women were classified as having low (47.4%), moderate (26.3%), and high (26.3%) activity. More women in the high IPAQ category reported performing PFM exercises several times a month or more (17.0%, vs. 10.7% for moderate activity and 12.0% for low activity; P < 0.01). Women most commonly reported doing PFM exercises to improve sex (25.9%), to prevent getting a problem (17.8%), and because they were instructed to start doing them after childbirth (18.0%). Of women who provided a reason for not doing PFM exercises, those in the low and moderate activity groups were more likely to cite laziness as a reason compared to women in the high activity group (47.6% and 51.2%, respectively, vs. 38.7%; P = 0.02). On multivariable logistic regression, physical activity level and lacking insurance coverage were significant predictors of performing PFM exercises several times a week or more. Interventions aimed at increasing PFM exercise participation may benefit from linking to motivation, self-efficacy, and physical activity. The relationship between insurance coverage and frequency of performing PFM exercises warrants further exploration.