Therapeutic exercise to improve pelvic floor muscle function in a female sporting population: a systematic review and meta-analysis

Background: Despite the high prevalence of pelvic floor dysfunction (PFD) among women who participate in sports, and the efforts made to affect these pathologies through pelvic floor muscle (PFM) training, its effects on PFM function remain unclear. Objective: To evaluate the effects of therapeutic exercise programmes on PFM function and quality of life in female athletes and physically active women. Data sources: The following databases were searched: MEDLINE, SCIELO, LILACS, SPORTDiscus, SCOPUS, CINHAL, SCIELO, PEDro, ScienceDirect and COCHRANE from January 2010 to May 2020. Study selection: Study selection criteria included clinical trials that recruited either female athletes or physically active women, and evaluated the effects of therapeutic exercise programmes on PFM function. Data synthesis: Ten studies met the eligibility criteria, capturing a total of 246 participants, of which 180 were apparently healthy individuals and 66 suffered from PFD. Results: Meta-analysis revealed significant improvements in maximal voluntary contraction of the PFMs and reduction of urine leakage after the exercise programmes, although no effects were found for vaginal resting pressure. Limitations: Most of the studies reviewed had a small sample size and a high risk of bias. Conclusions and implications of key findings: Data suggest the benefits of therapeutic exercise on PFM function, PFD symptoms and quality of life after therapeutic exercise programmes in women who participate in sports. Incorporating therapeutic exercises designed to increase PFM function into physical activity routines could be beneficial for both healthy women and those suffering from PFD. However, due to the stated limitations, firm conclusions cannot be made. (C) 2021 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.