- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02259712
Effectiveness of Hypopressive Exercises Versus Pelvic-perineal Physiotherapy (HEPFD)
Effectiveness of Hypopressive Exercises Versus Pelvic- Perineal Physiotherapy in Women With Pelvic Floor Dysfunction: Randomised, Single-blinded, Clinical Trial.
Introduction: Hypopressive Exercises are included within a method of physiotherapy which was created with the purpose of strengthening the deep muscles of the abdomen without damaging ligamentous and muscular structures of the perineum, also strengthening the muscles of pelvic floor reflexively. Although this technique has been included as treatment and a prevention method of pelvic floor dysfunction, there are few studies supporting its benefits. The investigators hypothesis is that the combination of both physiotherapy treatments will provided the best results for women who suffer pelvic floor dysfunctions.
Objective: To determine whether Hypopressive Exercises are an option to include in the physiotherapy treatment of women suffer at least one pelvic floor dysfunction and whether the results reported are comparable to those provided by pelvic-perineal physiotherapy.
Subjects and methods: A randomized clinical trial, the examiner being blinded unaware of the intervention group to which subjects were assigned. Participants will be randomly assigned to three groups:
- An experimental group, where the participants will be treated by Hypopressive exercises and hygienic and behavioral measures;
- Another experimental group where pelvic-perineal physiotherapy will join with Hypopressive exercises and hygienic and behavioral advises;
- And a third group where will be done pelvic-perineal physiotherapy and hygienic and behavioral measures.
Pre- intervention, immediate post-intervention, 3, 6 and 12 months assessments will be made. The selection criteria will be: adult women who present signs and symptoms that indicate a pelvic floor dysfunction or have a medical diagnosis to confirm it. All participants must understand and sign freely Informed Consent.
Sample size: Accepting an alpha risk of 0.05 and a beta risk of 0.2 in a bilateral contrast, 26 subjects were required in each group to detect a difference equal to or greater than 3 microvolts (Total of 78 subjects). It assumes a standard deviation of 4.8 microvolts and the rate of loss to follow up esteem 20% (Magalhães-Resende et al. 2012).
Data Analysis: A descriptive analysis of all variables was performed. It establish for all cases a confidence level of 95% (p <0.05). The effectiveness was assessed by comparing the experienced change of the three goups in outcome variables between physicaltherapy examinations.
Study Overview
Status
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Beatriz N Navarro, PhD student
- Phone Number: +34918854828
- Email: b.navarrobrazalez@gmail.com
Study Contact Backup
- Name: María T Torres, PhD
- Phone Number: +34918854828
- Email: maria.torres@uah.es
Study Locations
-
-
Madrid
-
Alcalá de Henares, Madrid, Spain, 28871
- Teacher care and research in physiotherapy Unit. Department of Physiotherapy. University of Alcala.
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Women who experience signs and symptoms evidencing pelvic floor dysfunction.
- Women with a medical diagnosis of pelvic floor dysfunction.
- Women with signs and or symptoms of urinary incontinence, anal incontinence, overactive bladder syndrome and prolapse in grade I-II.
- All participants must understand and sign freely Informed Consent.
Exclusion Criteria:
- Women minors.
- Pregnant women.
- Women who have had a vaginal delivery or cesarean in the past six months.
- Women with pelvic floor dysfunction which is serious and the first indication is surgical (prolapses grades III-IV).
- Women who have been treated for perineal physiotherapy in the past 12 months.
- Participants submit any pathology that may affect treatment (neurological, gynecological or urological), or recurrent urinary tract infection or hematuria.
- Women with cognitive limitations in understanding the information, respond to questionnaires, consent and / or participate in the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Pelvic-perineal physiotherapy
The treatment duration is 2 days per week during 8 weks (two months). The aproximate duration of the season is 45 minutes. The protocol consists in:
|
The therapeutic education will be doing during the 8 weeks of treatment. In the first day the knowledge and the briefs of the pelvic floor dysfunction will be assessed. Dietary and behavioral habits will also be discussed. In the second day anatomical and physiological explanation of the pelvic girdle will be the priority. In the third day will be explained the signs and symptoms of the different pelvic floor dysfunctions. In the four day will be analyzed the risk factors that may cause or worsen pelvic floor dysfunctions. In the fifth day will be begun to correct the bad habits. In the last day will be reviewed the knowledge and new habits acquired during the treatment. In all treatment days will be discussed the doubts of the participant.
Other Names:
Pre-treatment, post-treatment, 3, 6 and 12 months after physical therapy treatment.
Will be done a specific evaluation of pelvic floor muscles using the Modified Oxford Scale, superficial electromyography, perineometry and dynamometer.
For the evaluation of the impact, the signs and the symptoms questionnaires will be completed by the participants.
Other Names:
45 minutes physical therapy treatment 2 times per week during 8 weeks.
There will be done specific exercises of the pelvic floor muscles and coordination exercises of the pelvic floor muscles with other muscles in different positions.
Electrostimulation, biofeedbak, cones and dinamometric devices can be employed to improve the muscle performance.
Other Names:
|
Experimental: Hyporessive and Pelvic-perineal PT
The treatment duration is 2 days per week, 8 weeks (two months).
The session is about 45 minutes.
All women are instructed on hygienic and behavioral advises preventing pelvic floor dysfunctions.
They are teach basic anatomy and physiology to understand the importance of these advises and anatomical and physiological explanation of the pelvic girdle.
The participants are also treated by doing Hypopressive exercises and by specific physiotherapy for the strengthening the pelvic floor muscles.
|
The therapeutic education will be doing during the 8 weeks of treatment. In the first day the knowledge and the briefs of the pelvic floor dysfunction will be assessed. Dietary and behavioral habits will also be discussed. In the second day anatomical and physiological explanation of the pelvic girdle will be the priority. In the third day will be explained the signs and symptoms of the different pelvic floor dysfunctions. In the four day will be analyzed the risk factors that may cause or worsen pelvic floor dysfunctions. In the fifth day will be begun to correct the bad habits. In the last day will be reviewed the knowledge and new habits acquired during the treatment. In all treatment days will be discussed the doubts of the participant.
Other Names:
Pre-treatment, post-treatment, 3, 6 and 12 months after physical therapy treatment.
Will be done a specific evaluation of pelvic floor muscles using the Modified Oxford Scale, superficial electromyography, perineometry and dynamometer.
For the evaluation of the impact, the signs and the symptoms questionnaires will be completed by the participants.
Other Names:
45 minutes physical therapy treatment 2 times per week during 8 weeks.
There will be done specific exercises of the pelvic floor muscles and coordination exercises of the pelvic floor muscles with other muscles in different positions.
Electrostimulation, biofeedbak, cones and dinamometric devices can be employed to improve the muscle performance.
Other Names:
45 minutes treatment by hipopressive exercises 2 times per week during 8 weeks.
They will be doing in different positions: standing, kneeling, sitting and lying.
The patient will be teach a total of 30 exercises.
In the week number 8 the women with the physical therapist will choose 3 exercises that will be done daily at home during 20 minutes.
Other Names:
|
Experimental: Hypopressive exercises
The treatment is done 2 times per week for 8 weeks (2 months).
The session duration is about 45 minutes.
All participants are instructed on hygienic and behavioral advises preventing pelvic floor dysfunctions.
They are teach basic anatomy and physiology to understand the importance of these advises and anatomical and physiological explanation of the pelvic girdle (perineal organs bony, ligaments and muscular structures of the entire abdominal and pelvic cavity).
The participants are also treated by doing Hypopressive exercises in standing, sitting, and supine fours.
|
The therapeutic education will be doing during the 8 weeks of treatment. In the first day the knowledge and the briefs of the pelvic floor dysfunction will be assessed. Dietary and behavioral habits will also be discussed. In the second day anatomical and physiological explanation of the pelvic girdle will be the priority. In the third day will be explained the signs and symptoms of the different pelvic floor dysfunctions. In the four day will be analyzed the risk factors that may cause or worsen pelvic floor dysfunctions. In the fifth day will be begun to correct the bad habits. In the last day will be reviewed the knowledge and new habits acquired during the treatment. In all treatment days will be discussed the doubts of the participant.
Other Names:
Pre-treatment, post-treatment, 3, 6 and 12 months after physical therapy treatment.
Will be done a specific evaluation of pelvic floor muscles using the Modified Oxford Scale, superficial electromyography, perineometry and dynamometer.
For the evaluation of the impact, the signs and the symptoms questionnaires will be completed by the participants.
Other Names:
45 minutes treatment by hipopressive exercises 2 times per week during 8 weeks.
They will be doing in different positions: standing, kneeling, sitting and lying.
The patient will be teach a total of 30 exercises.
In the week number 8 the women with the physical therapist will choose 3 exercises that will be done daily at home during 20 minutes.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The change of signs, symptoms and impact of pelvic floor dysfunction between reviews
Time Frame: Pre-treatment, post-treatment, 3, 6 and 12 months assessments were required.
|
- Improve the impact of pelvic floor dysfunctions by 30% according to Spanish short version of Pelvic Floor Impact Questionnaire (PFIQ-7).
|
Pre-treatment, post-treatment, 3, 6 and 12 months assessments were required.
|
The change of signs, symptoms and impact of pelvic floor dysfunction between reviews
Time Frame: Pre-treatment, post-treatment, 3, 6 and 12 months assessments were required.
|
- Improve the signs and symptoms of pelvic floor dysfunction by 30% according to Spanish short version of Pelvic Floor Distress Inventory (PFDI-20).
|
Pre-treatment, post-treatment, 3, 6 and 12 months assessments were required.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The change of pelvic floor muscles strenght
Time Frame: Pre-treatment, post-treatment, 3, 6 and 12 months assessments were required.
|
- Improve the strength of the pelvic floor muscles by 2 points according to the Modified Oxford Scale.
|
Pre-treatment, post-treatment, 3, 6 and 12 months assessments were required.
|
The change of pelvic floor muscles pressure force
Time Frame: Pre-treatment, post-treatment, 3, 6 and 12 months assessments were required.
|
- Improve the strength of pelvic floor in 10 cm H2O measured with digital perineometer.
|
Pre-treatment, post-treatment, 3, 6 and 12 months assessments were required.
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Beatriz N Navarro, PhD student, University of Alcala
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Behavioral Symptoms
- Mental Disorders
- Digestive System Diseases
- Urologic Diseases
- Lower Urinary Tract Symptoms
- Urological Manifestations
- Pain
- Neurologic Manifestations
- Gastrointestinal Diseases
- Urination Disorders
- Intestinal Diseases
- Rectal Diseases
- Pregnancy Complications
- Elimination Disorders
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Male Urogenital Diseases
- Urinary Incontinence
- Enuresis
- Pelvic Floor Disorders
- Fecal Incontinence
- Pelvic Pain
Other Study ID Numbers
- OE 20/2013 (Other Identifier: Ethics Committee of University Hospital Prince of Asturias)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Urinary Incontinence
-
University of New MexicoRecruitingUrinary Incontinence | Urge Incontinence | Stress Incontinence, FemaleUnited States
-
Juna d.o.o.CompletedFemale Stress Urinary Incontinence | Mixed Incontinence, Urge and Stress
-
University of California, San FranciscoNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); Stanford...CompletedUrinary Incontinence, Stress | Urge Incontinence | Urinary Stress Incontinence | Stress Incontinence, Urinary | Stress Incontinence | Stress Incontinence, Female | Urgency UrinaryUnited States
-
Ludwig-Maximilians - University of MunichUnknownIncontinence, Overactive Bladder, Stress Urinary IncontinenceGermany
-
San Diego Sexual MedicineRecruitingStress Urinary Incontinence | Urge IncontinenceUnited States
-
Far Eastern Memorial HospitalRecruitingWomen With Stress Urinary IncontinenceTaiwan
-
Copenhagen University Hospital at HerlevZealand University HospitalTerminatedStress Urinary Incontinence | Urge Urinary IncontinenceDenmark
-
ScitonCompletedUrinary Incontinence | Stress Urinary Incontinence | Urge IncontinenceUnited States
-
Université de SherbrookeRecruitingUrinary Incontinence | Urinary Stress Incontinence | Post-Prostatectomy Incontinence | Stress Incontinence, MaleCanada
-
University of ZurichCompletedStress Urinary Incontinence | Urge Urinary Incontinence
Clinical Trials on Therapeutic education.
-
Roy La Touche ArbizuUniversidad Autonoma de Madrid; Centro Universitario La Salle; Servicio Madrileño...UnknownLow Back Pain | Chronic Nonspecific Low Back PainSpain
-
Nantes University HospitalTerminated
-
Assistance Publique - Hôpitaux de ParisCentre Leon Berard; Ministry of Health, France; Université Montpellier; Telecom... and other collaboratorsUnknownKidney Transplantation | End-stage Renal Disease | Dialysis
-
Assistance Publique - Hôpitaux de ParisCompleted
-
Beauvais HospitalNot yet recruitingNutrition Aspect of Cancer
-
ResicardAssistance Publique - Hôpitaux de Paris; Novartis; Agence Regionale de Sante... and other collaboratorsActive, not recruitingHeart FailureFrance
-
University Hospital, Strasbourg, FranceNot yet recruitingAuto-immune Myasthenia
-
University Hospital, Clermont-FerrandFrench Society of RheumatologyCompletedRheumatoid Arthritis | SpondyloarthritisFrance
-
Hôpital Léon BérardWithdrawn
-
Association pour le Développement et l'Organisation...WithdrawnAlveolar HypoventilationFrance