Assessing the effectiveness of Kegel exercises

WHAT ARE THESE [see my blog post here]

The most widely known exercises which prevent and treat urinary incontinence were created by Dr. Arnold Kegel in the fifities. This American gynecologist was the first to scientifically use exercises to strengthen the pelvic floor muscles in order to improve urinary incontinence mechanisms. These exercises improve the perineum muscle contraction, giving it more power (strong and fast), increase urethral compression against the pubic symphysis, increase intra-urethral pressure when intra-abdominal pressure is increased, help pelvic muscle hypertrophy and increase the volume of such muscles. Hence, structural support of this body area becomes more effective and prevents the urethra from descending when intra-abdominal pressure increases and, consequently, decreasing urinary leaking.

The pelvic floor muscles should support the viscera in the upright position and maintain urinary continence as well. So, they should be kept strong and in perfect condition.

Since Kegel first published the development of these exercises, they have been widely used and quoted in medical academic literature; however, as of then, it is also possible to find not only different techniques and systematization (that is, frequency, intensity, repetitions and associations) but also different instructions given to patients in scientific literature. According to theory on the development of exercises to treat stress urinary incontinence, the aim is to boost pelvic floor muscle (PFM) strength, coordination, speed and resistance in order to keep structures in an adequate position whenever there is an effort which causes intra-abdominal pressure increase and, thus, keeping a proper urethral closure strength. (Ashton-Miller et al., 2001).

ASSESSMENT

“After women were “taught” to contract their PFM while coughing, the authors noticed a significant incontinence reduction” [Urinary Incontinence, edited by Ammar Alhasso and Ashani Fernando].

According to the protocol of the Association of Women’s Health Obstetrics and Neonatal Nurses (Agency for Health Care Policy and Research, [AWHONN]), “PFM strengthening exercises should include 40 to 50 contractions per session, with a sequence of 8 to 12 slow and quick contractions, where contractions are slow and isometric, 5 seconds long at the beginning and lasting for 10 seconds later on. Long term and daily training can, however, allow more contractions per class or training session” [Urinary Incontinence, edited by Ammar Alhasso and Ashani Fernando].

DO THEM PROPERLY

“For kegels to work, you squeeze the muscles as hard as you can. It takes focus”. “To keep your muscles healthy, you relax the muscles completely after each kegel. Close your eyes and relax”

+ Drink a lot of water:

If you don’t drink enough water, your urine gets too concentrated. The extra-strong urine irritates the bladder and can cause urine leaks. It’s true! Drinking more water can help you stay dry. [Source]

DO NOT OVERDO THESE!

“A healthy muscle that works well and feels good is a muscle that is relaxed and supple, not tight and clenched”. [Source]

“kegels done without a device work better than kegels done with weights”. [Source]