title: Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial.
abstract: OBJECTIVE
  Previous studies have shown that women with pelvic floor dysfunctions present decreased cross-sectional area (CSA) of the levator ani muscle. One way to assess the effects of training programs is to measure the CSA of the muscle, using ultrasonography. The aim here was to evaluate the efficacy of pelvic floor muscle training and hypopressive exercises for increasing the CSA of the levator ani muscle in women with pelvic organ prolapse.
  
  
  METHODS
  Prospective randomized controlled trial at the Urogynecology outpatient clinic of Universidade Federal de São Paulo.
  
  
  METHODS
  Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI); a hypopressive exercise group (GII); and a control group (GIII). The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA) of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment.
  
  
  RESULTS
  The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001), but not in relation to GIII (P = 0.816).
  
  
  CONCLUSIONS
  The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle.
authors.affiliation: Department of Gynecology and Obstetrics, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil. btbernardes@hotmail.com
authors.forename: Bruno Teixeira
authors.initials: BT
authors.lastname: Bernardes
authors.forename: Ana Paula Magalhães
authors.initials: AP
authors.lastname: Resende
authors.forename: Liliana
authors.initials: L
authors.lastname: Stüpp
authors.forename: Emerson
authors.initials: E
authors.lastname: Oliveira
authors.forename: Rodrigo Aquino
authors.initials: RA
authors.lastname: Castro
authors.forename: Zsuzsanna Ilona Katalin Jármy di
authors.initials: ZI
authors.lastname: Bella
authors.forename: Manoel João Batista Castello
authors.initials: MJ
authors.lastname: Girão
authors.forename: Marair Gracio Ferreira
authors.initials: MG
authors.lastname: Sartori
mesh_terms: D004812:Epidemiologic Methods; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D017773:Pelvic Floor / Q000000981:diagnostic imaging / Q000502:physiology*; D056887:Pelvic Organ Prolapse / Q000628:therapy*; D014463:Ultrasonography