title: Should women with incontinence and prolapse do abdominal curls?
abstract: OBJECTIVE
  Urinary incontinence (UI) and pelvic organ prolapse (POP) occur in 30-50 % of women. It is proposed that increases in intra-abdominal pressure (IAP) caused by high-intensity activities may contribute to symptoms of pelvic floor dysfunction. There is a lack of consensus as to the type of activity restrictions that may be necessary in this population. The objective was to determine the change in IAP (cm H20) during abdominal curl and cough in patients with UI and POP attending urodynamic evaluation.
  
  
  METHODS
  In this exploratory descriptive study, 30 women with diagnosed POP and/or UI were recruited. IAP was measured by multichannel cystometry whilst participants performed three abdominal curls and three maximal coughs.
  
  
  RESULTS
  Participants were aged 29-80 (mean 56.2) years, and mean ± standard deviation (SD) body mass index (BMI) was 29.9 (5.2) kg/m(-2). All participants had UI and 12 had POP in addition to UI. IAP increased significantly from rest to abdominal curl and cough (19.6-50.3 and 78.4, respectively; p < 0.001). Greater pressures were generated in the women with POP than in those with UI only (p = 0.02). There were large variations in change in pressure between participants (1.67-159.66 for cough; 4-81.67 for abdominal curl).
  
  
  CONCLUSIONS
  The large variability in IAP generated during abdominal curl and cough suggests some current recommendations may be unnecessarily restrictive in some women but important in others. Advice for women with pelvic floor dysfunction undertaking tasks that increase IAP needs to be individualized.
authors.affiliation: Allied Health Department, Fiona Stanley Hospital, Locked Bag 100, Palmyra DC, WA, 6961, Australia.
authors.forename: Sally
authors.initials: S
authors.lastname: Simpson
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. Michelle.Brown@curtin.edu.au.
authors.forename: Michelle
authors.initials: M
authors.lastname: Deeble
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
authors.forename: Judith
authors.initials: J
authors.lastname: Thompson
authors.affiliation: Department of Physiotherapy, King Edward Memorial Hospital, 374 Bagot Rd, Subiaco, WA, 6008, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Andrews
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
authors.forename: Kathy
authors.initials: K
authors.lastname: Briffa
mesh_terms: D000009:Abdominal Muscles / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015992:Body Mass Index; D003371:Cough; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000503:physiopathology*; D011312:Pressure; D014549:Urinary Incontinence / Q000503:physiopathology*
keywords: Abdominal curl; Cough pressure; Exercise restriction; Intra-abdominal pressure; Pelvic organ prolapse; Urinary incontinence