title: Effectiveness of adding voluntary pelvic floor muscle contraction to a Pilates exercise program: an assessor-masked randomized controlled trial.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effectiveness of adding voluntary pelvic floor muscle contraction (PFMC) to a Pilates exercise program in sedentary nulliparous women.
  
  
  METHODS
  Fifty-seven healthy nulliparous and physically inactive women were randomized to a Pilates exercise program (PEP) with or without PFMC. Forty-eight women concluded this study (24 participants for each group). Each woman was evaluated before and after the PEP, by a physiotherapist and an urogynecologist (UG). Neither of the professionals was revealed to them. This physiotherapist measured their pelvic floor muscle strength by using both a perineometer (Peritron) and vaginal palpation (Oxford Scale). The UG, who performed 3D perineal ultrasound examinations, collected their data and evaluated the results for pubovisceral muscle thickness and the levator hiatus area (LA). Both professionals were blinded to the group allocation. The protocol for both groups consisted of 24 bi-weekly 1-h individual sessions of Pilates exercises, developed by another physiotherapist who specializes in PFM rehabilitation and the Pilates technique.
  
  
  RESULTS
  The PEP+ PFMC group showed significantly greater strength improvements than the PEP group when comparing the Oxford scale, vaginal pressure and pubovisceral muscle thickness during contraction measurements at baseline and post-treatment.
  
  
  CONCLUSIONS
  Our findings suggest that adding a voluntary PFMC to a Pilates exercise program is more effective than Pilates alone in improving PFM strength in sedentary nulliparous women.
authors.affiliation: Gynecology Department of Federal University of São Paulo, Rua Diogo Jacome 1000 apt 23 Moema, Cep:04512-001, São Paulo, SP, Brazil. lutorelli@yahoo.com.br.
authors.forename: Luiza
authors.initials: L
authors.lastname: Torelli
authors.affiliation: Gynecology Department of Federal University of São Paulo, Rua Diogo Jacome 1000 apt 23 Moema, Cep:04512-001, São Paulo, SP, Brazil.
authors.forename: Zsuzsanna Ilona Katalin
authors.initials: ZI
authors.lastname: de Jarmy Di Bella
authors.affiliation: Gynecology Department of Federal University of São Paulo, Rua Diogo Jacome 1000 apt 23 Moema, Cep:04512-001, São Paulo, SP, Brazil.
authors.forename: Claudinei Alves
authors.initials: CA
authors.lastname: Rodrigues
authors.affiliation: Gynecology Department of Federal University of São Paulo, Rua Diogo Jacome 1000 apt 23 Moema, Cep:04512-001, São Paulo, SP, Brazil.
authors.forename: Liliana
authors.initials: L
authors.lastname: Stüpp
authors.affiliation: Gynecology Department of Federal University of São Paulo, Rua Diogo Jacome 1000 apt 23 Moema, Cep:04512-001, São Paulo, SP, Brazil.
authors.forename: Manoel João Batista Castello
authors.initials: MJ
authors.lastname: Girão
authors.affiliation: Gynecology Department of Federal University of São Paulo, Rua Diogo Jacome 1000 apt 23 Moema, Cep:04512-001, São Paulo, SP, Brazil.
authors.forename: Marair Gracio Ferreira
authors.initials: MG
authors.lastname: Sartori
mesh_terms: D000328:Adult; D015444:Exercise; D026241:Exercise Movement Techniques; D005260:Female; D006801:Humans; D009119:Muscle Contraction / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology*; D017773:Pelvic Floor / Q000502:physiology*; D010502:Perineum / Q000502:physiology; D057185:Sedentary Behavior; D016037:Single-Blind Method; D014463:Ultrasonography; D014621:Vagina / Q000502:physiology; D055815:Young Adult
keywords: Pelvic floor muscle contraction; Pilates exercises