The Influence of Pelvic Floor Fascial (Manual) Mobilization in
Multiparous Women -A randomized controlled trial
Abstract
Objective Pelvic Floor Fascial Mobilization (PFFM) is an innovative
intervention to improve pelvic floor dysfunction. Design Pregnant women
at 24-30 weeks gestation, complaining of pelvic pain, and or stress
urinary incontinence, were prospectively randomized to PFFM (study
group) vs. pelvic floor muscle training (PFMT). Strength and function of
the pelvic floor muscles was compared before and after interventions.
Setting- Outpatient pregnancy clinic at a tertiary medical center
Sample- 40 women randomly allocated to PFFM or PFMT Methods Each patient
was treated twice, one week apart and was assessed immediately before
and after each intervention, and one week after the second treatment.
Main Outcome Measures PFDI 20 questionnaire , Oxford grading scale,
perineometry to measure pelvic floor symptoms function and strength,
transvaginal ultrasound cervical length Results PFFM group Oxford scale
improved from 2.65±1.18 to 3.45±1.28 after the first session
(p<0.001) with no difference in the PFMT group 3.40±1.05 vs
3.40±1.05 (p=1). Cervical Length elongated in the PFFM group after one
treatment (39.8±6.5 vs 43.4±10.2 mm, p<0.05, but not in the
PFMT group 40.9±6.7 vs 40.0±8.6 respectively (p=n.s). Among 26
participants who lasted the entire study – PFMT was associated with
more than 40% improvement in both Oxford as well as PFDI-20 and
Perineometry was improved by 23% (23.13±15.15 vs 28.58±16.07 cmH2O
(p<0.05) while no such difference was found with PFMT;
30.03±12.73 vs 30.25±9.61 cmH2O respectively (p=n.s). Conclusions PFFM
may improve pelvic floor function and strength, alleviate symptoms and
elongate the cervix. Further bigger study is needed to better evaluate
this method.