Effects of Osteopathic Manipulations and Muscle Training on the Myoelectric Activity of the Pelvic Floor

Giselle Notini Arcanjo

Status: Completed

Conditions: Urinary Incontinence

Treatments: Other: global osteopathic protocol; Other: HVLA; Other: pelvic floor muscle training

Study type: Interventional

Funder types: Other

Identifiers

NCT04584359

Utras1

Details and patient eligibility

About

The objective of this study was to compare the effects of four different interventions on pelvic floor muscle electromyographic activity in women with stress urinary incontinece: i) a global osteopathic protocol (myofascial, visceral, and articular techniques), ii) one manipulation technique (high velocity, low amplitude (HVLA)/thrust) of the sacroiliac joint and T10-L2, iii) Pelvic Floor Muscle training, and iv) a control group with no intervention. The hypothesis is that the global osteopathic protocol and HVLA technique can increase pelvic floor muscle electromyographic activity to a level greater than or equal to the standard care established in the literature (pelvic floor muscle training).

Full description

Participants represented a convenience sample and were recruited from hospitals, urogynecology doctors' clinics, invitations via social networks, gyms, clubs, and sports consultants. Women had to be between 30 and 60 years old and report symptoms of urine loss due to exertion in the last six months.The participants were randomly allocated into four groups (G1 = intervention using an HVLA/thrust technique for the sacroiliac and T10-L2 joints, G2 = global osteopathic protocol, G3 = PFT, and G4 = control) by a blinded researcher with a spreadsheet of random numbers.The primary outcome measure was surface electromyography (EMG) performed at five different times: before the intervention and immediately, 30 minutes, 60 minutes, and four weeks after. This evaluation was performed by a physiotherapist with ten years of experience in urogynecology and expertise in PFM electromyographic evaluation who was blinded to the group allocation.

Enrollment: 40 patients

Sex: Female

Ages: 30 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• symptoms of urine loss due to exertion in the last six months.

Exclusion criteria

• urgent or mixed urinary incontinency
• overactive bladder
• neurological disorder
• urinary or anal infection
• urogenital atrophy
• pelvic organ prolapse grade 3 or 4
• sensory pathways and motor not intact
• spine fracture

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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40 participants in 4 patient groups

HVLA techiniques (G1)

Experimental group

Description:

Performed with thrust (also known as HVLA) in the sacroiliac joint and T10-L2 level

Treatment:

Other: global osteopathic protocol

Other: HVLA

Global osteopathic protocol (G2)

Experimental group

Description:

Several elements were emphasized - myofascial, bone, and visceral.

Treatment:

Other: global osteopathic protocol

Pelvic floor muscle training (G3)

Experimental group

Description:

Muscle Training for four weeks, with a weekly face-to-face visit lasting 10-20 minutes.

Treatment:

Other: pelvic floor muscle training

Control group (G4)

No Intervention group

Description:

No intervention and was simply evaluated and re-evaluated.