Article
Pelvic floor rehabilitation in patients with levator ani muscle avulsion
Author/s | García Mejido, José Antonio
Suárez Serrano, Carmen Medrano Sánchez, Esther Mª Bonomi Barby, María José Armijo Sánchez, A. Sáinz Bueno, José Antonio |
Department | Universidad de Sevilla. Departamento de Cirugía Universidad de Sevilla. Departamento de Fisioterapia |
Publication Date | 2020 |
Deposit Date | 2024-05-17 |
Published in |
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Abstract | Objective: To determine if physiotherapy treatment applied to patients with levator ani muscle (LAM) avulsion identified after a
vaginal delivery, reduces the LAM hiatus area. Material and Methods: A prospective observational ... Objective: To determine if physiotherapy treatment applied to patients with levator ani muscle (LAM) avulsion identified after a vaginal delivery, reduces the LAM hiatus area. Material and Methods: A prospective observational study of 52 nulliparous (26 in the experimental and 26 in the control group). We included patients with LAM avulsion, diagnosed by 3-4D/transperineal ultrasound performed 3 months after delivery. Patients in the experimental group underwent a program of pelvic floor exercises, assisted by biofeedback and lumbopelvic stabilization exercises. Assessment of LAM was carried out at 6 and 9 months postpartum, using 3-4D/transperineal ultrasound, and taking the following measurements: levator hiatus area at rest, during Valsalva and at maximum contraction; LAM area, and thickness of right and left LAM. Results: Patients in the experimental group presented a reduction in the levator hiatus area at rest (17.0, 15.7, 15.9 cm2 ), during Valsalva (23.0, 20.8, 19.9 cm2 ) and at maximum contraction (15.6, 14.4 and 13.5 cm2 ), in comparison with patients in the control group, who presented a levator hiatus area at rest of 17.4, 17.2 and 16.8 cm2 , during Valsalva of 21.0, 20.8 and 20.3 cm2 , and at maximum contraction of 16.6, 16.1 and 15.6 cm2 , at 1, 6 and 9 months postpartum respectively (P < 0.05). However, no changes were appreciated in the successive examinations regarding LAM area between study groups: experimental 9.5, 8.9, 9.6 cm2 versus 8.9, 9.0, 9.2 cm2 in the control group. Conclusions: Physiotherapy treatment based on pelvic floor exercises with lumbopelvic stabilization exercises in patients with LAM avulsion reduces the levator hiatus area at rest, during Valsalva and at maximum contraction. |
Funding agencies | Instituto de Salud Carlos III |
Project ID. | PI16/01387 |
Citation | García Mejido, J.A., Suárez Serrano, C., Medrano Sánchez, E.M., Bonomi Barby, M.J., Armijo Sánchez, A. y Sáinz Bueno, J.A. (2020). Pelvic floor rehabilitation in patients with levator ani muscle avulsion. Clinical and Experimental Obstetrics & Gynecology, 47 (3), 341-347. https://doi.org/10.31083/J.CEOG.2020.03.5252. |
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