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Correct Performance of Pelvic Muscle Exercises in Women Reporting Prior Knowledge

Kandadai, Padma MD, MPH; O’Dell, Katharine CNM, PhD; Saini, Jyot MD

Female Pelvic Medicine & Reconstructive Surgery: May/June 2015 - Volume 21 - Issue 3 - p 135–140
doi: 10.1097/SPV.0000000000000145
Original Articles

Objectives This study aimed to assess correct performance of pelvic muscle exercises (PMEs) in women presenting for urogynecologic care who express prior PME knowledge and to identify optimal instruction.

Methods New patients referred to urogynecology clinic reporting knowledge of PME or Kegels were asked to complete a questionnaire concerning knowledge, prior instruction, and current use of PME. During examination, the participants were asked to perform their PME or Kegel. Initial levator strength was documented by Oxford Scale. Randomized-order instructions were then given to educate women who contracted incorrectly. The participants completed a postexamination questionnaire. Analyses described percentage of women who were able to perform a correct contraction on initial attempt and factors associated with correct performance. Standard statistical methods were used to assess factors associated with correct PME performance and initial strength.

Results Two hundred fifty eligible participants completed the questionnaires. Sixty (24%) participants were unable to correctly perform a PME initially. Of the 83 participants reporting current practice of PME, 23% performed them incorrectly. Prior instruction (odds ratio, 3.0; 95% confidence interval, 1.6–5.7; P < 0.01) and prior feedback (odds ratio, 3.5; 95% confidence interval, 1.0–12.0; P < 0.05) were associated with correct PME performance. In women who performed PME incorrectly at the initial assessment, “Squeeze the vaginal muscles you use to hold your urine” resulted in correct PME performance most often.

Conclusions Women reporting prior knowledge of PME may still perform them incorrectly. Providing instruction and feedback is strongly associated with correct performance and can be easily incorporated into pelvic examination. This may improve PME use and effectiveness to control symptoms of pelvic floor disorders.

Women who have received instruction and feedback are more likely to be able to perform pelvic muscle exercises correctly.

From the UMass Memorial Medical Center, Worcester, MA.

Reprints: Padma Kandadai, MD, MPH, Division of Urogynecology and Pelvic Surgery, Department of Obstetrics and Gynecology, Boston University Medical Center, 85 East Concord Street, 6th Floor, Boston, MA 02118. E-mail:

The authors have declared they have no conflicts of interest.

Presented at the American Urogynecologic Society Annual Scientific Meeting, October 17, 2013, Las Vegas, NV.

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