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The Association Between Pelvic Floor Muscle Force and General Strength and Fitness in Postpartum Women

Moss, Whitney, BS*; Shaw, Janet M., PhD; Yang, Meng, BS; Sheng, Xiaoming, PhD§; Hitchcock, Robert, PhD; Niederauer, Stefan, BS; Packer, Diane, SPT; Nygaard, Ingrid E., MD, MS**

Female Pelvic Medicine & Reconstructive Surgery: March 27, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000718
Original Article: PDF Only

Objective The aim of the study was to determine whether measures of muscular strength and fitness are associated with pelvic floor muscle (PFM) force 1-year postpartum in a population of primiparous women who delivered vaginally.

Methods This cross-sectional analysis is an ancillary study to an ongoing prospective cohort study and includes 203 primiparous women. Procedures collected 1-year postpartum included maximal PFM force, grip strength, trunk flexor muscle endurance, percent body fat, intra-abdominal pressure during trunk flexor endurance testing, intra-abdominal pressure during strain, and self-reported physical activity.

Results The mean (SD) age was 29.8 (5.0) years and the mean (SD) body mass index was 24.5 (5.2) kg/m2. Nineteen percent were of Hispanic ethnicity. The median (interquartile range) PFM force was 5.05 (2.86–7.94) N. The median (interquartile range) trunk flexor endurance time was 146.0 (78.0–267.0), whereas the mean (SD) grip strength and percent fat were 32.4 (6.4) kg and 29.4% (10.0), respectively.

There were no statistically significant associations between PFM force and any of the measures tested on analyses unadjusted or adjusted for self-report of doing PFM exercises. Of other factors evaluated, non-Hispanic ethnicity, increasing age, self-reported family history of pelvic organ prolapse or urinary incontinence, and normal and obese body mass index (both compared with overweight) were associated with lower PFM force.

Conclusions In primiparous women 1-year postpartum, we found no associations between PFM force and measures of strength and fitness. This study’s results are consistent with existing literature that specific, targeted, and consistent pelvic floor exercises are the best way to improve PFM strength.

From the *University of Utah School of Medicine, Salt Lake City, UT;

Department of Health, Kinesiology, and Recreation, University of Utah College of Health, Salt Lake City, UT;

Department of Family and Preventive Medicine, University of Utah, Salt LakeCity, UT,

§College of Nursing, Salt Lake City, UT and

Department of Bioengineering, University of Utah, Salt Lake City, UT;

Department of Physical Therapy, University of Utah College of Health, Salt Lake City, UT; and

**Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT.

Correspondence: Ingrid Nygaard, MD, MS, Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132. E-mail:

The study was supported by grant number 1P01HD080629 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

I.N. received an honorarium from Elsevier at the time of this article’s submission. The other authors have declared they have no conflicts of interest.

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