After reviewing the published literature, it is difficult to establish a common guideline regarding the number of sets and repetitions for pelvic floor exercises, the frequency of treatment sessions per week, and the duration of this training. While some publications do not provide specific details about the protocol followed, others indicate a minimum follow-up period of 8 weeks of exercise and a maximum follow-up period of up to one year after childbirth.

The frequency per week varies from two sessions per week to daily sessions in the reviewed studies. There is a higher number of authors who recommend daily pelvic floor exercise sessions, either under the guidance of a professional or alternating with exercises performed at home.

Most articles agree on programming three sets of 8-12 repetitions each, with a focus on sustained contractions held for 5-6 seconds to activate slow muscle fibers rather than quick contraction series. Several articles recommend performing exercises multiple times a day. There are also differences regarding whether to solely focus on training the perineal muscles or include them as part of a longer session of about 60 minutes, which may include stretching and strengthening of other muscles such as the transverse abdominal muscles, adductors and glutes in the lower limbs, and general arm muscles. Pelvic floor training is taught in various positions in the analyzed studies, with sitting and lying positions being the most common. Stretching exercises are generally performed in other positions, where incorporating perineal exercises is highly recommended.

Inés Carmona Barrientos

References:

1. Ahlund S, Nordgren B, Wilander EL, Wiklund I, Friden C. Is home-based pelvic floor muscle training effective in treatment of urinary incontinence after birth in primiparous women? A randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica 2013;92(8): 909–15.
2. Assis LC, Bernardes JM, Barbosa AM, Santini AC, Vianna LS, Dias A. Effectiveness of an illustrated home exercise guide on promoting urinary continence during pregnancy: a pragmatic randomized clinical trial [Portuguese]. Revista Brasileira de Ginecologia e Obstetricia 2015;37(10):460–6.
3. Cruz C, Riesco ML, Zanetti M. Supervised pelvic floor muscle training to treat urinary incontinence during pregnancy: a randomized controlled trial (Abstract number 403). Neurourology and Urodynamics 2014;33(6):867–8
4. Dinc A, Kizilkaya Beji N, Yalcin O. Effect of pelvic floor muscle exercises in the treatment of urinary incontinence during pregnancy and the postpartum period. International Urogynecology Journal 2009; Vol. 20, issue 10:1223–31.
5. Kim EY, Kim SY, Oh DW. Pelvic floor muscle exercises utilizing trunk stabilization for treating postpartum urinary incontinence: randomized controlled pilot trial of supervised versus unsupervised training. Clinical Rehabilitation 2012;26(2):132–41.
6. Kocaoz S, Eroglu K, Sivaslioglu AA. Role of pelvic floor muscle exercises in the prevention of stress urinary incontinence during pregnancy and the postpartum period. Gynecologic and Obstetric Investigation 2013;75(1):34–40.