These authors contributed equally to this study as co-first authors.
Lower urinary tract symptoms (LUTS) have been considered as clinically prevalent symptom in women, and can be ameliorated by the change of abdominal muscles and pelvic floor muscle (PFM). This study investigated the efficacy of Pilates program using Oov and mat on the change of abdominal muscle thickness, PFM function, and LUTS clinical score. 53 women experiencing LUTS were randomly assigned to Oov Pilates exercise group (OPEG) (n=20), mat Pilates exercise group (MPEG) (n= 16), and symptomatic control group (SCG) (n=17), respectively, and two groups using Oov and mat participated in 8-week Pilates program. Thickness of abdominal muscle, functional movement of PFM, and LUTS clinical score were measured from all groups. Thickness of rectus abdominis, internal oblique abdominis, transversus abdominis was significantly improved in OPEG (
Lower urinary tract symptoms (LUTS) have been known to have a significant impact on the majority of adults over the age of 40 in women; the International Continence Society has reported that the incidence rate of LUTS in women is approximately 66.0% (
Pelvic floor muscle (PFM) is a multi-layered muscle complex that forms the base of the abdominal pelvic cavity that contributes to controlling the posture, abdominal pressure, and excretion (
It is reported that Pilates plays a pivotal role in enhancing the “Power-house” of the body such as the back, abdomen, and PFM (
A total of 53 women aged between 40 and 55 years were diagnosed with LUTS and randomly divided into three groups: Oov Pilates exercise group (OPEG) (n=20), mat Pilates exercise group (MPEG) (n=16), and symptomatic control group (SCG) (n=17) (
OPEG used the Oov (HF Industries Pty Ltd, Taren Point, Australia) (
Thickness of rectus abdominis, external oblique abdominis, internal oblique abdominis, and transversus abdominis was measured using SONON Convex 300C (Sonon 300C, Healcerion Co., Seoul, Korea) with multiple frequencies technology and convex array transducer. The transducer was located at 5 cm below the 3 cm lateral of the xiphoid process for rectus abdominis and 2.5 cm inward of the axillary line between the iliac crest and the 12th rib inferior line for external oblique abdominis, internal oblique abdominis, and transversus abdominis. Using the Image-Pro Plus (Media Cyberbetics Inc., Silver Spring, MD, USA) for image analysis, anatomical thickness of each muscle was calculated (
Functional movement of PFM was measured by same device used for abdominal muscle thickness. This study applied the previously approved clinical procedures for measuring the functional movement of PFM (
All data were analyzed using IBM SPSS Statistics ver. 21.0 (IBM Co., Armonk, NY, USA). Analysis of covariance (ANCOVA) tests was performed to confirm the statistical differences between groups, and pre-post comparison within each group was conducted using the paired
After 8-week Pilates intervention, the thickness of rectus abdominis showed a significant difference among groups (
After 8-week Pilates program, the thickness of external oblique abdominis showed a significant thickness difference among groups (
After 8-week Pilates intervention, the thickness of internal oblique abdominis showed a significant thickness difference in internal oblique abdominis among groups (
After 8-week Pilates program, the thickness of transversus abdominis showed a significant thickness difference in among groups (
After the 8-week Pilates intervention, functional movement of PFM showed a significant difference in among groups (
After the 8-week Pilates intervention, significant difference in degree of voiding-related symptoms was found among groups (
The aim of our study was to investigate the efficacy of Pilates program using Oov and mat on abdominal muscles thickness, functional movement of PFM, and LUTS clinical score in middle-aged Korean women between 40−55 years diagnosed with LUTS. Our study found that Pilates program using the Oov was the key intervention that significantly increased the all part of abdominal muscles thickness, except the external oblique abdominis. Among all part of abdominal muscles thickness in OPEG and MPEG, the fact that transversus abdominis in OPEG had the most prominent improvement (OPEG: 84.31% ↑,
PFM has been assumed to interrelate with the function of the lower urinary tract and facilitate the synergistic action between the diaphragm and abdominal muscles to maintain intraperitoneal pressure (
In our result, as the OPEG showed the most dramatic change in rectus abdominis, internal oblique abdominis, and transversus abdominis, it is speculated that morphological change in abdominal muscles was be directly associated with ameliorated functional movement of PFM (
LUTS can be defined as urological symptoms associated with the storage and excretion of urine; aging, attenuated bladder contractility, decreased bladder volume, abdominal obesity, and weakened PFM were reported as a major cause of LUTS (
Consequently, our results highlighted that Pilates using Oov and mat can ameliorate the abdominal muscles thickness and functional movement of PFM potentially associated with alleviated LUTS, however, the application of Oov in Pilates program settings can be more effective countermeasure in managing the LUTS. Therefore, we speculate that 8-week Pilates using Oov can be more suitable exercise intervention to accomplish the improved abdominal muscles thickness and functional movement of PFM and contented quality of life in middle-aged women with LUTS.
No potential conflict of interest relevant to this article was reported.
The authors received no financial support for this article.
Oov (HF Industries Pty Ltd, Taren Point, Australia) used as an exercise interventional tool in Oov Pilates exercise group.
Anthropometrical assessment of subject
Group | Age (yr) | Height (cm) | Weight (kg) | BMI (kg/m2) |
---|---|---|---|---|
SCG (n=17) | 48.65±8.33 | 157.00±7.84 | 62.11±10.47 | 24.70±2.91 |
OPEG (n=20) | 41.30±5.81 | 160.80±4.21 | 64.12±10.28 | 24.73±3.37 |
MPEG (n=16) | 43.44±7.67 | 160.50±5.94 | 57.18±7.32 | 22.14±2.18 |
Sig. | 0.078 | 0.177 | 0.027 | 0.263 |
Values are presented as mean±standard deviation.
BMI, body mass index; SCG, symptomatic control group; OPEG, Oov Pilates exercise group; MPEG, mat Pilates exercise group; Sig., statistical significance among three groups.
8-Week Oov and mat Pilates program
Intervention method | Exercise program | Frequency | Intensity | |
---|---|---|---|---|
Oov Pilates (Oov) | Warm-up | Breathing→Stretch→Imprint and release→Arm & Knee circle | NA | NA |
Main exercise phase I & II (40 min) | Phase I (20 min)M |
1–4 weeks |
55%–65% HRR (RPE 11–13) | |
Mat Pilates (Mat) | Phase II (20 min) |
5–8 weeks |
65%–75% HRR (RPE 13–15) | |
Cool-down (10 min) | Breathing→Stretch→Cat stretch→Child’s pose | NA | NA |
NA, no application; HRR, heart rate reserve.
The change of abdominal muscle thickness
Variable | Group | Pre (mm) | Post (mm) | Δ (%) | Ap | AA | AB |
---|---|---|---|---|---|---|---|
Rectus abdominis | SCG | 0.86±0.11 | 0.83±0.10 | −3.49 | 0.250 | 0.003 |
OPEG>SCG ( |
OPEG | 0.79±0.18 | 1.09±0.28 | 37.97 | 0.001 | |||
MPEG | 0.92±0.10 | 1.01±0.27 | 9.78 | 0.140 | |||
| |||||||
External oblique abdominis | SCG | 0.86±0.11 | 0.83±0.10 | −17.53 | 0.048 |
0.011 |
OPEG>SCG ( |
OPEG | 0.79±0.18 | 1.09±0.28 | 12.24 | 0.140 | |||
MPEG | 0.92±0.10 | 1.01±0.27 | 15.15 | 0.170 | |||
| |||||||
Internal oblique abdominis | SCG | 0.96±0.20 | 0.88±0.22 | −8.33 | 0.195 | 0.041 |
OPEG>SCG ( |
OPEG | 0.79±0.18 | 1.09±0.28 | 34.69 | 0.012 | |||
MPEG | 0.92±0.10 | 1.01±0.27 | 19.35 | 0.262 | |||
| |||||||
Transversus abdominis | SCG | 0.99±0.26 | 0.99±0.19 | 0 | 0.966 | 0.001 |
OPEG>SCG ( |
OPEG | 1.02±0.35 | 1.88±0.57 | 84.31 | 0.001 | |||
MPEG | 0.96±0.22 | 1.38±0.65 | 43.75 | 0.035 |
Values are presented as mean±standard deviation.
SCG, symptomatic control group; OPEG, Oov Pilates exercise group; MPEG, mat Pilates exercise group; Δ (%), (Post-Pre)/Pre×100; Ap, paired
The change in functional movement of PFM and LUTS clinical score
Variable | Group | Pre (mm) | Post (mm) | Δ (%) | Ap | AA | AB |
---|---|---|---|---|---|---|---|
FMP | SCG | 0.92±0.09 | 0.82±0.32 | −10.87 | 0.242 | 0.001 |
OPEG>SCG ( |
OPEG | 0.84±0.13 | 0.41±0.16 | −51.19 | 0.001 | |||
MPEG | 0.99±0.17 | 0.74±0.39 | −25.25 | 0.023 | |||
| |||||||
LUTS clinical score | |||||||
DVS | SCG | 48.09±12.12 | 48.41±15.06 | 0.67 | 0.884 | 0.001 |
OPEG<SCG ( |
OPEG | 51.35±9.08 | 23.68±5.54 | −53.89 | 0.001 | |||
MPEG | 52.44±9.14 | 22.88±4.39 | −56.36 | 0.001 | |||
DVD | SCG | 22.29±4.36 | 26.06±5.38 | 16.91 | 0.955 | 0.001 |
OPEG<SCG ( |
OPEG | 20.88±3.17 | 12.68±3.57 | −39.27 | 0.001 | |||
MPEG | 25.94±4.78 | 12.00±3.25 | −53.73 | 0.001 |
Values are presented as mean±standard deviation.
FMP, functional movement of PFM; LUTS, lower urinary track symptoms; DVS, degree of voiding-related symptom; DVD, degree of voiding-related discomfort; SCG, symptomatic control group; OPEG, Oov Pilates exercise group; MPEG, mat Pilates exercise group; Δ (%), (Post-Pre)/Pre×100; Ap: paired