Assessing the Effect of Passive Ankle Dorsi Flexion while Doing Strengthening Exercises of Pelvic Floor Muscles on Pelvic Floor Muscles Strength in Women with Pelvic floor Muscles Relaxation Syndrome

Document Type : Original Article


1 Lecturer of midwifery, Faculty of nursing & midwifery, Mashhad University of Medical Science, Mashhad, Iran.

2 M.Sc. Student of midwifery, Faculty of nursing & midwifery, Mashhad University of Medical Science, Mashhad, Iran.

3 Associate Professor of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.

4 Assistant Professor of Exercise Physiology, Faculty of nursing & midwifery, Mashhad University of Medical Science, Mashhad, Iran.

5 Associate Professor of Biostatistics, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.


Introduction: The main cause of pelvic organs prolapse is failure of levator ani muscle. Conservative treatments like strengthening exercises of pelvic floor muscles lead to increasing contractile force and strength of muscles. The aim of this study was to assess the effect of passive ankle dorsi flexion on pelvic floor muscle activity during exercises.
Methods: This clinical trial study was carried out on 39 women aged 25-55 years with pelvic floor muscles relaxation who referred to women's clinic of educational hospitals of Mashhad University of Medical Sciences in 2010. After clinical examination and confirmation of pelvic floor muscle relaxation, women were divided randomly into two groups: doing strengthening exercises of PFM in standing position with passive ankle dorsi flexion (on wooden surface with 15 degree angle) (n=20) and horizontal standing position (n=19) for 8 weeks. Pelvic floor muscles strength was assessed with brink score before and after intervention. Data analyzed by using analytic-descriptive statistics. P value less than 0.05 was considered significant.
Results: Increased percent of pelvic floor muscles strength in standing position group was more than dorsi flexion (51.47% vs. 49.2%). But based on independent t-test, the difference between mean of Brink score in 2 groups was not statistically significant (p=0.516). Chi-Square test showed the difference between improvement percent of stress urinary incontinence was not statistically significant in 2 groups (p=0.572).
Conclusion: Doing Pelvic floor muscle exercises with passive ankle dorsi flexion and horizontal standing position can increase the effectiveness of kegel exercises but effectiveness of horizontal standing position is more than passive ankle dorsi flexion.


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