Correct performance of pelvic muscle exercises in women reporting prior knowledge

Female Pelvic Med Reconstr Surg. 2015 May-Jun;21(3):135-40. doi: 10.1097/SPV.0000000000000145.


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.

MeSH terms

  • Biofeedback, Psychology
  • Exercise Therapy*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Muscle Contraction / physiology
  • Muscle Strength / physiology
  • Patient Education as Topic
  • Pelvic Floor Disorders / psychology
  • Pelvic Floor Disorders / therapy*
  • Surveys and Questionnaires