Efficacy of hypopressive abdominal gymnastics in rehabilitating the pelvic floor of women: A systematic review

Actas Urol Esp (Engl Ed). 2018 Nov;42(9):557-566. doi: 10.1016/j.acuro.2017.10.004. Epub 2017 Dec 14.
[Article in English, Spanish]


Background: Hypopressive abdominal gymnastics has been proposed as a new paradigm in rehabilitating the pelvic floor. Its claims contraindicate the recommendation for pelvic floor muscle training during the postpartum period.

Objective: To determine whether hypopressive abdominal gymnastics is more effective than pelvic floor muscle training or other alternative conservative treatments for rehabilitating the pelvic floor.

Methods: We consulted the databases of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, Latin American and Caribbean Health Sciences Literature (LILACS), Physiotherapy Evidence Database (PEDro), PubMed, Scopus, Trip Database and Web of Science. We selected systematic reviews, clinical trials and analytical studies that assessed the efficacy of hypopressive abdominal gymnastics in women. The measured outcomes were the strengthening of the pelvic floor muscles, the incidence of urine incontinence or prolapse and symptom remission. We included 4 clinical trials, whose quality was measured with the PEDro scale.

Results: Hypopressive gymnastics is less effective than pelvic floor muscle training for activating pelvic floor muscles, achieving closure of the levator hiatus of the anus and increasing pelvic floor muscle thickness, strength and resistance.

Practical implication: The evidence reviewed does not support the recommendation for hypopressive abdominal gymnastics for strengthening the pelvic floor either during the postpartum period or outside that period. Pelvic floor muscle training remains the first-line treatment for pelvic floor dysfunction.

Conclusion: There is a lack of quality clinical trials that have evaluated the efficacy of hypopressive abdominal gymnastics.

Keywords: Disfunciones del suelo pélvico; Hipopresivos; Hypopressive; Músculos del suelo pélvico; Pelvic floor dysfunction; Pelvic floor muscles.

Publication types

  • Systematic Review

MeSH terms

  • Exercise Therapy* / methods
  • Female
  • Humans
  • Pelvic Floor Disorders / rehabilitation*