RT Journal Article
T1 Quantification of 3/4D ultrasound pelvic floor changes induced by postpartum muscle training in patients with levator ani muscle avulsion: a parallel randomized controlled trial
A1 Antonio Sainz-Bueno, Jose
A1 Jose Bonomi, Maria
A1 Suarez-Serrano, Carmen
A1 Medrano-Sanchez, Esther M.
A1 Armijo, Alberto
A1 Fernandez-Palacin, Ana
A1 Antonio Garcia-Mejido, Jose
K1 Rehabilitation
K1 pelvic floor
K1 ultrasonography
K1 birth injuries
K1 Risk-factors
K1 Women
K1 Prolapse
K1 Delivery
K1 Trauma
AB Background: We believe that physiotherapy with muscle training (MT) of the postpartum pelvic floor may lead to a change in the clinical management of patients with avulsion of the puborectal portion of the levator ani muscle (LAM). Our objective is to assess whether physiotherapy with MT of the postpartum pelvic floor in patients with LAM avulsion produces changes in pelvic flom morphology evaluated by 3/4D transperineal ultrasound.Methods: This parallel randomized controlled trial (RCT) included 97 primiparous patients. A study was conducted in three parts. In the first part (3 months postpartum), primiparous patients with LAM avulsion were recruited, and the levator hiatus and the LAM areas were measured using 3/4D transperineal ultrasound. In the second part (3 to 6 months postpartum), patients were randomized into two groups, with one undergoing rehabilitation (experimental group) and another without rehabilitation (control group). At the end of 6 months, a new transperineal ultrasound was performed. In the third part (9 months postpartum), the levator hiatus and LAM, dimensions were analyzed again. The RCT was registered at ClinicalTrials. gov (NCT03686956). Project PI16/01387 funded by Institute de Salud Carlos III (Spain) integrated in the national I+D+i 2013-2016 and cofounded by the European Union (ERDF/ESF, "Investing in your future").Results: A total of 92 completed the study, including 46 patients in the experimental group and 46 in the control group. The experimental group had a greater LAM area at 6 months (9.2 +/- 1.9 vs. 7.6 +/- 2.1 cm(2), P=0.008; 95% CI: 0.6-3.0) and 9 months after labor (9.4 +/- 2.7 vs. 7.6 +/- 2.0 cm(2), P=0.012; 95% CI: 0.4-3.2), which was not observed at 3 months postpartum (8.3 +/- 1.6 vs. 7.5 +/- 2.3 cm(2); P=0.183; 95% CI: 0.39-1.99). The levator hiatus area decreased more in the experimental group in almost all comparisons. The most significant change occurred from 3 to 6 months during the Valsalva maneuver (-3.92 +/- 5.12 vs. 0.45 +/- 3.06 cm(2); P
PB Ame publ co
SN 2223-4292
YR 2021
FD 2021-12-20
LK http://hdl.handle.net/10668/21773
UL http://hdl.handle.net/10668/21773
LA en
DS RISalud
RD Apr 14, 2025