The Effectiveness of Pelvic Floor Muscle Rehabilitation inFemale Athletes with Urinary Incontinence: A Systematic Review

Abstract

Background: High-level sports activities in female athletes carry a significant risk of triggering urinary incontinence due to the sudden increase in abdominal pressure during movement. Objective: The objective of this systematic review is to assess the effectiveness of pelvic floor muscle training in nulliparous female athletes for the prevention and treatment of urinary incontinence. Method: Following the PRISMA guidelines, this systematic review of randomized controlled trials was conducted using two main search engines – PubMed and Science Direct, and included scientific articles published over the last fifteen years. This review focused on the PICO framework to identify studies eligible for inclusion. Nulliparous female athletes, aged over or equal to 18 years, with a body mass index ranging between 18 and 30 kg/m2, and who were suffering from urinary incontinence, were included. The intervention consisted of pelvic floor muscle training, and the comparison groups consisted of athletes with or without additional interventions. The outcomes focused on the prevention and treatment of urinary incontinence, including symptom reduction, improvement in pelvic floor function, and increase in overall continence. Only randomized controlled trials, published in either French or English were included. Results: One-hundred and twenty-seven articles were identified, reviewed, and checked according to the inclusion criteria, and only eight articles were eligible for inclusion. The studies were analysed and evaluated using the Cochrane Risk of Bias Tool (RoB 2). The results showed that pelvic floor muscle training in female athletes reduces urinary incontinence regardless of the technique used. Additionally, pelvic floor muscle training, which includes pelvic floor awareness, strengthening, and increasing contraction power, and pre-activation of pelvic floor contraction during sports activities, can help prevent pelvic dysfunctions, particularly urinary incontinence. Conclusion: In conclusion, this systematic review highlights the importance of integrating pelvic floor muscle training into physical preparation programs of female athletes to prevent and manage urinary incontinence. Early intervention and structured training protocols can help mitigate any pelvic dysfunctions in female athletes and improve their performance and quality of life.