Page 72 - Petelin, Ana. 2024. Ed. Zdravje delovno aktivnih in starejših odraslih | Health of the Working-Age and Older Adults. Zbornik prispevkov z recenzijo | Proceedings. Koper: University of Primorska Press

The interventions in the included studies examined varying durations
of PFM contractions, rest periods, and the overall length of the intervention.
Regardless of the duration of PFM contraction or rest periods between them,
all studies have consistently shown a significant reduction in CLBP. Howev-
er, there is no consensus on the optimal length for such interventions – in the
studies analysed, the intervention period ranged from 4 to 24 weeks, with all
studies reporting pain reduction outcomes. In previous research where pel-
vic floor exercises were used to treat urinary incontinence, interventions typ-
ically lasted around 12 weeks, which was sufficient to improve PFM strength
(McLean et al., 2013).
PFMT has been proven effective when integrated with other interven-
tions. In most of the reviewed studies (Bhatnagar and Sahu, 2017; Bi et al.,
2013; Dsingh and Kaur, 2020; Ghaderi et al., 2016; Mohseni-Bandpei et al., 2011;
Rathi, 2013), PFMT was used in combination with back or abdominal muscle
strengthening exercises, except in one study (Kumar et al., 2015) where PFMT
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was applied without other exercise interventions. Combining PFMT with core
muscle strengthening exercises is reasonable to include in physiotherapeutic
zdravje delovno aktivnih in starejših odraslih | health of working-age and older adults
treatment of individuals with CLBP (Sapsford and Hodges, 2001) due to the in-
dispensable connection between core muscles (especially the multifidus and
transverse abdominal muscles) and PFM. The concurrent activation of these
muscle groups enhances intra-abdominal pressure (Rathi, 2013). This increase
in pressure facilitates improved segmental stability, which is essential for mit-
igating pain and functional impairment in individuals with CLBP (Kim and
Lee, 2013). This could explain how PFMT impacts CLBP. There is still no con-
sensus on whether PFM strengthening alone affects CLBP or if the pain reduc-
tion is a result of the strengthened core muscles that are simultaneously trained
with PFM (Bernard et al., 2021).
In this systematic literature review, several limitations need to be con-
sidered. The interventions were relatively short-term. The included studies in-
volved a small number of participants, and it is also worth noting the general-
ly lower quality of the research.

Conclusion
PFMT is a physiotherapy method used to adress various conditions, includ-
ing urinary incontinence, symptoms associated with pelvic organ prolapse,
and sexual function in the postpartum period. It is also gaining importance
in the management of CLBP. The main finding of our literature review is that
combining PFMT with standard treatment is an effective approach to reduc-
ing pain and improving functionality in individuals with CLBP. Addition-
ally, in most of the studies, standard treatment augmented with PFMT was
found to be more effective than standard treatment alone. In the future, more
high-quality randomized controlled trials with a larger number of participants
are needed on the topic of PFMT to contribute to the establishment of clearer
guidelines for the physiotherapeutic management of individuals with CLBP. It