The objective of this randomized controlled trial is to determine whether a standardized
Pilates exercise program can effectively strengthen pelvic floor muscles when compared with
conventional pelvic muscle rehabilitation.
Urinary incontinence is a widespread problem that affects 10-40% of all ambulatory women and
pelvic floor muscle training is an effective treatment for this problem. However, its
efficacy is proportionate to the effort expended. Even among women who are diligent with
pelvic muscle rehabilitation, long term follow-up reveals that benefits are lost in the
absence of maintenance exercises.
While this intervention is effective, recent studies demonstrate that long term adherence to
treatment is low. As compliance appears to be a prerequisite to achieving sustained
benefit, finding a method of pelvic muscle strengthening that better lends itself to long
term commitment could prove beneficial.
The currently popular exercise program, known as Pilates (named after founder, Joseph
Pilates) consists of a series of low impact, flexibility and muscle toning exercises. The
philosophy centers around developing core strength which includes strengthening the pelvic
floor. Its use has been described in the US since the 1920s.4 Five million Americans
currently participate, as opposed to five thousand ten years ago.5 Given its mainstream
popularity, Pilates would be an appealing as a therapeutic modality for women experiencing
pelvic muscle weakness. Currently, there are no studies that assess the efficacy of
Pilates in increasing pelvic muscle strength.
- Women 18 yrs or older
- No pelvic organ prolapse beyond the hymenal ring.
- Age or medical condition that make it difficult for patient to tolerate exam or
follow verbal instructions.
- Vaginal infections or urinary tract infections
- Medical or physical conditions which exclude the proper performance of Pilates.