Bone-Targeted High-Intensity Training Does Not Reduce Quality of Life Related to Pelvic Floor Dysfunction: The MEDEX-OP Randomized Controlled Trial.

Abstract

Introduction and hypothesis: High-intensity resistance and impact training (HiRIT) is the most effective exercise for improving bone strength, but it is traditionally discouraged for individuals with pelvic floor dysfunction, a condition that often coexists with osteoporosis. We therefore aimed to compare the effect of HiRIT with low-intensity Pilates-based exercise (LiPBE) on quality of life related to pelvic floor dysfunction in postmenopausal women.

Methods: Healthy postmenopausal women with low bone mass were recruited and randomized to 8-month, twice-weekly supervised HiRIT or LiPBE. Pelvic floor-related quality of life was assessed using the Pelvic Floor Disability Index (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). Subgroup analysis was conducted to explore the overall effect of exercise (HiRIT or LiPBE) on PFDI-20 and PFIQ-7 total scores in individuals with and without a history of pelvic organ prolapse (POP).

Results: A total of 115 women were included (mean age 64.4 years). There were no significant between-group differences in 8-month change in the PFDI-20 or its subscales, or the PFIQ-7. There was a significant within-group improvement in the Pelvic Organ Prolapse Distress Inventory subscale of the PFDI-20 (-2.3 [95% CI -4.4, 0.2]) in the LiPBE group. Exploratory subgroup analyses of the combined exercise groups showed an improvement in the PFDI-20 among participants with a history of POP over the 8-month training period (-11.9 [95% CI -22.8, -1.1]).

Conclusion: Our findings suggest no negative effects of bone-targeted HiRIT on pelvic floor-related quality of life in postmenopausal women. On the contrary, our data provide preliminary evidence that exercise may have beneficial effects on pelvic floor health. However, further studies are needed.