Effect of pelvic floor symptoms on women's participation in exercise: A mixed-methods systematic review with meta-analysis

JODIE G. DAKIC, JEAN HAY-SMITH, JILL COOK, KUAN YIN LIN, MARLENA CALO, HELENA FRAWLEY

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)

Abstract

OBJECTIVE: To (1) review the effect of pelvic floor (PF) symptoms (urinary incontinence [UI], pelvic organ prolapse, and anal incontinence) on exercise participation in women, and (2) explore PF symptoms as a barrier to exercising. DESIGN: Mixed-methods systematic review with meta-analysis. LITERATURE SEARCH: Eight databases were systematically searched up to September 2020. STUDY SELECTION CRITERIA: We included full-text, peer-reviewed observational, experimental, or qualitative studies in adult, community-dwelling women with PF symptoms. Outcomes included the participant-reported effect on exercise or the perception of PF symptoms as an exercise barrier. Study quality was assessed using a modified version of the Mixed Methods Appraisal Tool. DATA SYNTHESIS: Meta-analysis was performed where possible. Deductive and inductive content analysis was used to synthesize qualitative data. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and the GRADE-Confidence in the Evidence from Reviews of Qualitative research (CERQual) guided interpretation of the certainty of evidence. RESULTS: Thirty-three studies were included. In 47% (95% confidence interval [CI]: 37%, 56%; I2 = 98.6%) of women with past, current, or fear of PF symptoms, UI symptoms adversely affected exercise participation (21 studies, n = 14 836 women). Thirty-nine percent (95% CI: 22%, 57%; I2 = 93.0%; 6 studies, n = 426) reported a moderate or great effect on exercise. Pelvic organ prolapse affected exercise for 28% of women (95% CI: 24%, 33%; I2 = 0.0%; 2 studies, n = 406). There were no quantitative studies of anal incontinence. CONCLUSION: For 1 in 2 women, UI symptoms negatively affect exercise participation. Half of women with UI reported either stopping or modifying exercise due to their symptoms. Limited data on pelvic organ prolapse also demonstrated adverse exercise effect.

Original languageEnglish
Pages (from-to)345-361
Number of pages17
JournalJournal of Orthopaedic and Sports Physical Therapy
Volume51
Issue number7
DOIs
Publication statusPublished - 2021 Jul

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation

Fingerprint

Dive into the research topics of 'Effect of pelvic floor symptoms on women's participation in exercise: A mixed-methods systematic review with meta-analysis'. Together they form a unique fingerprint.

Cite this