The comparative effectiveness of pelvic floor muscle training and hypopressive breathing techniques for pelvic organ prolapse: A systematic review and pooled analysis of randomized controlled trials
Abstract
Background Pelvic floor (PF) disorder affects 25 % of females, often progressing to Pelvic Organ Prolapse (POP). PF muscle training (PFMT) and hypopressive breathing (HB) are conservative techniques used to repair pelvic muscles. This study analyzes the comparative efficacy of PFMT and HB for POP.Methods A systematic review was conducted and seven records were included in the pooled analysis, which compared PF outcomes between HB and PFMT.Results PFMT (d = 2.14 and d = 1.07) demonstrated a larger effect size compared to HB (d = 1.24 and d = 0.78) for sEMG contractility and the Modified Oxford Scale, respectively. The Pelvic Floor Disability Index (PFDI-20) found a lower effect size of PFMT (d = 0.558) compared to HB (d = 0.961).Conclusions PFMT was found to improve PF strength (Oxford) more than HB, while HB had a greater effect on quality of life (PFDI-20). Results were insignificant for contractility.
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The use of hypopressive techniques has shown no proven efficacy to date.
“The use of hypopressive techniques, to date, has shown no proven efficacy [56,57].”
From Pelvic Floor Muscle Training Following Surgery for Pelvic Organ Prolapse: Recommendation from Scientific Literature (2026) · cites this paper as [57]
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References 40 · Cited by 4
- Authors
- Mitchell, J. R., Brancaccio, H. E., Blusewicz Spt, M., Lo, D. F., Goodwin, B., & Carey, D.
- Affiliations
- Futures Forward Research Institute (US)
- Rutgers, The State University of New Jersey (US)
- Ocean Medical Center (US)
- Corresponding author
- Mitchell, Jessica R.
- Brancaccio, Hanna E.
- Lo, David F.
- Goodwin, Brandon
- Carey, Danielle
- Venue
- The American Journal of Surgery
- Publisher
- Elsevier BV
- Published
- 2025-04
- Volume
- 242
- Pages
- 116111
- ISSN
- 0002-9610 (ISSN-L)
- OpenAlex
- W4404608784
- Cited by
- 4
- References
- 40
- Citations by year
- 2026: 2 · 2025: 2
- FWCI
- 0.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The American Journal of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- pelvic floor muscle training, pelvic organ prolapse, pelvic floor dysfunction, Oxford scale, quality of life, conservative treatment, pooled analysis
- MeSH terms
- Breathing Exercises, Exercise Therapy, Female, Humans, Quality of Life, Randomized Controlled Trials as Topic, Treatment Outcome, Pelvic Floor, Muscle Strength, Pelvic Organ Prolapse
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