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Paula method of circular muscle exercises for urinary stress incontinence—a clinical trial

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Abstract

The aim of this study was to determine the efficacy of the Paula method of circular muscle training in the management of stress incontinence (SI). The theory behind this method states that activity of distant sphincters affects other muscles. In a pilot study, 59 women, mainly hospital employees, were randomly assigned to participate in exercises according to the Paula method or pelvic floor training. Efficacy was measured by reports of incontinence, quality of life (I-QOL), pad test, and pelvic floor muscle strength (assessed by perineometer and digital examination). Both the Paula exercises and pelvic floor training produced significant changes in urinary leakage compared to baseline as measured by the pad test [mean decrease of 5.4 g (p=0.002) and 9.5 g (p=0.003), respectively]. Women randomized to the Paula method reported improvement in I-QOL scores. The Paula method was found to be efficacious for SI in a population of Israeli women. Larger community-based studies will be required to confirm these results and enable evaluation of between-group differences.

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Acknowledgments

This work was supported by an Internal Grant for Paramedical Personnel at Hadassah and the Lillian Silverstein Fund.

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Authors and Affiliations

  1. Department of Obstetrics, School of Nursing, Hadassah/Hebrew University, Jerusalem, Israel

    M. Liebergall-Wischnitzer

  2. Department of Obstetrics and Gynecology, Hadassah/Hebrew University, Jerusalem, Israel

    D. Hochner-Celnikier, Y. Lavy & R. Arbel

  3. Braun School of Public Health and Community Medicine, Hadassah/Hebrew University, POB 12000, Jerusalem, 91120, Israel

    O. Manor & O. Paltiel

Authors
  1. M. Liebergall-Wischnitzer
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  2. D. Hochner-Celnikier
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  3. Y. Lavy
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  4. O. Manor
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  5. R. Arbel
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  6. O. Paltiel
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Corresponding author

Correspondence to O. Paltiel.

Appendix

Appendix

Table Examples of Paula method exercises. All exercises can be done lying, standing, or sitting. The participant exercises at her own pace and would be instructed over time to let any other area that she wishes join the area being exercised
Full size table

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Liebergall-Wischnitzer, M., Hochner-Celnikier, D., Lavy, Y. et al. Paula method of circular muscle exercises for urinary stress incontinence—a clinical trial. Int Urogynecol J 16, 345–351 (2005). https://doi.org/10.1007/s00192-004-1261-6

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  • DOI: https://doi.org/10.1007/s00192-004-1261-6

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