The Effect of Exercises Used in High Intensity and High Impact Training on Pelvic Floor Function: A Systematic Review

Objective(s): To investigate the effects of exercises used in high intensity (HI) and high impact training (HIT) on pelvic floor (PF) function.

Data Sources: Three searches were conducted between September 2022 and February 2023 using combinations of keywords: “urinary incontinence,” “pelvic floor,” “CrossFit,” “High-intensity training,” “High-impact training,” and “powerlifting.” Databases included: Academic Search Ultimate, CINAHL Complete, eBook collection (EBSCOhost), Health Source: Nursing/Academic Edition, MEDLINE, OmniFile Full Text Select, and ERIC. A total of 43 articles were identified.

Study Selection: Three independent reviewers performed the selection process based on article titles, abstracts, and full-text reading. The 29 included studies were peer-reviewed, examined the relationship between urinary incontinence (UI) and HI, HIT, and were in English. Systematic reviews, duplicate articles, and non-English articles were excluded.

Data Extraction: The PEDro scale and LOER hierarchy of evidence scales were used to assess the quality of the studies. PEDro scores of the included studies ranged from 3-7/10. The LOER hierarchy of evidence used included Type II-IV studies.

Data Synthesis: Studies reviewed included a total of 9,933 participants (8,999 females and 938 males), ranging from 18 to 68 years old. Twenty-five studies included surveys about UI, 4 included PF examination, and 2 included pelvic floor training (PFT). Primary measures used in the studies included: International Consultation on Incontinence Questionnaire-Short Form, Incontinence Severity Index and maximum voluntary contraction of PF. Commonly reported exercises related to UI were identified. UI was reported to impact quality of life. PFT was reported to be beneficial for UI treatment.

Conclusions: Reports of UI were higher in females performing HI and HIT exercises. Research reports on the prevalence of UI in males was limited. Pelvic Health Physical Therapy may be beneficial in treating UI in males and females who participate in HI and HIT exercises. Further investigation of the effects of incorporating PFT on UI, as part of HI and HIT in males and females is recommended.

Author(s) Disclosures: The authors declare they have no relevant or material financial interests that relate to the research described in this abstract.