Group Exercise for Improvement in Urinary Incontinence using Motor Learning and Sensory Awareness based on the Feldenkrais Method® of Somatic Education
Keywords:
urinary incontinence, pelvic floor, Feldenkrais Method, motor control, sensory awareness, group exercise, women's healthAbstract
Background: Purpose and Rationale
The pelvic floor functions as an integrated neuromuscular system. Dysfunction and motor control problems in the pelvic floor system cause various kinds of pelvic distress, including urinary incontinence (UI) and dyscoordination. Many women have pelvic floor dysfunction and do not know it or have UI and do not seek physical therapy. There is a need for effective group treatment programs to reduce and prevent incontinence and promote pelvic health. The purpose of this report is to present a group exercise model that used a sensory motor learning method drawing from the Feldenkrais Method® of Somatic Education, health education and group support. The Feldenkrais Method is a sensory motor learning educational process. The program’s goal was to improve sensory motor coordination in order to reduce symptoms of UI and pelvic distress.
Case Description
This mixed method case report describes a five-week group treatment program for 12 self-referred women with UI. There were five weekly two-hour classes, for a total of 10 hours. The program included, (1) Feldenkrais Method Awareness Through Movement® lessons, (2) relevant health education information about the bony, muscular and organ anatomy of the pelvis, (3) bladder training, including the reflex relationship between the bladder and pelvic floor, and healthy voiding habits, (4) the role of the parasympathetic and sympathetic nervous systems, and (5) how the pelvic floor works as an integrated system. Each class included group support and discussion. Home practice was with provided pre-recorded Awareness Through Movement audio lessons on CD.
Outcomes
The measures used were the Urogenital Distress Inventory 6 (UDI-6) and Incontinence Impact Questionnaire 7- short form (IIQ-7). The results from these scales demonstrated the effectiveness of the program for reducing mild to moderate UI and symptoms of pelvic distress, such as pelvic pain, in women. As measured by the UDI-6, 66% of the women had reduced distress.
Conclusion
This pelvic floor program using Feldenkrais Method Awareness through Movement lessons, health education including bladder training and group support is an effective option for reducing mild-moderate urinary incontinence and improving quality of life. Further research would be valuable to expand on this approach.