Tamozhanska G. V.

HYPOPRESSIVE EXERCISES AS A COMPONENT OF COMPREHENSIVE PHYSIOTHERAPEUTIC RECOVERY OF WOMEN IN THE POSTPARTUM PERIOD

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About the author:

Tamozhanska G. V.

Heading:

THERAPY AND REHABILITATION

Type of article:

Scientific article

Annotation:

Pelvic floor muscle dysfunction (PFD) is a common medical and social problem after childbirth. Classical kinesiotherapy techniques are often aimed only at isolated muscle contraction, while hypopressive exercises allow for a comprehensive restoration of the synergism of the core and pelvic floor muscles without increasing intraabdominal pressure. The aim of the study was: to assess the effectiveness of a 12-week hypopressive training program in improving the functional state of the pelvic floor, endurance of the abdominal muscles and psychosomatic status of women in the postpartum period. The study involved 48 women from 45 days to 6 months postpartum. The participants were divided into two groups: the main group (MG, n=24, a course of hypopressive exercises lasting 12 weeks, 2 times a week for 30 minutes) and the control group (CG, n=24, usual level of activity). Diagnostics included the PFDI-20 questionnaire, functional tests “plank” and “side bridge”, as well as a 5-point Likert scale for assessing the subjective perception of one’s own body. At the end of the study, a statistically significant decrease in the total score of the PFDI-20 questionnaire by 52.8% (p=0.003) was recorded in the MG, which indicates a pronounced regression of PFD symptoms, while in the CG the improvement was only 2.4%. The strength endurance of the abdominal muscles in the MG significantly increased: in the “plank” test – by 160.0%, the right lateral bridge – by 93.3%, the left – by 120.0%. In the CG, there was no significant change or a certain regression in the functional capabilities of the abdominal muscles. The level of subjective body acceptance in the MG increased by 82.6% versus 4.2% in the CG. Intergroup differences after rehabilitation are highly significant (p<0.001). The hypopressive exercise program is a highly effective and safe method of postpartum recovery. It provides synergistic activation of deep abdominal stabilizers and pelvic muscles, effectively eliminates clinical manifestations of PFD and significantly improves the psychosomatic status and quality of life of women.

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Bibliography:

1. Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An International Urogynecological Association (IUGA) / International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Organ Prolapse (POP). Neurourol Urodyn. 2016;35(2):137-68. DOI: https://doi.org/10.1002/nau.22922
2. Pizzol D, Demurtas J, Celotto S, Maggi S, Smith L, Angiolelli G, et al. Urinary incontinence and quality of life: a systematic review and meta-analysis. Aging Clin Exp Res. 2021;33(1):25-35. DOI: https://doi.org/10.1007/s40520-020-01712-y
3. Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM. Pelvic floor dysfunction: prevalence and associated factors. BMC Public Health. 2023;23(1):2005. DOI: https://doi.org/10.1186/s12889-023-16901-3
4. Blomquist JL, Muñoz A, Carroll M, Handa VL. Association of Delivery Mode With Pelvic Floor Disorders After Childbirth. JAMA. 2018;320(23):2438-2447. DOI: https://doi.org/10.1001/jama.2018.18315
5. Chilaka C, Toozs-Hobson P, Chilaka V. Pelvic floor dysfunction and obesity. Best Pract Res Clin Obstet Gynaecol. 2023;90:102389. DOI: https://doi.org/10.1016/j.bpobgyn.2023.102389
6. Meutia AP, Diningtyas T, Hidayah GN, Moegni F, Priyatini T, Hakim S, et al. Exploring pelvic floor dysfunction: prevalence and risk factors through APFQ analysis. Eur J Obstet Gynecol Reprod Biol. 2026;324:115209. DOI: https://doi.org/10.1016/j.ejogrb.2026.115209
7. Molnár T, Domján A, Szűcs M, Surányi A, Bódis J. Utilizing Synergism between the Transverse Abdominal and Pelvic Floor Muscles at Different Postures in Nulliparous Women: A Randomized Case-Control Study. Urol Int. 2022;106(3):274-281. DOI: https://doi.org/10.1159/000519590
8. Soriano L, González-Millán C, Álvarez Sáez MM, Curbelo R, Carmona L. Effect of an abdominal hypopressive technique programme on pelvic floor muscle tone and urinary incontinence in women: a randomised crossover trial. Physiotherapy. 2020;108:37-44. DOI: https://doi.org/10.1016/j.physio.2020.02.004
9. Ithamar L, de Moura Filho AG, Benedetti Rodrigues MA, Duque Cortez KC, Machado VG, de Paiva Lima CRO, et al. Abdominal and pelvic floor electromyographic analysis during abdominal hypopressive gymnastics. J Bodyw Mov Ther. 2018;22(1):159-165. DOI: https://doi.org/10.1016/j.jbmt.2017.06.011
10. Navarro Brazález B, Sánchez Sánchez B, Prieto Gómez V, De La Villa Polo P, McLean L, Torres Lacomba M. Pelvic floor and abdominal muscle responses during hypopressive exercises in women with pelvic floor dysfunction. Neurourol Urodyn. 2020;39(2):793-803. DOI: https://doi.org/10.1002/nau.24284
11. Hernandez-Lucas P, Escobio-Prieto I, Moro López-Menchero P. Effects of Hypopressive Techniques on the CORE Complex: A Systematic Review. Healthcare (Basel). 2025;13(12):1443. DOI: https://doi.org/10.3390/healthcare13121443
12. Athanasiou S, Grigoriadis T, Chalabalaki A, Protopapas A, Antsaklis A. Pelvic organ prolapse contributes to sexual dysfunction: a crosssectional study. Acta Obstet Gynecol Scand. 2012;91(6):704-9. DOI: https://doi.org/10.1111/j.1600-0412.2012.01396.x
13. Sánchez-Sánchez B, Torres-Lacomba M, Yuste-Sánchez MJ, Navarro-Brazález B, Pacheco-da-Costa S, Gutiérrez-Ortega C, et al. Cultural adaptation and validation of the Pelvic Floor Distress Inventory Short Form (PFDI-20) and Pelvic Floor Impact Questionnaire Short Form (PFIQ-7) Spanish versions. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):281-285. DOI: https://doi.org/10.1016/j.ejogrb.2013.07.006
14. Bohannon RW, Steffl M, Glenney SS, Green M, Cashwell L, Prajerova K, et al. The prone bridge test: Performance, validity, and reliability among older and younger adults. J Bodyw Mov Ther. 2018;22(2):385-389. DOI: https://doi.org/10.1016/j.jbmt.2017.07.005
15. Javadian Y, Behtash H, Akbari M, Taghipour-Darzi M, Zekavat H. The effects of stabilizing exercises on pain and disability of patients with lumbar segmental instability. J Back Musculoskelet Rehabil. 2012;25(3):149-55. DOI: https://doi.org/10.3233/bmr-2012-0321
16. Moreno-Muñoz MDM, Hita-Contreras F, Estudillo-Martínez MD, Aibar-Almazán A, Castellote-Caballero Y, Bergamin M, et al. The Effects of Abdominal Hypopressive Training on Postural Control and Deep Trunk Muscle Activation: A Randomized Controlled Trial. Int J Environ Res Public Health. 2021;18(5):2741. DOI: https://doi.org/10.3390/ijerph18052741
17. Stüpp L, Resende AP, Petricelli CD, Nakamura MU, Alexandre SM, Zanetti MR. Pelvic floor muscle and transversus abdominis activation in abdominal hypopressive technique through surface electromyography. Neurourol Urodyn. 2011;30(8):1518-21. DOI: https://doi.org/10.1002/nau.21151
18. Da Cuña-Carrera I, Alonso-Calvete A, Soto-González M, Lantarón-Caeiro EM. How Do the Abdominal Muscles Change during Hypopressive Exercise? Medicina (Kaunas). 2021;57(7):702. DOI: https://doi.org/10.3390/medicina57070702
19. Moreira SE, Debs AL, de Oliveira EH, da Silva MCN, Pinto RMC, Pereira-Baldon VS. Hypopressive exercises for diastasis recti and pelvic floor symptoms in postpartum women: A randomized trial. Braz J Phys Ther. 2026;30(3):101584. DOI: https://doi.org/10.1016/j.bjpt.2026.101584
20. Molina-Torres G, Moreno-Muñoz M, Rebullido TR, Castellote-Caballero Y, Bergamin M, Gobbo S, et al. The effects of an 8-week hypopressive exercise training program on urinary incontinence and pelvic floor muscle activation: A randomized controlled trial. Neurourol Urodyn. 2023;42(2):500-509. DOI: https://doi.org/10.1002/nau.25110

Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 3, 182, 519-525 pages, index UDC 615.825.1:618.6-06:616.62-008.22

DOI:

10.29254/2077-4214-2026-3-182-519-525