Effect of Pelvic Floor Fascial Mobilization on Pelvic Floor Dysfunction in Multiparous Pregnant Women - A Randomized Pilot Study

Background Pelvic floor fascial mobilization (PFFM) is an innovative intravaginal and/or intrarectal manual therapy technique developed to treat pelvic distress by improving fascial gliding and muscle function. Aim The effect of PFFM on pelvic floor distress during pregnancy was compared to conventional pelvic floor muscle training. Methods A pilot prospective randomized clinical trial. The primary outcome was the strength and function of the pelvic floor muscles measured via the Oxford grading scale, perineometry, and hip range of motion. Each subject was treated twice, one week apart. Results Forty multiparous pregnant women at 24-30 weeks gestation, with pelvic distress, were allocated to PFFM (study group (n=20)) vs. pelvic floor muscle training (control group (n=20)). There was no difference in the severity of pelvic distress between the study and control groups before the interventions (PFDI-20: 27.1±12.2 vs. 26.0±13.5, respectively, p=0.7). Twenty-six subjects completed the study protocol. PFDI-20 showed significant improvement: 42% improvement in the study group vs. 12% improvement in the controls (p=0.001 for both groups). Group-by-time interaction (Cohen's d) was significant after the first treatment session for Oxford score, right hip internal rotation range of motion, and cervical length in the PFFM group and for perineometry and right hip internal rotation at the end of the study. Conclusions Based on this pilot randomized trial, PFFM may potentially and partially 1. alleviate symptoms, 2. improve pelvic floor function and strength, and 3. elongate the cervix after one or two treatment sessions. Further, a more extensive study is needed to confirm these results.