Integrating the Effect of Franklin Method along with Pelvic Floor Muscle Training in Pelvic Organ Prolapse
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Abstract
Background: Pelvic organ prolapse (POP) is the descent of pelvic organ from its anatomical position which affects the quality of life in women. Traditional pelvic floor muscle training (PFMT) has shown benefits, but adherence and technique execution can be challenging. The Franklin method allows individuals to recognise the body image and enhance neuromuscular control. This study aims to determine the effects of Franklin method with Pelvic Floor Muscle Training for women with POP.
Methods: This study includes a group of women with pelvic organ prolapse stage 1 and 2, age 45-55, no associated neurological defects and no present history of the uro-gynecological disorder. Participants were excluded from the study if they had any of the following: uncontrolled systemic illness, history of malignancy, active infection such as pelvic inflammatory disease, ongoing hormonal therapy, inability to understand or respond accurately to the questionnaire, or if they had undergone pelvic surgery within the past 4 weeks. All the participants (120) underwent Franklin method and PFMT for 6 weeks, the outcome measures included Prolapse Quality of Life questionnaire (P-QoL) and ICIQ-FLUTS tamil measured before and after intervention.
Result: The mean values of P-QoL before and after intervention were 56.74 and 47.06. In ICIQ-FLUTS tamil, the overall mean value was pre-test:36.09 and post-test:20.22. Quality of life and incontinence symptoms showed a significant improvement (p value ≤0.001) after the 6 weeks of intervention.
Conclusion: Franklin method along with PFMT showed significant improvement in symptoms of POP.
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2.Hadizadeh-Talasaz Z, Khadivzadeh T, Mohajeri T, Sadeghi M. Worldwide Prevalence of Pelvic Organ Prolapse: A Systematic Review and Meta-Analysis. Iranian Journal of Public Health. 2024 Mar 13 [cited 2024 Nov 20];53(3). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11194659/#sec14
3.Ryan GA, Purandare NC, Ganeriwal SA, Purandare CN. Conservative Management of Pelvic Organ Prolapse: Indian Contribution. Journal of Obstetrics and Gynaecology of India. 2021 Feb 1;71(1):3–10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960828/
4.Wang R, Tulikangas P, Tunitsky E. 26: Relationship between pelvic organ prolapse and age at first birth. American Journal of Obstetrics and Gynecology. 2020 Mar;222(3):S790.
5.Joseph N, Krishnan C, Reddy BA, Adnan NA, Han LM, Min YJ. Clinical Profile of Uterine Prolapse Cases in South India. The Journal of Obstetrics and Gynecology of India. 2015 Oct 16;66(S1):428–34.
6.Pang H, Zhang L, Han S, Li Z, Gong J, Liu Q, et al. A nationwide population-based survey on the prevalence and risk factors of symptomatic pelvic organ prolapse in adult women in China - a pelvic organ prolapse quantification system-based study. BJOG. 2021 Jul;128(8):1313-1323. doi:10.1111/1471-0528.16675. PMID: 33619817; PMCID: PMC8252658.
7.C Persu, Chapple C, V Cauni, S Gutue, P Geavlete. Pelvic Organ Prolapse Quantification System (POP–Q) – a new era in pelvic prolapse staging. Journal of Medicine and Life 2011 Feb 25;4(1):75. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3056425/
8.American College of Obstetricians and Gynecologists. Surgery for pelvic organ prolapse [www.acog.org]. 2022. Available from: https://www.acog.org/womens-health/faqs/surgery-for-pelvic-organ-prolapse
9.Sokol AI, Sokol ER. General gynecology: the requisites in obstetrics and gynecology. Philadelphia: Mosby; 2007.
10.Saunders K. Recent Advances in Understanding Pelvic-Floor Tissue of Women With and Without Pelvic Organ Prolapse: Considerations for Physical Therapists. Physical Therapy. 2017 Feb 28;97(4):455–63.
11.Dwyer L, Kearney R. Conservative management of pelvic organ prolapse. Obstetrics, Gynaecology & Reproductive Medicine. 2021 Feb;31(2):35–41.
12.Sun Y, Chen H, Liu Y, Jiao R, Yuan J, Zhang X, et al. Conservative interventions for the treatment of pelvic organ prolapse. Medicine. 2019 Nov 22 [cited 2022 Apr 19];98(47):e18116. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882662/
13.Bø K, Anglès-Acedo S, Batra A, Brækken IH, Chan YL, Jorge CH, et al. International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training. International Urogynecology Journal [Internet]. 2022 Oct 1;33(10):2633–67. Available from: https://pubmed.ncbi.nlm.nih.gov/35980443/
14.Espiño-Albela A, Castaño-García C, Díaz-Mohedo E, Ibáñez-Vera AJ. Effects of Pelvic-Floor Muscle Training in Patients with Pelvic Organ Prolapse Approached with Surgery vs. Conservative Treatment: A Systematic Review. Journal of Personalized Medicine. 2022 May 17;12(5):806.
15.Franklin E. Dynamic Alignment Through Imagery. Human Kinetics; 2022.
16.Digesu GA, Khullar V, Cardozo L, Robinson D, Salvatore S. P-QOL: a validated questionnaire to assess the symptoms and quality of life of women with urogenital prolapse. International Urogynecology Journal and Pelvic Floor Dysfunction [Internet]. 2005 May 1 [cited 2020 Nov 23];16(3):176–81; discussion 181. Available from: https://pubmed.ncbi.nlm.nih.gov/15875234/
17.Sánchez-Sánchez B, Yuste-Sánchez MJ, Arranz-Martín B, Navarro-Brazález B, Romay-Barrero H, Torres-Lacomba M. Quality of Life in POP: Validity, Reliability and Responsiveness of the Prolapse Quality of Life Questionnaire (P-QoL) in Spanish Women. International Journal of Environmental Research and Public Health. 2020 Mar 5;17(5):1690.
18.ICIQ-UI SF [Internet]. ICIQ. Available from: https://iciq.net/iciq-ui-sf
19.Lim R, Liong ML, Lau YK, Yuen KH. Validity, reliability, and responsiveness of the ICIQ-UI SF and ICIQ-FLUTS qol in the Malaysian population. Neurourology and Urodynamics. 2015 Dec 23;36(2):438–42.
20.Ekanayake CD, Arunasalam Pathmeswaran, A. A. Nilanga Nishad, Samaranayake KU, Wijesinghe PS. Translation and validation of ICIQ-FLUTS for Tamil-speaking women. International urogynecology journal. 2017 Mar 25;28(12):1875–81.
21.Emmanuel Ifeanyi Obeagu. Uterine Prolapse: An Update of Prevalence and Risk Factors. Journal of gynecology and womens health. 2023 Aug 9;25(4).
22.Ryhtä I, Axelin A, Parisod H, Holopainen A, Hamari L. Effectiveness of exercise interventions on urinary incontinence and pelvic organ prolapse in pregnant and postpartum women: umbrella review and clinical guideline development. JBI Evidence Implementation [Internet]. 2023 Dec 1 [cited 2023 Dec 4];21(4):394. Available from: https://journals.lww.com/ijebh/fulltext/2023/12000/effectiveness_of_exercise_interventions_on_urinary.10.aspx
23.Fenocchi L, Best C, Mason H, Elders A, Hagen S, Maxwell M. Long-term effects and costs of pelvic floor muscle training for prolapse: trial follow-up record-linkage study. International Urogynecology Journal. 2022 Jun 28;34(1):239–46.
24. Schütze S, Heinloth M, Uhde M, Schütze J, Hüner B, Janni W, Deniz M. The effect of pelvic floor muscle training on pelvic floor function and sexuality postpartum: A randomized study including 300 primiparous. Arch Gynecol Obstet. 2022;306(3):785-793. doi: 10.1007/s00404-022-06542-z. Epub 2022 Apr 4. PMID: 35377043; PMCID: PMC8977567.
25.Panman C, Wiegersma M, Kollen B, Berger M, Lisman‐Van Leeuwen Y, Vermeulen K, et al. Two‐year effects and cost‐effectiveness of pelvic floor muscle training in mild pelvic organ prolapse: a randomised controlled trial in primary care. BJOG: An International Journal of Obstetrics & Gynaecology. 2016 Mar 21;124(3):511–20.
26.Abraham A, Gose R, Schindler R, Nelson BH, Hackney ME. Dynamic Neuro-Cognitive Imagery (DNITM) Improves Developpé Performance, Kinematics, and Mental Imagery Ability in University-Level Dance Students. Frontiers in Psychology. 2019 Mar 1;10.
2.Hadizadeh-Talasaz Z, Khadivzadeh T, Mohajeri T, Sadeghi M. Worldwide Prevalence of Pelvic Organ Prolapse: A Systematic Review and Meta-Analysis. Iranian Journal of Public Health. 2024 Mar 13 [cited 2024 Nov 20];53(3). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11194659/#sec14
3.Ryan GA, Purandare NC, Ganeriwal SA, Purandare CN. Conservative Management of Pelvic Organ Prolapse: Indian Contribution. Journal of Obstetrics and Gynaecology of India. 2021 Feb 1;71(1):3–10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960828/
4.Wang R, Tulikangas P, Tunitsky E. 26: Relationship between pelvic organ prolapse and age at first birth. American Journal of Obstetrics and Gynecology. 2020 Mar;222(3):S790.
5.Joseph N, Krishnan C, Reddy BA, Adnan NA, Han LM, Min YJ. Clinical Profile of Uterine Prolapse Cases in South India. The Journal of Obstetrics and Gynecology of India. 2015 Oct 16;66(S1):428–34.
6.Pang H, Zhang L, Han S, Li Z, Gong J, Liu Q, et al. A nationwide population-based survey on the prevalence and risk factors of symptomatic pelvic organ prolapse in adult women in China - a pelvic organ prolapse quantification system-based study. BJOG. 2021 Jul;128(8):1313-1323. doi:10.1111/1471-0528.16675. PMID: 33619817; PMCID: PMC8252658.
7.C Persu, Chapple C, V Cauni, S Gutue, P Geavlete. Pelvic Organ Prolapse Quantification System (POP–Q) – a new era in pelvic prolapse staging. Journal of Medicine and Life 2011 Feb 25;4(1):75. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3056425/
8.American College of Obstetricians and Gynecologists. Surgery for pelvic organ prolapse [www.acog.org]. 2022. Available from: https://www.acog.org/womens-health/faqs/surgery-for-pelvic-organ-prolapse
9.Sokol AI, Sokol ER. General gynecology: the requisites in obstetrics and gynecology. Philadelphia: Mosby; 2007.
10.Saunders K. Recent Advances in Understanding Pelvic-Floor Tissue of Women With and Without Pelvic Organ Prolapse: Considerations for Physical Therapists. Physical Therapy. 2017 Feb 28;97(4):455–63.
11.Dwyer L, Kearney R. Conservative management of pelvic organ prolapse. Obstetrics, Gynaecology & Reproductive Medicine. 2021 Feb;31(2):35–41.
12.Sun Y, Chen H, Liu Y, Jiao R, Yuan J, Zhang X, et al. Conservative interventions for the treatment of pelvic organ prolapse. Medicine. 2019 Nov 22 [cited 2022 Apr 19];98(47):e18116. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6882662/
13.Bø K, Anglès-Acedo S, Batra A, Brækken IH, Chan YL, Jorge CH, et al. International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training. International Urogynecology Journal [Internet]. 2022 Oct 1;33(10):2633–67. Available from: https://pubmed.ncbi.nlm.nih.gov/35980443/
14.Espiño-Albela A, Castaño-García C, Díaz-Mohedo E, Ibáñez-Vera AJ. Effects of Pelvic-Floor Muscle Training in Patients with Pelvic Organ Prolapse Approached with Surgery vs. Conservative Treatment: A Systematic Review. Journal of Personalized Medicine. 2022 May 17;12(5):806.
15.Franklin E. Dynamic Alignment Through Imagery. Human Kinetics; 2022.
16.Digesu GA, Khullar V, Cardozo L, Robinson D, Salvatore S. P-QOL: a validated questionnaire to assess the symptoms and quality of life of women with urogenital prolapse. International Urogynecology Journal and Pelvic Floor Dysfunction [Internet]. 2005 May 1 [cited 2020 Nov 23];16(3):176–81; discussion 181. Available from: https://pubmed.ncbi.nlm.nih.gov/15875234/
17.Sánchez-Sánchez B, Yuste-Sánchez MJ, Arranz-Martín B, Navarro-Brazález B, Romay-Barrero H, Torres-Lacomba M. Quality of Life in POP: Validity, Reliability and Responsiveness of the Prolapse Quality of Life Questionnaire (P-QoL) in Spanish Women. International Journal of Environmental Research and Public Health. 2020 Mar 5;17(5):1690.
18.ICIQ-UI SF [Internet]. ICIQ. Available from: https://iciq.net/iciq-ui-sf
19.Lim R, Liong ML, Lau YK, Yuen KH. Validity, reliability, and responsiveness of the ICIQ-UI SF and ICIQ-FLUTS qol in the Malaysian population. Neurourology and Urodynamics. 2015 Dec 23;36(2):438–42.
20.Ekanayake CD, Arunasalam Pathmeswaran, A. A. Nilanga Nishad, Samaranayake KU, Wijesinghe PS. Translation and validation of ICIQ-FLUTS for Tamil-speaking women. International urogynecology journal. 2017 Mar 25;28(12):1875–81.
21.Emmanuel Ifeanyi Obeagu. Uterine Prolapse: An Update of Prevalence and Risk Factors. Journal of gynecology and womens health. 2023 Aug 9;25(4).
22.Ryhtä I, Axelin A, Parisod H, Holopainen A, Hamari L. Effectiveness of exercise interventions on urinary incontinence and pelvic organ prolapse in pregnant and postpartum women: umbrella review and clinical guideline development. JBI Evidence Implementation [Internet]. 2023 Dec 1 [cited 2023 Dec 4];21(4):394. Available from: https://journals.lww.com/ijebh/fulltext/2023/12000/effectiveness_of_exercise_interventions_on_urinary.10.aspx
23.Fenocchi L, Best C, Mason H, Elders A, Hagen S, Maxwell M. Long-term effects and costs of pelvic floor muscle training for prolapse: trial follow-up record-linkage study. International Urogynecology Journal. 2022 Jun 28;34(1):239–46.
24. Schütze S, Heinloth M, Uhde M, Schütze J, Hüner B, Janni W, Deniz M. The effect of pelvic floor muscle training on pelvic floor function and sexuality postpartum: A randomized study including 300 primiparous. Arch Gynecol Obstet. 2022;306(3):785-793. doi: 10.1007/s00404-022-06542-z. Epub 2022 Apr 4. PMID: 35377043; PMCID: PMC8977567.
25.Panman C, Wiegersma M, Kollen B, Berger M, Lisman‐Van Leeuwen Y, Vermeulen K, et al. Two‐year effects and cost‐effectiveness of pelvic floor muscle training in mild pelvic organ prolapse: a randomised controlled trial in primary care. BJOG: An International Journal of Obstetrics & Gynaecology. 2016 Mar 21;124(3):511–20.
26.Abraham A, Gose R, Schindler R, Nelson BH, Hackney ME. Dynamic Neuro-Cognitive Imagery (DNITM) Improves Developpé Performance, Kinematics, and Mental Imagery Ability in University-Level Dance Students. Frontiers in Psychology. 2019 Mar 1;10.
| Issue | Articles in Press | |
| Section | Research Article(s) | |
| Keywords | ||
| Pelvic organ prolapse, Franklin method, Pelvic Floor Muscle Training, Prolapse Quality of Life, International Consultation on Incontinence Questionnaire- Female Lower Urinary Tract Syndrome | ||
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How to Cite
1.
Ravi K, Selvakumar S, Basha M. Integrating the Effect of Franklin Method along with Pelvic Floor Muscle Training in Pelvic Organ Prolapse. jmr. 2025;(-).
