Pre-rehabilitation of the pelvic floor before radiation therapy for cervical cancer: a pilot study

Abstract

Introduction and hypothesis The objective was to evaluate pelvic floormuscle (PFM) function regarding strength, activation and incontinence, approximately 1 month before and after radiation therapy in women with cervical cancer. Methods This was a pilot study of 49 women with cervical cancer at stages I to III. Thesewomen attended an educational session with a physical therapist who taught themto performpreventive pelvic floormuscle exercises (PFMEs; slowand fast contractions and the “knack”) at home before, during and after radiation therapy. The women received instructions for performing PFME prior to radiation therapy. The modified Oxford scale, electromyography (EMG), the International Consultation on Incontinence Questionnaire Short Form to assess urinary incontinence and two questions for faecal and gas incontinence were used. Results Twenty-eight women (57%; mean age = 44 years, range 27–66) completed the study, 21 (43%) were lost to follow-up. There was no significant change from baseline to post-radiation therapy in muscle strength, EMG records and incontinence (p > 0.05). The median of PFM strength was equal at baseline and after intervention (median = 2; IQR = 1). Conclusions The results of this study suggest that pre-rehabilitation teaching PFMEs might be a protective factor for preserving PFM strength and preventing incontinence 1 month after radiation therapy. It is a feasible intervention.