No evidence popular pelvic exercise works

Abdominal hypopressive technique (AHT), an exercise method widely touted for 20 years as a way of controlling bladder leakage and pelvic organ prolapse, doesn’t work, according to a new report. 

AHT is a breathing exercise developed in the 1980s by Belgian physiotherapist Marcel Caufriez. Highly popular, it is taught by more than 1500 practitioners in 14 countries, including in Australia. 

But a report published last week in the British Journal of Sports Medicine finds no scientific evidence to support the claimed benefits of AHT.

Authors Kari Bo, of the Norwegian School of Sport Sciences, in Oslo, and Saul Martín-Rodríguez, of the College of Physical Education, in Las Palmas, Spain, acknowledge the “worldwide huge interest” in AHT but say it “lacks scientific evidence to support its benefits. At this stage, AHT is based on a theory with 20 years of clinical practice.”

In contrast, they note that pelvic floor muscle training, developed by US gynecologist Arnold Kegel in the 1940s, has systematically verifiable effectiveness in treating problems such as urinary incontinence and pelvic organ prolapse.

The theory behind AHT is that through deep-breathing exercises and body posture, pressure on abdominal muscles is reduced, which in turn involuntarily activates muscles in the abdominal wall and pelvic floor, so reducing urinary incontinence and pelvic organ prolapse.

The report notes similarities to other breathing-based exercises such as pilates and tai chi.

The main finding of the report, and a key component of the authors’ research, is that there has been a lack of rigorous testing into the claimed benefits of AHT. The researchers cite two trials, one which found that adding AHT to pelvic floor muscle training produced no benefit, while the other found pelvic floor training worked better than AHT.

“Hence,” they conclude, “AHT is controversial and should be further studied.

“At present, there is no scientific evidence to recommend its use to patients. This particular treatment currently illustrates the phenomenon that not all recommended treatments are evidence based.”

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