Arnold Kegel was the first to propose exercises of contraction and relaxation of the pelvic muscles as a means for the non-surgical treatment of urinary incontinence. Originally the intention was for the patient to do as many of the exercises as possible, up to 500 times a day. Many patients contracted other muscles in addition to the pelvic muscles. Over time, the way of performing these exercises has changed substantially. The intention is that the abdominal muscles and buttocks remain relaxed while contracting the pelvic muscles.
The frequency and intensity of the contractions has also changed to avid muscle fatigue. Additionally, berthing exercises are included to help improve the work of the muscles. The exercises are designed to work both the fast-twitch muscle fibers (forming the striated sphincter) and the slow-twitch (which form much of the pelvic muscles that provide support for the bladder and rectum).Today, these are also known as the pelvic floor exercises.
Exercises for the fast-twitch muscle fiber: these fibers are found mainly in the muscle that forms the urogenital diaphragm and external sphincter (both urethral and anal). They are important to prevent loss of urine when sneezing, coughing, or lifting.
Exercises for the slow-twitch muscle fibers: Slow-twitch fibers have more endurance than fast-twitch fibers, that is, they tire less quickly and, therefore, provide ongoing support to the pelvic organs. The pelvic floor muscled have mostly show-twitch fibers, which support both the bladder and the urethra in the best position ford continence.
While the exercise can be done in any position, it is recommended when the patient starts this therapy, to perform in it the supine (lying on the back) position with the legs semi-flexed, resting on a couple of pillows or sitting in a comfortable chair. This is for the purpose of keeping the abdominal muscles relaxed.
Each training program is designed according to the needs and possibilities of each patient, taking into account his activity level, time availability, work hours, cognitive level, etc.
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