Volume 23, Issue 30 (1-2026)                   RSMT 2026, 23(30): 161-181 | Back to browse issues page

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Arabmomeni A, Ramazani M. A Comparison Of The Effects Of Core Stabilization Functional, EMS And Combined Exercises On Pelvic Floor Muscles Strength And Endurance In Patients With Rectal Prolapse. RSMT 2026; 23 (30) :161-181
URL: http://jsmt.khu.ac.ir/article-1-640-en.html
Ph. D, Department of Sports Sciences, Faculty of Humanities, Kho.C., Islamic Azad University, Khomeinishahr, Iran. , H.momeni1350@gmail.com
Abstract:   (5927 Views)
Background and Objective: Rectal prolapse, characterized by the protrusion of the internal anal wall, is a debilitating condition often associated with pelvic floor muscle weakness. The present study aimed to compare the effects of functional core stability exercises, electrical muscle stimulation (EMS), and a combination of these modalities on pelvic floor muscle strength and endurance in women with rectal prolapse.
Methodology: This quasi-experimental study employed a pretest–posttest design. A total of 48 women with rectal prolapse from Isfahan were selected through convenience sampling and randomly assigned to four groups: functional exercise, EMS exercise, combined exercise and control. The intervention program lasted eight weeks, with three 60-minute sessions per week. Outcome variables were assessed before and after the intervention. Data were analyzed using multivariate analysis of covariance (MANCOVA) followed by Bonferroni post hoc tests.
Results: The findings demonstrated a significant improvement in pelvic floor muscle strength and endurance in both the EMS and combined exercise groups (P≤0.05). Although the functional exercise group showed an increase in muscle strength, this change did not reach statistical significance (P>0.05). Furthermore, the combined training group exhibited significantly greater improvements across variables compared to the EMS-only and functional-only groups (P≤0.05).
Conclusion: These results suggest that integrating electrical stimulation with functional training provides superior benefits in enhancing pelvic floor muscle strength and endurance in women with rectal prolapse. Therefore, rehabilitation centers, physicians, and therapists are encouraged to adopt such combined approaches as an effective strategy for improving clinical outcomes in this patient population
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Type of Study: Research | Subject: آسیب شناسی و حرکات اصلاحی
Received: 2024/10/27 | Accepted: 2025/07/9 | Published: 2026/01/30

References
1. Weintraub, A. Y., Glinter, H., & Marcus-Braun, N. (2020). Narrative review of the epidemiology, diagnosis and pathophysiology of pelvic organ prolapse. International braz j urol: official journal of the Brazilian Society of Urology, 46(1), 5-14. https://doi.org/10.1590/s1677-5538.ibju.2018.0581 [DOI:10.1590/S1677-5538.IBJU.2018.0581]
2. Hamahata, Y., Akagi, K., Maeda, T., Nemoto, K., & Koike, J. (2022). Management of pelvic organ prolapse (pop) and rectal prolapse. Journal of the anus, rectum and colon, 6(2), 83-91. [DOI:10.23922/jarc.2020-007]
3. Oruc, M., & Erol, T. (2023). Current diagnostic tools and treatment modalities for rectal prolapse. World journal of clinical cases, 11(16), 3680-3693. [DOI:10.12998/wjcc.v11.i16.3680]
4. Delshad, S., Piri, N., & Mirmoghadam, Z. (2020). The most common symptoms of internal rectal prolapse in children referred to maryam hospital, Karaj: During 2015 to 2020. aumj, 10 (1) :105-114. URL: http://aums.abzums.ac.ir/article-1-1255-fa.html
5. Bo, K., & Sherburn, M. (2005). Evaluation of female pelvic-floor muscle function and strength. Physical Therapy, 85(3): 269-82. [DOI:10.1093/ptj/85.3.269]
6. Raizada, V., & Mittal, R. K. (2008). Pelvic floor anatomy and applied physiology. Gastroenterology clinics of North America, 37(3), 493-vii. [DOI:10.1016/j.gtc.2008.06.003]
7. Mirbod, S. M., Sarami, H., Mortazi, F., Zarinmoghadam, M. (2012). Effects of isometric exercise on the alleviation of lumbar and pelvic pain in pregnant women resident in Isfahan, Iran. Journal of Research in Rehabilitation Sciences, 7(5): -. doi: 10.22122/jrrs.v7i5.365
8. Hodges, P. W., & Richardson, C. A. (1999). Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Archives of physical medicine and rehabilitation, 80(9), 1005-1012. https://doi.org/10.1016/S0003-9993(99)90052-7 [DOI:10.1016/s0003-9993(99)90052-7]
9. Lak, R., Amiri, M., Abdollahi, I., Biglarian, A., Bazaz Behbahani, R., & Zargoosh., M. (2016). Research paper: effect of strength and endurance training on the pelvic floor muscles in women with stress urinary incontinence. jrehab, 17 (3) :222-231 URL: http://rehabilitationj.uswr.ac.ir/article-1-2079-fa.html. [DOI:10.21859/jrehab-1703222]
10. Hoseleh, A., Yaghoubi, A., Ariamanesha, A. S., & Rezaeian, N. (2023). The effect of resistance training along with electrical muscle stimulation on serum levels of PGC-1α, IGF-1 and myostatin in athletes after ACL surgery. Journal of Practical Studies of Biosciences in Sport, 11(26): 20-29. doi: 10.22077/jpsbs.2022.4794.1674
11. Abbasi, H., Alizadeh, M. H., Daneshmandi, H., & Barati, A. H. (2015). Comparing the effect of functional, extra-functional and combined exercises on dynamic balance in athletes with functional ankle instability. Studies in Sport Medicine, 7(17): 34-15.
12. Feito, Y., Heinrich, K. M., Butcher, S. J., & Poston, W. S. C. (2018). High-intensity functional training (hift): definition and research implications for improved fitness. Sports (Basel, Switzerland), 6(3), 76. [DOI:10.3390/sports6030076]
13. Matos, F., Amaral, J., Martinez, E., Canário-Lemos, R., Moreira, T., Cavalcante, J., Peixoto, R., Pinheiro, B. N., Junior, L. S., Uchoa, P., Garrido, N., Reis, V. M., Monteiro, G. M., & Vilaça-Alves, J. (2022). Changes in muscle thickness after 8 weeks of strength training, electromyostimulation, and both combined in healthy young adults. International journal of environmental research and public health, 19(6), 3184. [DOI:10.3390/ijerph19063184]
14. Antônio, F. I. , Bø, K. , Pena, C. C. , Bueno, S. M. , Mateus-Vasconcelos, E. C. L. , Fernandes, A. C. N. L. , & Ferreira, C. H. J. (2022). Intravaginal electrical stimulation increases voluntarily pelvic floor muscle contractions in women who are unable to voluntarily contract their pelvic floor muscles: a randomised trial. Journal of Physiotherapy, 68(1), 37-42. doi: 10.1016/j.jphys.2021.12.004. Epub 2021 Dec 21. [DOI:10.1016/j.jphys.2021.12.004]
15. Zhu, H. , Zhang, D. , Gao, L. , Liu, H. , Di, Y. , Xie, B. ,... & Sun, X. (2022). Effect of pelvic floor workout on pelvic floor muscle function recovery of postpartum women: protocol for a randomized controlled trial. International journal of environmental research and public health, 19(17), 11073. doi: 10.3390/ijerph191711073. [DOI:10.3390/ijerph191711073]
16. Zhong, F., Miao, W., Yu, Z., Hong, L., & Deng, N. (2021). Clinical effect of electrical stimulation biofeedback therapy combined with pelvic floor functional exercise on postpartum pelvic organ prolapse. American journal of translational research, 13(6), 6629-6637. PMID: 34306406; PMCID: PMC8290786.
17. Zhou, Y., Gan, G., & Zhang, W. (2020). Clinical effect of electrical stimulation combined with biofeedback pelvic floor muscle training on postpartum pelvic floor dysfunction. Chin J Postgrad Med, 43:393-397. PMCID: PMC8290786 PMID: 34306406.
18. Goodarzi Nasab, M., Shojaodin, S. S., & Naser Melli, M. H. (2021).The effect of Kegel exercises on pain, urinary incontinence and strength of pelvic floor muscles in women with stress urinary incontinence and back pain. The Iranian Journal of Obstetrics, Gynecology and Infertility, 24(8): 59-67. doi: 10.22038/ijogi.2021.19068
19. Middlekauff, M. L. , Egger, M. J. , Nygaard, I. E. , & Shaw, J. M. (2016). The impact of acute and chronic strenuous exercise on pelvic floor muscle strength and support in nulliparous healthy women. American journal of obstetrics and gynecology, 215(3), 316-e1. doi: 10.1016/j.ajog.2016.02.031. Epub 2016 Feb 17. [DOI:10.1016/j.ajog.2016.02.031]
20. Mohseni-Bandpei, M. A. , Rahmani, N. , Behtash, H. , & Karimloo, M. (2011). The effect of pelvic floor muscle exercise on women with chronic non-specific low back pain. Journal of bodywork and movement therapies, 15(1), 75-81. [DOI:10.1016/j.jbmt.2009.12.001]
21. Lak, R., Amiri, M., Abdollahi. I., Biglarian, A., Bazaz Behbahani, R., & Zargoosh, M. (2016). Research Paper: Effect of Strength and Endurance Training on the Pelvic Floor Muscles in Women with Stress Urinary Incontinence. jrehab, 17 (3) :222-231URL: http://rehabilitationj.uswr.ac.ir/article-1-2079-fa.html. [DOI:10.21859/jrehab-1703222]
22. Nahidi, F., Limoui, V., Valai, N., Ezgoli, G., and Kokbi, R. (2012). Comparison of the effect of pelvic floor muscles and vaginal cones exercise in stress urinary incontinence patients. Researcher bulletin of medical sciences, 10(43), 39-44. SID. https://sid.ir/paper/18312/fa
23. Nguyen, J., Lind, L., Choe, J., Mckindsey, F., Sinow, R., Bhatia, N. (2000). Lumbosacral spine and pelvic inlet changesassociated with pelvic organ prolapse, Obstet Gynecol, 95(3), 332-6. doi: 10.1016/s0029-7844(99)00561-x [DOI:10.1016/S0029-7844(99)00561-X]
24. Hundley, A. F., Wu, J. M., & Visco, A. G. (2005). A comparison of perineometer to brink score for assessment of pelvic floor muscle strength. American journal of obstetrics and gynecology, 192(5), 1583-1591. [DOI:10.1016/j.ajog.2004.11.015]
25. Hodges, P. W., Sapsford, R., & Pengel, L. H. (2007). Postural and respiratory functions of the pelvic floor muscles. Neurourology and urodynamics, 26(3), 362-371. [DOI:10.1002/nau.20232]
26. Bø, K., Bo, K., Berghmans, B., Van, Kampen, M., & Morkved. S. (2007). Evidence-based physical therapy for the pelvic floor: bridging science and clinical practice: Elsevier Health Sciences. doi: 10.1016/C2009-0-64182-9 [DOI:10.1016/C2009-0-64182-9]
27. Zahedpour, F., Mohammadi, M., Damavandi, M., & Agah, J. (2017). The effect of core stability training on postpartum lumbar lordosis and low back pain in nulliparous women. the iranian journal of obstetrics, Gynecology and infertility. 20(3): 89-97. doi: 10.22038/ijogi.2017.8876
28. Thapa, N., Yang, J. G., Bae, S., Kim, G. M., Park, H. J., & Park, H. (2022). Effect of electrical muscle stimulation and resistance exercise intervention on physical and brain function in middle-aged and older women. International journal of environmental research and public health, 20(1), 101. [DOI:10.3390/ijerph20010101]
29. Castro, R. A. , Arruda, R. M. , Zanetti, M. R. , Santos, P. D. , Sartori, M. G. , & Girão, M. J. (2008). Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics, 63(4), 465-472. doi: 10.1590/s1807-59322008000400009 [DOI:10.1590/S1807-59322008000400009]
30. Lazaros, T. , Ioannis, T. , Vasileios, S. , Christina, P. , & Michael, S. (2023). The effect of pelvic floor muscle training in women with functional bladder outlet obstruction. Archives of Gynecology and Obstetrics, 307(5), 1489-1494. doi: 10.1007/s00404-023-06930-z [DOI:10.1007/s00404-023-06930-z]
31. Sahin, U. K. , Acaröz, S. , Çirakoğlu, A. , Benli̇, E. , & Akbayrak, T. (2022). Effects of external electrical stimulation added to pelvic floor muscle training in women with stress urinary incontinence: A randomized controlled study. Neurourology and Urodynamics, 41(8), 1781-1792. doi: 10.1002/nau.25022 [DOI:10.1002/nau.25022]
32. Li, Y., Liu, H., Wu, Y., & Gong, X. (2017). Effect of biofeedback combined with electrical stimulation and kegel training in the treatment of postpartum pelvic floor dysfunction. J Xinxiang Med Coll. 34:619-622. PMCID: PMC9908449 PMID: 36777851
33. Wille, S., Sobottka, A., Heidenreich, A., & Hofmann, R. (2003). Pelvic floor exercises, electrical stimulation and biofeedback after radical prostatectomy: results of a prospective randomized trial. The Journal of urology, 170(2 Pt 1), 490-493. [DOI:10.1097/01.ju.0000076141.33973.75]
34. Ouchi, M. , Kitta, T. , Kanno, Y. , Moriya, K. , Suzuki, S. , Shinohara, N. , & Kato, K. (2018). Medium-term follow-up after supervised pelvic floor muscle training for patients with anterior vaginal wall prolapse. European Journal of Obstetrics & Gynecology and Reproductive Biology, 225, 95-100. doi: 10.1016/j.ejogrb.2018.04.015 [DOI:10.1016/j.ejogrb.2018.04.015]
35. Kasaeian, D., Dehghan Manshadi, F., Shokouhi, N., Miri, E., & Tabatabaee, S. M. (2022). Comparison of pelvic floor muscle function in women with stress urinary incontinence and overactive bladder and healthy women. the scientific journal of rehabilitation medicine, 11(3): 382-393. doi: 10.32598/SJRM.11.3.3 [DOI:10.32598/SJRM.11.3.3]
36. Alves, F. K. , Riccetto, C. , Adami, D. B. , Marques, J. , Pereira, L. C. , Palma, P. , & Botelho, S. (2015). A pelvic floor muscle training program in postmenopausal women: A randomized controlled trial. Maturitas, 81(2), 300-305. doi: 10.1016/j.maturitas.2015.03.006 [DOI:10.1016/j.maturitas.2015.03.006]
37. Yune, J. J., Shen, J. K., Pierce, M. A., Hardesty, J. S., Kim, J., & Siddighi, S. (2018). Intravesical electrical stimulation treatment for overactive bladder: An observational study. Investigative and clinical urology, 59(4), 246-251. [DOI:10.4111/icu.2018.59.4.246]
38. Bae, S., Lee, K. W., Jeong, H. C., Park, B. H., Bae, W. J., Lee, Y. S., Han, C. H., Kang, S. H., & Kim, S. W. (2020). Effects of low-frequency intravaginal electrical stimulation on female urinary incontinence, quality of life, and urinary symptoms: A pilot study. Lower urinary tract symptoms, 12(1), 25-32. [DOI:10.1111/luts.12278]
39. Grimes, W. R., & Stratton, M. (2022). Pelvic Floor Dysfunction. In StatPearls. StatPearls Publishing.
40. Jo, H. C., Baek, J. C., Park, J. E., Park, J. K., Jo, I. A., Choi, W. J., & Sung, J. H. (2019). Clinicopathologic characteristics and treatment patterns of pelvic organ prolapse in South Korea. The Pan African medical journal, 34, 14. [DOI:10.11604/pamj.2019.34.14.19823]
41. Liu, C., Shiroy, D. M., Jones, L. Y., & Clark, D. O. (2014). Systematic review of functional training on muscle strength, physical functioning, and activities of daily living in older adults. European Review of Aging and Physical Activity, 11(2), 95. [DOI:10.1007/s11556-014-0144-1]
42. Ghaderi, F., Mohammadi, K., Amir Sasan, R., Niko Kheslat, S., & Oskouei, A. E. (2016). Effects of stabilization exercises focusing on pelvic floor muscles on low back pain and urinary incontinence in women. Urology, 93, 50-54. https://doi.org/10.1016/j.urology.2016.03.034 [DOI:10.1016/j.urology.2016.03.034.]

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