Table 1 Types of training provided during MOTHERFIT1 and MOTHERFIT2 with accompanying aim and exercises
Type of training | Aim | Exercise(s) |
|---|---|---|
Awareness | Continue breathing during PFM contraction | Breathing and PFM exercises |
Skills | Consciously timed voluntary pre-contraction | The ‘Knack’– closing of vaginal hiatus and in-, up- and forward movement of the PFMs before and during increased abdominal pressure |
Functional | Increase awareness to avoid unnecessary abdominal pressure and to prevent unnecessary or extreme perineal descent during daily activities | Correct pushing technique during defecation, or a PFM contraction in situations associated with a rise in abdominal pressure |
Muscle strength and endurance | Build up long-lasting muscle volume, providing structural support/‘stiffness’, resulting in reduced perineal descent | Slow velocity • Build up to 8–12 contractions, of 6–8 s (if possible), add 3–4 fast contractions on top at the end to recruit more slow-twitch fibres. Start with double time rest (complete relaxation) between contractions • Three sets of exercises during the day in varying positions: lying, sitting, kneeling, standing position • Preferably daily training, but minimally 3–4 days a week, during at least 5–6 months • Maintenance muscle strength after 6 months’ training; 2 days a week where intensity is more important than frequency |
Muscle contraction: speed | Build up explosive strength | Fast repetitions • Build up from 10 sets of 3 quick contractions to 10 sets of 5 quick contractions, 3 times a day |