Author
Kari Bø
Other affiliations: American Physical Therapy Association, Akershus University Hospital
Bio: Kari Bø is an academic researcher from Norwegian School of Sport Sciences. The author has contributed to research in topics: Urinary incontinence & Pelvic Floor Muscle. The author has an hindex of 63, co-authored 266 publications receiving 12452 citations. Previous affiliations of Kari Bø include American Physical Therapy Association & Akershus University Hospital.
Papers published on a yearly basis
Papers
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TL;DR: Training of the pelvic floor muscles is superior to electrical stimulation and vaginal cones in the treatment of genuine stress incontinence.
Abstract: Objective :To compare the effect of pelvic floor exercises, electrical stimulation,vaginal cones, and no treatment for genuine stress incontinence. Design :Stratified, single blind, randomised controlled trial. Setting :Multicentre. Participants : 107 women with clinically and urodynamically proved genuine stress incontinence. Mean (range) age was 49.5 (24-70) years, and mean (range) duration of symptoms 10.8 (1-45) years. Interventions : Pelvic floor exercise (n=25) comprised 8-12 contractions 3 times a day and exercise in groups with skilled physical therapists once a week. The electrical stimulation group (n=25) used vaginal intermittent stimulation with the MS 106 Twin at 50 Hz 30 minutes a day. The vaginal cones group (n=27) used cones for 20 minutes a day. The untreated control group (n=30) was offered the use of a continence guard. Muscle strength was measured by vaginal squeeze pressure once a month. Main outcome measures : Pad test with standardised bladder volume, and self report of severity. Results :Improvement in muscle strength was significantly greater (P=0.03) after pelvic floor exercises (11.0 cm H 2 O (95% confidence interval 7.7 to 14.3) before v 19.2 cm H 2 O (15.3 to 23.1) after) than either electrical stimulation (14.8 cm H 2 O (10.9 to 18.7) v 18.6 cm H 2 O (13.3 to 23.9)) or vaginal cones (11.8 cm H 2 O (8.5 to 15.1) v 15.4 cm H 2 O (11.1 to 19.7)). Reduction in leakage on pad test was greater in the exercise group (−30.2 g; −43.3 to 16.9) than in the electrical stimulation group (−7.4 g; −20.9 to 6.1) and the vaginal cones group (−14.7 g; −27.6 to −1.8). On completion of the trial one participant in the control group, 14 in the pelvic floor exercise group, three in the electrical stimulation group, and two in the vaginal cones group no longer considered themselves as having a problem. Conclusion : Training of the pelvic floor muscles is superior to electrical stimulation and vaginal cones in the treatment of genuine stress incontinence.
646 citations
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TL;DR: The aims of this article are to give an overview of methods to assess PFM function and strength and to discuss the responsiveness, reliability, and validity of data obtained with the methods available for clinical practice and research today.
Abstract: Evaluation of pelvic-floor muscle (PFM) function and strength is necessary (1) to be able to teach and give feedback regarding a woman's ability to contract the PFM and (2) to document changes in PFM function and strength throughout intervention. The aims of this article are to give an overview of methods to assess PFM function and strength and to discuss the responsiveness, reliability, and validity of data obtained with the methods available for clinical practice and research today. Palpation, visual observation, electromyography, ultrasound, and magnetic resonance imaging (MRI) measure different aspects of PFM function. Vaginal palpation is standard when assessing the ability to contract the PFM. However, ultrasound and MRI seem to be more objective measurements of the lifting aspect of the PFM. Dynamometers can measure force directly and may yield more valid measurements of PFM strength than pressure transducers. Further research is needed to establish reliability and validity scores for imaging techniques. Imaging techniques may become important clinical tools in future physical therapist practice and research to measure both pathophysiology and impairment of PFM dysfunction.
480 citations
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TL;DR: This report presents a standardization of terminology of pelvic $oor muscle function and dysfunction to facilitate comparison of results and enable eiective communication by investigators performing pelvic £oor muscle studies.
Abstract: STANDARDIZATION This report presents a standardization of terminology of pelvic £oor muscle function and dysfunction. No earlier documents contained de¢nitions on this terminology. These de¢nitions are descriptive and do not imply underlying assumptions that may later prove to be incorrect or incomplete. By following this principle, the International Continence Society aims to facilitate comparison of results and enable eiective communication by investigators performing pelvic £oor muscle studies.
442 citations
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TL;DR: The aims of this article are to discuss the theories behind why PFM training is effective in treating SUI and to discuss each theory in the framework of new knowledge of functional anatomy and examples of results from RCTs.
Abstract: To date several randomized controlled trials (RCT) have shown that pelvic floor muscle (PFM) training is effective in the treatment of female stress (SUI) and mixed urinary incontinence and, therefore, it is recommended as a first-line therapy. While the effectiveness of treatment is established, there are different theoretical rationales for why PFM training is effective. The aims of this article are to discuss the theories behind why PFM training is effective in treating SUI and to discuss each theory in the framework of new knowledge of functional anatomy and examples of results from RCTs. There are three proposed theories to explain the effectiveness of PFM training for SUI: 1) women learn to consciously pre-contract the PFMs before and during increases in abdominal pressure (such as coughing, physical activity) to prevent leakage; 2) strength training builds up long-lasting muscle volume and thus provides structural support; and 3) abdominal muscle training indirectly strengthens the PFM. The first can be placed in a behavioral construct, while the two latter both have the aim of changing neuromuscular function and morphology, thus making the PFM contraction automatic. To date there are RCTs and basic anatomy studies to support the first two concepts only.
399 citations
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TL;DR: A systematic review of the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes finds there is a need for more basic research on pelvic floor muscle function during physical activity and the effect of pelvic floor Muscle training inFemale elite athletes.
Abstract: Urinary incontinence is defined as “the complaint of any involuntary leakage of urine” and is a common problem in the female population with prevalence rates varying between 10% and 55% in 15- to 64-year-old women. The most frequent form of urinary incontinence in women is stress urinary incontinence, defined as “involuntary leakage on effort or exertion, or on sneezing or coughing”. The aim of this article is to systematically review the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes. Stress urinary incontinence is a barrier to women’s participation in sport and fitness activities and, therefore, it may be a threat to women’s health, self-esteem and well-being. The prevalence during sports among young, nulliparous elite athletes varies between 0% (golf) and 80% (trampolinists). The highest prevalence is found in sports involving high impact activities such as gymnastics, track and field, and some ball games. A ‘stiff’ and strong pelvic floor positioned at an optimal level inside the pelvis may be a crucial factor in counteracting the increases in abdominal pressure occurring during high-impact activities. There are no randomised controlled trials or reports on the effect of any treatment for stress urinary incontinence in female elite athletes. However, strength training of the pelvic floor muscles has been shown to be effective in treating stress urinary incontinence in parous females in the general population. In randomised controlled trials, reported cure rates, defined as <2g of leakage on pad tests, varied between 44% and 69%. Pelvic floor muscle training has no serious adverse effects and has been recommended as first-line treatment in the general population. Use of preventive devices such as vaginal tampons or pessaries can prevent leakage during high impact physical activity. The pelvic floor muscles need to be much stronger in elite athletes than in other women. There is a need for more basic research on pelvic floor muscle function during physical activity and the effect of pelvic floor muscle training in female elite athletes.
319 citations
Cited by
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University of Coimbra1, University of Southern Queensland2, National Institute for Health and Welfare3, Arizona State University4, Ghent University5, Institute of Technology, Tralee6, University of Ottawa7, Glasgow Caledonian University8, Oregon Health & Science University9, Cambridge University Hospitals NHS Foundation Trust10, George Washington University11, Norwegian School of Sport Sciences12, Norwegian Institute of Public Health13, University of Sydney14, Alberta Health Services15, Queen's University Belfast16, University of Bristol17, Pennington Biomedical Research Center18, University of Cape Town19, University of Regensburg20, University of East Anglia21, University of Granada22, University of Colombo23, National Institutes of Health24, World Health Organization25
TL;DR: New WHO 2020 guidelines on physical activity and sedentary behaviour reaffirm messages that some physical activity is better than none, that more physical Activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours.
Abstract: Objectives To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150-300 min of moderate-intensity, or 75-150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. Conclusion These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018-2030 and to strengthen surveillance systems that track progress towards national and global targets.
3,218 citations
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TL;DR: Next to existing terminology of the lower urinary tract, due to its increasing complexity, the terminology for pelvic floor dysfunction in women may be better updated by a female‐specific approach and clinically based consensus report.
Abstract: Introduction and hypothesis Next to existing terminology of the lower urinary tract, due to its increasing complexity, the terminology for pelvic floor dysfunction in women may be better updated by a female-specific approach and clinically based consensus report. Methods This report combines the input of members of the Standardization and Terminology Committees of two Inter
2,500 citations
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2,219 citations
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14 Dec 2009
TL;DR: The IOM's Food and Nutrition Board and the Division of Behavioral and Social Sciences and Education Board on Children, Youth, and Families as mentioned in this paper reviewed and updated the IOM (1990) recommendations for weight gain during pregnancy and recommend ways to encourage their adoption through consumer education, strategies to assist practitioners, and public health strategies.
Abstract: Sponsors asked the IOM's Food and Nutrition Board and the Division of Behavioral and Social Sciences and Education Board on Children, Youth, and Families to review and update the IOM (1990) recommendations for weight gain during pregnancy and recommend ways to encourage their adoption through consumer education, strategies to assist practitioners, and public health strategies.The committee was asked to address the following tasks: 1. Review evidence on the relationship between weight gain patterns before, during, and after pregnancy and maternal and child health outcomes, with particular attention to the prevalence of maternal obesity racial/ethnic and age differences, components of GWG, and implications of weight during pregnancy on postpartum weight retention, maternal and child obesity, and later child health. 2. Within a life-stage framework consider factors in relation to GWG that are associated with maternal health outcomes such as lactation performance, postpartum weight retention, cardiovascular disease, metabolic processes including glucose and insulin-related issues, and risk of other chronic diseases; for infants and children, in addition to low birth weight, consider early developmental impacts and obesity-related consequences (e.g., mental health, diabetes). 3. Recommend revisions to the existing guidelines, where necessary, including the need for specific pregnancy weight guidelines for underweight, normal weight, and overweight and obese women and adolescents and women carrying twins or higher-order multiples. 4. Consider a range of approaches to promote appropriate weight gain, including: individual (behavior), psychosocial, community, health care, and health systems; timing and components of interventions; and ways to enhance awareness and adoption of the guidelines, including interdisciplinary approaches, consumer education to men and women, strategies to assist practitioners to use the guidelines, and public health strategies. 5. Identify gaps in knowledge and recommend research priorities.
2,050 citations
31 May 2006
TL;DR: This research highlights the need to understand more fully the rationale behind the continued use of EMMARM, as well as the barriers to doing so, in patients and clinicians.
Abstract: Peter Craig, MRC Population Health Sciences Research Network Paul Dieppe, Nuffield Department of Orthopaedic Surgery, University of Oxford Sally Macintyre, MRC Social and Public Health Sciences Unit Susan Michie, Centre for Outcomes Research and Effectiveness, University College London Irwin Nazareth, MRC General Practice Research Framework Mark Petticrew, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine
1,995 citations