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Kegel Exercises

Kegel exercises were first described in the medical literature almost 50 years ago (Kegel 1948). Although originally labeled "progressive resistance exercise" (p. 238), many articles published since then refer to these exercises to restore strength and function to the perineal floor as Kegel exercises (Kuhns-Hastings 1988; Mooney and Dougherty 1989; Newman, Lynch, Smith, and Cell 1991; Powers and Williams 1992; Rose, Baigis-Smith, Smith, and Newman 1990; Samples, Dougherty, Abrams, and Batich 1988). Other terminology for these exercises includes pelvic floor exercises (PFE) (Black 1990; Blannin 1989; Wells 1990; Wells 1991), pelvic muscle exercise (Sampselle 1990), and circumvaginal muscles (CVM) (Dougherty, Bishop, Abrams, Batich, and Gimotty 1989). Pelvic floor exercises is the term most often used in Great Britain and the term Kegel exercises is more commonly used in the United States. Kegel's original premise is that birth canal musculature is especially responsive to conserving and restoring function (Kegel 1948). The perineal muscle cells that have been stretched and torn during the birthing process can be reeducated to function again after delivery. Because these injured muscle cells are interspersed among intact muscle cells, when the uninjured muscle cells are actively exercised, the injured muscle cells are put to work at the same time. This exercise results in reeducation and reinnervation of the injured cells and tissues. The benefit of maintaining muscular function and strength in the perineal area is the relationship between weakened perineal muscles and urinary incontinence.

A review of the literature

The specifics of how to perform Kegel exercises vary. Kegel (1948) states a common practice of instructing patients "to draw in the perineal region repeatedly" (p. 241). Later in the article, Kegel describes a more formal exercise program beginning with five minutes of exercises, three times a day, increasing to "twenty minutes, three times daily" (p....