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The World Health Organization considers urinary incontinence a public health problem. This pathology affects both men and women and, like anal incontinence, genital prolapses, sexual dysfunctions and pelvic pain have a great negative impact on patients' quality of life. In the past, these pathologies were seen as a natural consequence of age, and people adapted to the changes imposed by them. Modern society and the increase in life expectancy have made people worry about quality of life and well-being, seeking treatment for these pathologies at an earlier age.

The lack of protocols for perineal rehabilitation that respect the evolution of the treatment and the individuality of each patient led me to develop the protocol “ Active Perineal Rehabilitation ”. This protocol aims to rehabilitate the muscles of the perineum so that these muscles are able to perform their functions. The only movement resulting from the contraction of the perineum is its elevation in a cephalad direction and anteriorization towards the pubic symphysis. The rehabilitation of these muscles is carried out by contracting, relaxing and stretching them.

APR is based on exercise physiology, taking into account the cognitive, neuromuscular and metabolic changes caused by rehabilitation, being indicated for muscle rehabilitation in the treatment of female and male urinary incontinence, male and female sexual dysfunctions, anal incontinence, constipation, genital prolapses and pelvic pain. When these pathologies are at a more advanced stage and surgery is necessary, perineal rehabilitation is recommended before and after surgery, as a complementary treatment to surgery.

Laira Ramos

Active Perineal Rehabilitation


Perineal rehabilitation is a complex treatment that, of course, should not be done using just one technique. Although it is possible to have excellent results with the Active Perineal Rehabilitation protocol, it is not sufficient to address all aspects of this neuromuscular rehabilitation.

In this sense, the need arose to develop a program with passive techniques that are also used in the treatment. These techniques are those in which the exercises are applied by the physical therapist, without the active participation of the patient.

Laira Ramos

Passive Perineal Rehabilitation

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