{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:13:01Z","timestamp":1785460381501,"version":"3.56.0"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T00:00:00Z","timestamp":1741478400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004410","name":"Scientific and Technological Research Council of Turkey","doi-asserted-by":"publisher","award":["224S541"],"award-info":[{"award-number":["224S541"]}],"id":[{"id":"10.13039\/501100004410","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The aim of this study was to compare the effects of pelvic floor muscle contraction training (PFMCT) using verbal education, digital vaginal palpation (DVP), or perineometer on the common errors made during pelvic floor muscle contraction (PFMC) in women. Materials and Methods: A total of 48 women participated, and they were randomly assigned to three groups (Group I: PFMCT with verbal education, n = 16; Group II: PFMCT with DVP, n = 16; and Group III: PFMCT with perineometer, n = 16). Participants who had not previously received PFMCT were evaluated for pelvic floor muscle strength using the Modified Oxford Scale (MOS), and pelvic floor muscle activation was assessed with electromyographic biofeedback (EMG-BF). Possible errors during pelvic floor muscle contraction (gluteal, adductor and\/or abdominal muscle contractions, stop breathing (breath holding), enhanced inhaling, and straining) were evaluated through inspection, palpation, or EMG-BF. After pre-training evaluations, all participants received training on pelvic floor. After this general training, each group received PFMCT using the specific training method for their group. After the training, the same evaluations were repeated. The sessions were conducted one-on-one and lasted for an average of one hour. Results: After the training, MOS values increased in Group II and Group III, while EMG-BF values only increased in Group II (p &lt; 0.05). The number of incorrect movements during PFMC decreased after the training in all three groups (p &lt; 0.05). The abdominal muscle contraction value monitored by EMG-BF only decreased in Group II (p &lt; 0.05). Conclusions: Our study demonstrated that the PFMCT applied using the DVP method was more effective in creating more accurate and stronger muscle contractions and reducing common errors when compared to pre- and post-training values. Significant differences were observed between the groups in terms of performance improvements, with Group II showing the most notable progress. These results support the potential for DVP to yield better outcomes when used in PFMT.<\/jats:p>","DOI":"10.3390\/medicina61030477","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T08:46:41Z","timestamp":1741596401000},"page":"477","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Randomized Control Trial Comparing Common Errors Made by Women During Three Different Methods of Pelvic Floor Muscle Contraction Training: By Verbal Education vs. Vaginal PalpationTraining vs. Perineometer Training"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0496-5550","authenticated-orcid":false,"given":"Duygu Sultan","family":"\u00d6ge","sequence":"first","affiliation":[{"name":"Fundamental Physiothetapy and Rehabilitation Programme, Graduate School of Health Sciences, Hacettepe University, 06100 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"K\u0131l\u0131\u00e7 Hamzao\u011flu","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Meram Medical School, Necmettin Erbakan University, 42080 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2294-2483","authenticated-orcid":false,"given":"Hanife","family":"Do\u011fan","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Nezahat Kele\u015fo\u011flu Faculty of Health Sciences, Necmettin Erbakan University, 42090 Konya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5840-5252","authenticated-orcid":false,"given":"T\u00fcrkan","family":"Akbayrak","sequence":"additional","affiliation":[{"name":"Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s00192-009-1060-1","article-title":"Breathing with the pelvic floor? Correlation of pelvic floor muscle function and expiratory flows in healthy young nulliparous women","volume":"21","author":"Talasz","year":"2010","journal-title":"Int. Urogynecol J."},{"key":"ref_2","unstructured":"B\u00f8, K., Berghmans, B., M\u00f8rkved, S., and Van Kampen, M. (2015). Evidence-Based Physical Therapy for the Pelvic Floor Bridging Science and Clinical Practice, Elsevier Churchill Livingstone. [2nd ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1007\/s00192-020-04469-0","article-title":"Ability to contract the pelvic floor muscles and association with muscle function in incontinent women","volume":"31","author":"Fitz","year":"2020","journal-title":"Int. Urogynecol. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1080\/09593985.2017.1419520","article-title":"Physiotherapy methods to facilitate pelvic floor muscle contraction: A systematic review","volume":"34","author":"Ribeiro","year":"2018","journal-title":"Physiother. Theory Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1007\/s00192-006-0081-2","article-title":"Assessment of voluntary pelvic floor muscle contraction in continent and incontinent women using transperineal ultrasound, manual muscle testing and vaginal squeeze pressure measurements","volume":"17","author":"Thompson","year":"2006","journal-title":"Int. Urogynecol. J. Pelvic Floor Dysfunct."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ejogrb.2017.11.019","article-title":"Common errors made in attempt to contract the pelvic floor muscles in women early after delivery: A prospective observational study","volume":"220","author":"Neels","year":"2018","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1007\/s00404-024-07389-2","article-title":"Randomised controlled pilot trial to assess effect of electrical stimulation of weak pelvic floor muscles","volume":"309","author":"Villumstad","year":"2024","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1007\/s001920170059","article-title":"The use of perineal ultrasound to quantify levator activity and teach pelvic floor muscle exercises","volume":"12","author":"Dietz","year":"2001","journal-title":"Int. Urogynecol. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"107.e1","DOI":"10.1016\/j.ajog.2007.02.052","article-title":"Teaching and practicing of pelvic floor muscle exercises in primiparous women during pregnancy and the postpartum period","volume":"197","author":"Fine","year":"2007","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1590\/S0103-51502012000300019","article-title":"Physiotherapy for perineal consciousness: A comparison between pelvic floor muscle training alone and with biofeedback","volume":"25","author":"Pinheiro","year":"2012","journal-title":"Fisioter. Em Mov."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/00222899809601334","article-title":"Instructions for motor learning: Differential effects of internal versus external focus of attention","volume":"30","author":"Wulf","year":"1998","journal-title":"J. Mot. Behav."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"170","DOI":"10.2519\/jospt.2015.4986","article-title":"Optimization of the anterior cruciate ligament injury prevention paradigm: Novel feedback techniques to enhance motor learning and reduce injury risk","volume":"45","author":"Benjaminse","year":"2015","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.brainresbull.2005.06.035","article-title":"Increased movement accuracy and reduced EMG activity as the result of adopting an external focus of attention","volume":"67","author":"Zachry","year":"2005","journal-title":"Brain Res. Bull."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1037\/bul0000335","article-title":"Superiority of external attentional focus for motor performance and learning: Systematic reviews and meta-analyses","volume":"147","author":"Chua","year":"2021","journal-title":"Psychol. Bull."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d: A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_16","first-page":"273","article-title":"Standardize mini mental test\u2019in T\u00fcrk toplumunda hafif demans tan\u203a s\u203a nda ge\u00e7erlik ve g\u00fcvenilirli\u011fi","volume":"13","author":"Ertan","year":"2002","journal-title":"T\u00fcrk Psikiyatr. Derg."},{"key":"ref_17","unstructured":"Akbayrak, T., and Kaya, S. (2016). Kad\u0131n Sa\u011fl\u0131\u011f\u0131nda Fizyoterapi ve Rehabilitasyon, Hipokrat Kitabevi & Pelikan Kitabevi."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Arranz-Mart\u00edn, B., Garc\u00eda-Gallego, P., Romay-Barrero, H., Navarro-Braz\u00e1lez, B., Mart\u00ednez-Torres, C., and Torres-Lacomba, M. (2021). Bladder Base Displacement during Abdominal Muscles Contraction and Functional Activities in Primiparous Women Assessed by Transabdominal Ultrasound: A Descriptive Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11010025"},{"key":"ref_19","first-page":"72","article-title":"The Correlations between Three Methods of Pelvic Floor Muscle Strength Assessment in Nulliparous Women: 2D Transperineal Ultrasound, Modified Oxford Scale, and PFX2\u00ae Perineometer","volume":"23","author":"Iaocharoen","year":"2023","journal-title":"Asian Med. J. Altern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Porr\u00f3n-Irigaray, A., Rodr\u00edguez-L\u00f3pez, E.S., Acevedo-G\u00f3mez, M.B., Ojedo-Mart\u00edn, C., and Benito-de-Pedro, M. (2024). Coactivation of the Pelvic Floor and Gluteus Medius Muscles While Walking and Running in Female Runners. Sensors, 24.","DOI":"10.3390\/s24051356"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Chmielewska, D., Stania, M., Sobota, G., Kwa\u015bna, K., B\u0142aszczak, E., Taradaj, J., and Juras, G. (2015). Impact of different body positions on bioelectrical activity of the pelvic floor muscles in nulliparous continent women. BioMed Res. Int., 2015.","DOI":"10.1155\/2015\/905897"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"410","DOI":"10.14744\/SEMB.2023.09522","article-title":"Investigation of Deltoid Muscle Activation From Different Angles in Body Building Athletes","volume":"57","author":"Kurtoglu","year":"2023","journal-title":"Med. Bull. Sisli Etfal Hosp."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1002\/nau.24284","article-title":"Pelvic floor and abdominal muscle responses during hypopressive exercises in women with pelvic floor dysfunction","volume":"39","author":"McLean","year":"2020","journal-title":"Neurourol. Urodyn."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Abe-Takahashi, Y., Kitta, T., Ouchi, M., Okayauchi, M., Chiba, H., Higuchi, M., Togo, M., and Shinohara, N. (2020). Reliability and validity of pelvic floor muscle strength assessment using the MizCure perineometer. BMC Women\u2019s Health, 20.","DOI":"10.1186\/s12905-020-01127-x"},{"key":"ref_25","unstructured":"\u015eahin, \u00dc.K. (2020). Stres \u0130nkontinans\u0131 Olan Kad\u0131nlarda Pelvik Taban Kas E\u011fitimine Ek Olarak Uygulanan Eksternal Elektrik Stim\u00fclasyonunun Etkileri. [PhD Thesis, Hacettepe University]."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s00192-014-2483-x","article-title":"Pelvic floor awareness and the positive effect of verbal instructions in 958 women early postdelivery","volume":"26","author":"Vermandel","year":"2015","journal-title":"Int. Urogynecol. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1002\/nau.22529","article-title":"State of the art review: Intravaginal probes for recording electromyography from the pelvic floor muscles","volume":"34","author":"Keshwani","year":"2015","journal-title":"Neurourol. Urodyn."},{"key":"ref_28","unstructured":"Ka\u00e7ar, R. (2024). Effect of Core Muscle Endurance on Pain, Posture and Upper Extremity Function in Upper Strings Players. [Master\u2019s Thesis, Gazi \u00dcniversitesi]."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s001920200027","article-title":"Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure","volume":"13","author":"Neumann","year":"2002","journal-title":"Int. Urogynecol. J. Pelvic Floor Dysfunct."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1002\/nau.1930090504","article-title":"Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: II. Validity of vaginal pressure measurements of pelvic floor muscle strength and the necessity of supplementary methods for control of correct contraction","volume":"9","author":"Kvarstein","year":"1990","journal-title":"Neurourol. Urodyn."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/477\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:49:34Z","timestamp":1760028574000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,9]]},"references-count":30,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["medicina61030477"],"URL":"https:\/\/doi.org\/10.3390\/medicina61030477","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,9]]}}}