Hypopressive Exercise for Pelvic Floor Rehabilitation in Women: A Critical Narrative Review of Current Evidence

Dr. Bhavika Parikh

Abstract: Background: Hypopressive exercise (HE), also described as abdominal hypopressive technique (AHT), is a breathing- and posture-based exercise approach proposed for pelvic floor rehabilitation. Its clinical use has expanded despite continuing uncertainty regarding its comparative effectiveness relative to pelvic floor muscle training (PFMT). Objective: To critically synthesize current evidence concerning the effects of HE on pelvic floor muscle function, pelvic organ prolapse (POP), urinary incontinence (UI), postpartum pelvic floor outcomes, abdominal muscle outcomes, and patient-reported outcomes, with particular attention to comparisons with PFMT and combined programmes. Methods: This critical narrative review was developed from an original academic presentation and updated through targeted literature verification using PubMed and publisher-indexed records through September 2026. Priority was given to randomized controlled trials, prospective comparative studies, and systematic reviews involving adult women. Because the underlying work did not use a prospectively registered systematic-review protocol, reproducible duplicate screening, formal risk-of-bias procedures across all studies, or meta-analysis, it is presented as a narrative review rather than a systematic review. Results: The evidence is heterogeneous. Randomized trials in POP have generally reported greater benefit from PFMT than HE for several pelvic-floor outcomes, and adding HE to PFMT has not consistently produced additional benefit. Other trials have reported improvement with HE compared with no intervention and similar improvements to PFMT for selected outcomes. A 2024 systematic review found that HE could improve pelvic floor strength, tone and symptoms, but effects were generally less than or similar to PFMT, with no additional benefit when combined with PFMT. Recent 2025?2026 studies add evidence of improved pelvic floor contractility and selected postpartum abdominal, body-image and pelvic-floor symptom outcomes, while a 2026 observational study found levator ani activation without a significant reduction in intra-abdominal pressure. Conclusion: Current evidence does not establish HE as superior to PFMT for pelvic floor rehabilitation. HE may have a complementary role in selected women, particularly when abdominal, postural, breathing, functional or preference-related goals are relevant. PFMT should remain a central component of evidence-based pelvic floor rehabilitation.

Keywords: hypopressive exercise; abdominal hypopressive technique; pelvic floor muscle training; pelvic floor dysfunction; pelvic organ prolapse; urinary incontinence; postpartum rehabilitation

How to Cite?: Dr. Bhavika Parikh, "Hypopressive Exercise for Pelvic Floor Rehabilitation in Women: A Critical Narrative Review of Current Evidence", Volume 15 Issue 9, September 2026, International Journal of Science and Research (IJSR), Pages: 1088-1093, https://www.ijsr.net/getabstract.php?paperid=MR26917085623, DOI: https://dx.doi.org/10.21275/MR26917085623

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