Paula method of circular muscle exercises for urinary stress incontinence - A clinical trial

M. Liebergall-Wischnitzer, D. Hochner-Celnikier, Y. Lavy, O. Manor, R. Arbel, Ora Paltiel*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


The aim of this study was to determine the efficacy of the Paula method of circular muscle training in the management of stress incontinence (SI). The theory behind this method states that activity of distant sphincters affects other muscles. In a pilot study, 59 women, mainly hospital employees, were randomly assigned to participate in exercises according to the Paula method or pelvic floor training. Efficacy was measured by reports of incontinence, quality of life (I-QOL), pad test, and pelvic floor muscle strength (assessed by perineometer and digital examination). Both the Paula exercises and pelvic floor training produced significant changes in urinary leakage compared to baseline as measured by the pad test [mean decrease of 5.4 g (p=0.002) and 9.5 g (p =0.003), respectively]. Women randomized to the Paula method reported improvement in I-QOL scores. The Paula method was found to be efficacious for SI in a population of Israeli women. Larger community-based studies will be required to confirm these results and enable evaluation of between-group differences.

Original languageAmerican English
Pages (from-to)345-351
Number of pages7
JournalInternational Urogynecology Journal
Issue number5
StatePublished - Oct 2005

Bibliographical note

Funding Information:
Acknowledgments This work was supported by an Internal Grant for Paramedical Personnel at Hadassah and the Lillian Silverstein Fund.


  • Circular muscle training
  • Paula method
  • Stress incontinence


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