Pelvic Floor Muscle (Kegel) Exercises

Pelvic Floor Muscle (Kegel) Exercises Policy 

Purpose: To provide guidelines for residents capable of performing pelvic floor muscle exercises (Kegel exercises) to strengthen their pelvic floor muscles, improving urinary and bowel control and overall pelvic health. 

Procedure: 

I. Resident Eligibility: This exercise program is appropriate for residents who are capable of comprehending and following directions, specifically those in the restoration level and high level of compensation cognitive function. 

II. Finding the Muscle: 

• Have the resident imagine tightening muscles to avoid passing gas. 

• Have the resident "wink" the rectum. 

• Have the resident voluntarily stop the stream of urine when voiding. 

• Have the resident tighten muscles to pull the rectum, vagina, and urethra up and inside the body. 

• Have the resident insert the tip of their finger into their anus and squeeze the muscle around the finger. 

• For males, have the resident try to make the penis move up and down without moving the rest of the body. 

III. Performing the Exercise: 

• The quality of the muscle contraction is critical. Though instructed properly, many residents cannot achieve an effective contraction of the pelvic floor muscles or contract accessory musculature. Residents should not hold their breath while performing the exercises. 

• Squeeze the muscle for 5 seconds, relax for 5 seconds. The balance between contracting and relaxing is important. Have the resident count the seconds of contraction and relaxation out loud. 

• Repeat the exercise 5 times, progressing to 10 as the resident is able. 

• Repeat the exercise session 3 times during the day. 

• For one session, perform the exercises lying down; for another, sitting; and for another, standing. 

IV. Frequency of Exercise: 

• Perform the exercise 3 times a day, with 5-10 repetitions each session. 

• Perform the exercise in a different position each session (lying, sitting, and standing). 

• The time of day each exercise is performed is not critical. 

Documentation: 

• Document the resident's participation, progress, and any difficulties or improvements in their care plan. 

• Report any issues or concerns to the supervising nurse or physical therapist for further evaluation and adjustment of the exercise program. 

References: 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS.