Hypopressive exercise

Hypopressive exercise (also known as hypopressive gymnastics, hypopressive technique, hypopressive method, hypopressive abdominal exercises, hypopressive abdominal technique) refers to a type of physical therapy developed in the 1980s by Marcel Caufriez, studying urogynecological postpartum recovery. The exercises were developed after Caufriez was performing a vaginal examination on a patient with uterine prolapse. He observed reduction of the prolapse during diaphragmatic aspiration. Since the development of the exercises, there have been a handful of initial studies which suggest the exercises may be of benefit in pelvic organ prolapse and incontinence. The exercises are also claimed to be of benefit in sports and prevention.

Hypo- comes from the Greek word ὑπο meaning "under". "Pressive" has the French origin pressif meaning "urgent", or alternately, marked by pressure or oppressiveness. Hence, hypopressive could be defined as "inducing lowered pressure."

The essential features of hypopressive exercise involve exhalation with expansion of the ribcage, which is paradoxical to normal ribcage movement during exhalation. The resultant negative pressure in the thoracic cavity thereby elevates the diaphragm. Apnea is then maintained after this exhalation (i.e. not breathing after exhalation). In response to the reduced abdominopelvic pressure, there is involuntary contraction of the pelvic floor and abdominal wall. This posture gives the exercise its recognizable appearance of expanded ribcage and contracted abdomen, which is then combined into a variety of postures and motions.

While voluntary contraction involves type II muscle (fast twitch) fibers, the hypopressive exercises are claimed to stimulate type I (slow twitch) fibers. Since the pelvic floor is composed of mainly involuntary fibers, traditional exercise may reduce the basal tonicity of the pelvic floor muscles.

The three criteria described by Caufriez that define a hypopressive exercise are:

Hypothesized explanations for these changes include splenic contraction reflex or changes in erythropoietin.

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