Studies and scientific evidence on pelvic floor training
Does pelvic floor muscle training work?
Medical science is unanimous: regular, correctly performed pelvic floor exercises can relieve complaints such as bladder weakness, incontinence, erectile dysfunction or prostate problems in many cases.
Like any muscle, untrained pelvic floor muscles become weak over time. Consistent pelvic floor training helps to strengthen the muscles, improve circulation and increase conscious control.
Biofeedback training devices such as PelvicTool Home & Sport from Alonea offer an effective method of strengthening and training the pelvic floor muscles by providing precise and immediate feedback on muscle activity.
Therapeutic support is essential for people with pelvic dysfunction. Targeted pelvic floor rehabilitation and regular pelvic floor training can often successfully alleviate symptoms.
„Controlled excretion is dependent on healthy pelvic floor muscles“
Studies on pelvic floor training with biofeedback
Studies of biofeedback pelvic floor training devices, which use the same physical measurement principle as Alonea’s PelvicTool (measuring the force exerted by the pelvic floor on a soft sensor tube), show that improvements in incontinence problems can be achieved.
This is documented, for example in master theses of the Zurich University of Applied Sciences (ZHAW), which were carried out in cooperation with the fitness chain «Kieser-Training» und dem City hospital Zurich, Triemli. These are exploratory studies.
„Although I lost the feeling in my pelvic floor muscles after a radical prostatectomy (RPE), I learned to control my pelvic floor muscles and reduce my incontinence symptoms with the help of PelvicTool. Seeing the progress on the app motivated me to continue.“
Improvements in muscle strength and control
Those who train regularly with the PelvicTool quickly achieve significant improvements in muscle strength and muscle control. Both are considered prerequisites for the successful therapy of incontinence problems.
Training progress is documented by automatically storing training data in the PelvicTool-App on the user’s smartphone or tablet. The results are clearly displayed both graphically and numerically. It is important that training results are tracked over time. Comparing individual results will of course show fluctuations as you do not always sit on the PelvicTool in exactly the same way and your own ‘daily form’ may vary slightly.
The PelvicTool helps you to become aware of, control and strengthen your pelvic floor.
![beckenbodentrainer-pelvictool-app](https://alonea.ch/wp-content/uploads/2024/04/beckenbodentrainer-pelvictool-app-s-scaled.jpg)
Easy and effective pelvic floor training.
Scientific studies pelvic floor trainingg
Numerous studies have focussed on pelvic floor training and its therapeutic effects. The selected scientific articles mainly refer to studies from recent years.
A particular focus is on the comparison of biofeedback methods and other Pelvic floor training methods. Some of the more recent relevant meta-studies on pelvic floor training are also listed. This grouping is intended to facilitate quick access to relevant studies on the various topics.
General studies on pelvic floor training, biofeedback, comparison of methods
- Narayanan SP, Bharucha AE. A Practical Guide to Biofeedback Therapy for Pelvic Floor Disorders. Curr Gastroenterol Rep. 2019 Apr 23;21(5):21. doi: 10.1007/s11894-019-0688-3. PMID:31016468
- Hite M, Curran T. Biofeedback for Pelvic Floor Disorders. Clin Colon Rectal Surg. 2021 Jan;34(1):56-61. doi: 10.1055/s-0040-1714287. Epub 2020 Sep 4. PMID:33536850
- García-Sánchez E, Ávila-Gandía V, López-Román J, Martínez-Rodríguez A, Rubio-Arias JÁ. What Pelvic Floor Muscle Training Load is Optimal in Minimizing Urine Loss in Women with Stress Urinary Incontinence? A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2019 Nov 8;16(22):4358. doi: 10.3390/ijerph16224358. PMID:31717291
- de Oliveira Camargo F, Rodrigues AM, Arruda RM, Ferreira Sartori MG, Girão MJ, Castro RA. Pelvic floor muscle training in female stress urinary incontinence: comparison between group training and individual treatment using PERFECT assessment scheme. Int Urogynecol J Pelvic Floor Dysfunct. 2009 Dec;20(12):1455-62. doi: 10.1007/s00192-009-0971-1. Epub 2009 Aug 19. PMID:19690792
Studies pelvic floor muscle training, prostate removal, cancer
- Wang W, Huang QM, Liu FP, Mao QQ. Effectiveness of preoperative pelvic floor muscle training for urinary incontinence after radical prostatectomy: a meta-analysis. BMC Urol. 2014 Dec 16;14:99. doi: 10.1186/1471-2490-14-99. PMID: 25515968
- Feng D, Liu S, Li D, Han P, Wei W. Analysis of conventional versus advanced pelvic floor muscle training in the management of urinary incontinence after radical prostatectomy: a systematic review and meta-analysis of randomized controlled trials. Transl Androl Urol. 2020 Oct;9(5):2031-2045. doi: 10.21037/tau-20-615. PMID: 33209667
- Xiangyun L, Zhen L, Mengyao H, Lin Z, Xiaonan S, Jingxiong W, Chunhui L, Wenwen C, Weigang Y, Yancai L. Curative effect of pelvic floor muscle exercise on urinary incontinence after radical prostatectomy-Comparisons of different approaches at different time point. Andrologia. 2022 Jun;54(5):e14373. doi: 10.1111/and.14373. Epub 2022 Mar 13. PMID: 35279870
- Xin L, Li M, Pan M. The therapeutic effect of pelvic floor muscle training on stress urinary incontinence following prostatectomy: a systematic review and meta-analysis. Transl Androl Urol. 2023 Jul 31;12(7):1155-1166. doi: 10.21037/tau-23-337. Epub 2023 Jul 24. PMID: 37554527
- Hsu LF, Liao YM, Lai FC, Tsai PS. Beneficial effects of biofeedback-assisted pelvic floor muscle training in patients with urinary incontinence after radical prostatectomy: A systematic review and metaanalysis. Int J Nurs Stud. 2016 Aug;60:99-111. doi: 10.1016/j.ijnurstu.2016.03.013. Epub 2016 Mar 30. PMID: 27297372
- Ribeiro LH, Prota C, Gomes CM, de Bessa J Jr, Boldarine MP, Dall’Oglio MF, Bruschini H, Srougi M. Long-term effect of early postoperative pelvic floor biofeedback on continence in men undergoing radical prostatectomy: a prospective, randomized, controlled trial. J Urol. 2010 Sep;184(3):1034-9. doi: 10.1016/j.juro.2010.05.040. PMID: 20643454
- Baumann FT, Reimer N, Gockeln T, Reike A, Hallek M, Ricci C, Zopf EM, Schmid D, Taaffe D, Newton RU, Galvao DA, Leitzmann M. Supervised pelvic floor muscle exercise is more effective than unsupervised pelvic floor muscle exercise at improving urinary incontinence in prostate cancer patients following radical prostatectomy – a systematic review and meta-analysis. Disabil Rehabil. 2022 Sep;44(19):5374-5385. doi: 10.1080/09638288.2021.1937717. Epub 2021 Sep 22. PMID: 34550846
- Sacomori C, Lorca LA, Martinez-Mardones M, Salas-Ocaranza RI, Reyes-Reyes GP, Pizarro-Hinojosa MN, Plasser-Troncoso J. A randomized clinical trial to assess the effectiveness of pre- and post-surgical pelvic floor physiotherapy for bowel symptoms, pelvic floor function, and quality of life of patients with rectal cancer: CARRET protocol. Trials. 2021 Jul 13;22(1):448. doi: 10.1186/s13063-021-05396-1. PMID: 34256795
- Kim YU, Lee DG, Ko YH. Pelvic floor muscle exercise with biofeedback helps regain urinary continence after robot-assisted radical prostatectomy. Yeungnam Univ J Med. 2021 Jan;38(1):39-46. doi: 10.12701/yujm.2020.00276. Epub 2020 Jun 22. PMID: 32668526
- Sayner A, Nahon I. Pelvic Floor Muscle Training in Radical Prostatectomy and Recent Understanding of the Male Continence Mechanism: A Review. Semin Oncol Nurs. 2020 Aug;36(4):151050. doi: 10.1016/j.soncn.2020.151050. Epub 2020 Jul 14. PMID: 32674975
- Hodges PW, Stafford RE, Hall L, Neumann P, Morrison S, Frawley H, Doorbar-Baptist S, Nahon I, Crow J, Thompson J, Cameron AP. Reconsideration of pelvic floor muscle training to prevent and treat incontinence after radical prostatectomy. Urol Oncol. 2020 May;38(5):354-371. doi: 10.1016/j.urolonc.2019.12.007. Epub 2019 Dec 25. PMID: 31882228
- Milios JE, Ackland TR, Green DJ. Pelvic floor muscle training in radical prostatectomy: a randomized controlled trial of the impacts on pelvic floor muscle function and urinary incontinence. BMC Urol. 2019 Nov 15;19(1):116. doi: 10.1186/s12894-019-0546-5. PMID: 31729959
- Aydın Sayılan A, Özbaş A. The Effect of Pelvic Floor Muscle Training On Incontinence Problems After Radical Prostatectomy. Am J Mens Health. 2018 Jul;12(4):1007-1015. doi: 10.1177/1557988318757242. Epub 2018 Mar 14. PMID: 29540090
- Yu K, Bu F, Jian T, Liu Z, Hu R, Chen S, Lu J. Urinary incontinence rehabilitation of after radical prostatectomy: a systematic review and network meta-analysis. Front Oncol. 2024 Mar 22;13:1307434. doi: 10.3389/fonc.2023.1307434. eCollection 2023. PMID: 38584666
Pelvic floor studies in old age
- Gödl-Purrer, B. Der Beckenboden im Alter. Manuelle Medizin 58, 204–209 (2020). https://doi.org/10.1007/s00337-020-00702-5
- Fritsch H (2015) Anatomie des weiblichen Beckenbodens. In: Michel M, Thüroff J, Janetschek G, Wirth M (Hrsg) Die Urologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. doi:10.1007/978-3-662-63400-4
- Schleip R (2003) Fascial plasticity: a new neurobiological explanation. J Bodyw Mov Ther 7(1):11–19. https://doi.org/10.1016/S1360-8592(02)00067-0
- Burnett LA, Cook M, Shah S, Michelle Wong M, Kado DM, Alperin M. Age-associated changes in the mechanical properties of human cadaveric pelvic floor muscles. J Biomech. 2020 Jan 2;98:109436. doi: 10.1016/j.jbiomech.2019.109436. Epub 2019 Oct 31. PMID:31708240
- Schleip R, Gabbiani G, Wilke J, Naylor I, Hinz B, Zorn A, Jäger H, Breul R, Schreiner S, Klingler W. Fascia Is Able to Actively Contract and May Thereby Influence Musculoskeletal Dynamics: A Histochemical and Mechanographic Investigation. Front Physiol. 2019 Apr 2;10:336. doi: 10.3389/fphys.2019.00336. eCollection 2019. PMID:31001134
- Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018 Oct 4;10(10):CD005654. doi: 10.1002/14651858.CD005654.pub4. PMID:30288727
- Talasz H, Kofler M, Kalchschmid E, Pretterklieber M, Lechleitner M. Breathing with the pelvic floor? Correlation of pelvic floor muscle function and expiratory flows in healthy young nulliparous women. Int Urogynecol J. 2010 Apr;21(4):475-81. doi: 10.1007/s00192-009-1060-1. Epub 2009 Dec 8. PMID:19997721
- Sliekerten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. Pelvic floor muscle function in a general female population in relation with age and parity and the relation between voluntary and involuntary contractions of the pelvic floor musculature. Int Urogynecol J Pelvic Floor Dysfunct. 2009 Dec;20(12):1497-504. doi: 10.1007/s00192-009-0978-7. Epub 2009 Sep 4. PMID:19756345
- Delancey JO, Kane Low L, Miller JM, Patel DA, Tumbarello JA. Graphic integration of causal factors of pelvic floor disorders: an integrated life span model. Am J Obstet Gynecol. 2008 Dec;199(6):610.e1-5. doi: 10.1016/j.ajog.2008.04.001. Epub 2008 Jun 4. PMID:18533115
- Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, Spino C, Whitehead WE, Wu J, Brody DJ; Pelvic Floor Disorders Network. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008 Sep 17;300(11):1311-6. doi: 10.1001/jama.300.11.1311. PMID:18799443
- Miller JM, Sampselle C, Ashton-Miller J, Hong GR, DeLancey JO. Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2008 Jun;19(6):773-82. doi: 10.1007/s00192-007-0525-3. PMID:18204797
- Trowbridge ER, Wei JT, Fenner DE, Ashton-Miller JA, Delancey JO. Effects of aging on lower urinary tract and pelvic floor function in nulliparous women. Obstet Gynecol. 2007 Mar;109(3):715-20. doi: 10.1097/01.AOG.0000257074.98122.69. PMID:17329525
- Talasz H, Gosch M, Enzelsberger H, Rhomberg HP. Female geriatric patients with urinary incontinence symptoms and their control over pelvic floor muscles Z Gerontol Geriatr. 2005 Dec;38(6):424-30. doi: 10.1007/s00391-005-0301-2. PMID:16362558
- Sapsford RR, Hodges PW, Richardson CA, Cooper DH, Markwell SJ, Jull GA. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises Neurourol Urodyn. 2001;20(1):31-42. doi: 10.1002/1520-6777(2001)20:1<31::aid-nau5>3.0.co;2-p. PMID:11135380
Studies on pelvic floor muscle training and faecal incontinence
- Bharucha AE, Knowles CH, Mack I, Malcolm A, Oblizajek N, Rao S, Scott SM, Shin A, Enck P. Faecal incontinence in adults. Nat Rev Dis Primers. 2022 Aug 10;8(1):53. doi: 10.1038/s41572-022-00381-7. PMID:35948559
- Öztürk Ö, Özin Y, Bacaksız F, Tenlik İ, Arı D, Gökbulut V, Akdoğan Ö, Yüksel M, Yeşil B, Yalınkılıç ZM. The Efficacy of Biofeedback Treatment in Patients with Fecal Incontinence. Turk J Gastroenterol. 2021 Jul;32(7):567-574. doi: 10.5152/tjg.2021.20430. PMID:34464319
- Mazur-Bialy AI, Kołomańska-Bogucka D, Opławski M, Tim S. Physiotherapy for Prevention and Treatment of Fecal Incontinence in Women-Systematic Review of Methods. J Clin Med. 2020 Oct 12;9(10):3255. doi: 10.3390/jcm9103255. PMID:33053702
- Brown HW, Dyer KY, Rogers RG. Management of Fecal Incontinence. Obstet Gynecol. 2020 Oct;136(4):811-822. doi: 10.1097/AOG.0000000000004054. PMID:32925633
- Pun MY, Leung PH, Chan TC, Pang C, Chan KH, Kannan P. The effectiveness of physiotherapy interventions on fecal incontinence and quality of life following colorectal surgery: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer. 2024 Jan 13;32(2):103. doi: 10.1007/s00520-023-08294-1. PMID:38217744
- Narayanan SP, Bharucha AE. A Practical Guide to Biofeedback Therapy for Pelvic Floor Disorders. Curr Gastroenterol Rep. 2019 Apr 23;21(5):21. doi: 10.1007/s11894-019-0688-3. PMID:31016468
- Freeman A, Menees S. Fecal Incontinence and Pelvic Floor Dysfunction in Women: A Review. Gastroenterol Clin North Am. 2016 Jun;45(2):217-37. doi: 10.1016/j.gtc.2016.02.002. PMID:27261895
- Vonthein R, Heimerl T, Schwandner T, Ziegler A. Electrical stimulation and biofeedback for the treatment of fecal incontinence: a systematic review. Int J Colorectal Dis. 2013 Nov;28(11):1567-77. doi: 10.1007/s00384-013-1739-0. Epub 2013 Jul 31. PMID:23900652
- Enck P, Van der Voort IR, Klosterhalfen S. Biofeedback therapy in fecal incontinence and constipation Neurogastroenterol Motil. 2009 Nov;21(11):1133-41. doi: 10.1111/j.1365-2982.2009.01345.x. Epub 2009 Jun 30. PMID:19566591
- Heymen S, Scarlett Y, Jones K, Ringel Y, Drossman D, Whitehead WE. Randomized controlled trial shows biofeedback to be superior to pelvic floor exercises for fecal incontinence. Dis Colon Rectum. 2009 Oct;52(10):1730-7. doi: 10.1007/DCR.0b013e3181b55455. PMID:19966605
- Norton C, Chelvanayagam S, Wilson-Barnett J, Redfern S, Kamm MA. Randomized controlled trial of biofeedback for fecal incontinence. Gastroenterology. 2003 Nov;125(5):1320-9. doi: 10.1016/j.gastro.2003.09.039. PMID:14598248
- Ko CY, Tong J, Lehman RE, Shelton AA, Schrock TR, Welton ML. Biofeedback is effective therapy for fecal incontinence and constipation. Arch Surg. 1997 Aug;132(8):829-33; discussion 833-4. doi: 10.1001/archsurg.1997.01430320031004. PMID:9267265
Studies on pelvic floor training for children and adolescents
- Santos JD, Lopes RI, Koyle MA. Bladder and bowel dysfunction in children: An update on the diagnosis and treatment of a common, but underdiagnosed pediatric problem. Can Urol Assoc J. 2017 Jan-Feb;11(1-2Suppl1):S64-S72. doi: 10.5489/cuaj.4411. PMID:28265323
- Ladi-Seyedian S, Kajbafzadeh AM, Sharifi-Rad L, Shadgan B, Fan E. Management of non-neuropathic underactive bladder in children with voiding dysfunction by animated biofeedback: a randomized clinical trial. Urology. 2015 Jan;85(1):205-10. doi: 10.1016/j.urology.2014.09.025. Epub 2014 Nov 11. PMID:25444633
- Kajbafzadeh AM, Sharifi-Rad L, Ghahestani SM, Ahmadi H, Kajbafzadeh M, Mahboubi AH. Animated biofeedback: an ideal treatment for children with dysfunctional elimination syndrome. J Urol. 2011 Dec;186(6):2379-84. doi: 10.1016/j.juro.2011.07.118. Epub 2011 Oct 22. PMID:22019033
- Schulman SL, Von Zuben FC, Plachter N, Kodman-Jones C. Biofeedback methodology: does it matter how we teach children how to relax the pelvic floor during voiding? J Urol. 2001 Dec;166(6):2423-6. doi: 10.1016/s0022-5347(05)65607-8. PMID:11696803
- De Paepe H, Renson C, Van Laecke E, Raes A, Vande Walle J, Hoebeke P. Pelvic-floor therapy and toilet training in young children with dysfunctional voiding and obstipation. BJU Int. 2000 May;85(7):889-93. doi: 10.1046/j.1464-410x.2000.00664.x. PMID:10792172
- Schneider MS, King LR, Surwit RS. Kegel exercises and childhood incontinence: a new role for an old treatment. J Pediatr. 1994 Jan;124(1):91-2. doi: 10.1016/s0022-3476(94)70259-4. PMID:8283381
- Sugar EC, Firlit CF. Urodynamic biofeedback: a new therapeutic approach for childhood incontinence/infection (vesical voluntary sphincter dyssynergia). J Urol. 1982 Dec;128(6):1253-8. doi: 10.1016/s0022-5347(17)53450-3. PMID:7154180
- Zivkovic V, Lazovic M, Vlajkovic M, Slavkovic A, Dimitrijevic L, Stankovic I, Vacic N. Diaphragmatic breathing exercises and pelvic floor retraining in children with dysfunctional voiding. Eur J Phys Rehabil Med. 2012 Sep;48(3):413-21. Epub 2012 Jun 5. PMID:22669134
- Baskin, L. S., Kogan, B. A., & Stock, J. A. (2019). Handbook of Pediatric Urology. Wolters Kluwer
Studies on pelvic floor training after pregnancy and birth
- Meekins AR, Siddiqui NY. Diagnosis and Management of Postpartum Pelvic Floor Disorders. Obstet Gynecol Clin North Am. 2020 Sep;47(3):477-486. doi: 10.1016/j.ogc.2020.05.002. PMID:32762932
- Höder A, Stenbeck J, Fernando M, Lange E. Pelvic floor muscle training with biofeedback or feedback from a physiotherapist for urinary and anal incontinence after childbirth – a systematic review. BMC Womens Health. 2023 Nov 18;23(1):618. doi: 10.1186/s12905-023-02765-7. PMID:37980530
- Oakley SH, Ghodsi VC, Crisp CC, Estanol MV, Westermann LB, Novicki KM, Kleeman SD, Pauls RN. Impact of Pelvic Floor Physical Therapy on Quality of Life and Function After Obstetric Anal Sphincter Injury: A Randomized Controlled Trial. Female Pelvic Med Reconstr Surg. 2016 Jul-Aug;22(4):205-13. doi: 10.1097/SPV.0000000000000255. PMID:26829343
- Peirce C, Murphy C, Fitzpatrick M, Cassidy M, Daly L, O’Connell PR, O’Herlihy C. Randomised controlled trial comparing early home biofeedback physiotherapy with pelvic floor exercises for the treatment of third-degree tears (EBAPT Trial). BJOG. 2013 Sep;120(10):1240-7; discussion 1246. doi: 10.1111/1471-0528.12194. Epub 2013 Jun 19. PMID:23782995
- Romeikienė KE, Bartkevičienė D. Pelvic-Floor Dysfunction Prevention in Prepartum and Postpartum. Periods Medicina (Kaunas). 2021 Apr 16;57(4):387. doi: 10.3390/medicina57040387. PMID:33923810
- Alouini S, Memic S, Couillandre A. Pelvic Floor Muscle Training for Urinary Incontinence with or without Biofeedback or Electrostimulation in Women: A Systematic Review. Int J Environ Res Public Health. 2022 Feb 27;19(5):2789. doi: 10.3390/ijerph19052789. PMID:35270480
Studies on pelvic floor and sports
- Bonaldi L, Mascolini MV, Todesco M, Zara A, Rossato C, Fede C, Fontanella CG, Stecco C. Urinary Incontinence and Other Pelvic Floor Dysfunctions as Underestimated Problems in People under Forty Years: What Is Their Relationship with Sport? Life (Basel). 2023 Dec 30;14(1):67. doi: 10.3390/life14010067. PMID:38255682
- Culleton-Quinn E, Bø K, Fleming N, Mockler D, Cusack C, Daly D. Elite female athletes’ experiences of symptoms of pelvic floor dysfunction: A systematic review. Int Urogynecol J. 2022 Oct;33(10):2681-2711. doi: 10.1007/s00192-022-05302-6. Epub 2022 Aug 30. PMID:36040507
- Giagio S, Innocenti T, Pillastrini P, Gava G, Salvioli S. What is known from the existing literature about the available interventions for pelvic floor dysfunction among female athletes? A scoping review. Neurourol Urodyn. 2022 Feb;41(2):573-584. doi: 10.1002/nau.24883. Epub 2022 Jan 30. PMID:35094428
- Giagio S, Salvioli S, Pillastrini P, Innocenti T. Sport and pelvic floor dysfunction in male and female athletes: A scoping review. Neurourol Urodyn. 2021 Jan;40(1):55-64. doi: 10.1002/nau.24564. Epub 2020 Nov 2. PMID:33137211
- Pires T, Pires P, Moreira H, Viana R. Prevalence of Urinary Incontinence in High-Impact Sport Athletes: A Systematic Review and Meta-Analysis. J Hum Kinet. 2020 Jul 21;73:279-288. doi: 10.2478/hukin-2020-0008. eCollection 2020 Jul. PMID:32774559
- Bø K. Urinary incontinence, pelvic floor dysfunction, exercise and sport. Sports Med. 2004;34(7):451-64. doi: 10.2165/00007256-200434070-00004. PMID:15233598
Further information
Training recommendation pelvic floor trainer Home & Sport
Training the pelvic floor muscles is not fundamentally different from training other muscle groups. The muscle will become stronger and easier to control if you continuously build it up through regular training.
However, with pelvic floor muscles, the focus is often not so much on pure muscle strength, but on their control: More attention should be paid to neuromuscular aspects.
Learn more about the recommended frequency and intensity of training in our instructions!
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