Sex efficiency through exercises : special physical culture for women / by Th. H. van de Velde ; [photos, by E. Steinemann].

assistance is not given to the patient, who has to strain herself in consequence. Trunk Lifting and Lowering. As described under No. 16 of exercises during pregnancy (Chapter XIII.), Fig. 33. In the second note to that descrip- tion I have mentioned that the exercise may be performed alone. In such brief mention of puerperal gymnastics as is known to me in literature, the exercise is only recommended in the completely active form, and with modifications such as folding the hands over the abdomen, supporting them on the hips, folding them behind the head or stretching the arms at a level with the head. And there is no mention of the need for firm support to the feet. I am of opinion that the exercise in this form is best reserved for the later phases of the puerperal state. But, in the form and with the modifications described (in Note 2 to No. 16), it may take an early place in our repertory, even if quite active. But do not leave either the feet or the lower leg without some support that presses them firmly downwards! In general I think it is preferable to substitute this way of exercising by the exercise of " Trunk Lifting and Lowering, Holding Towel" as described in No. 18 on page 130, which enables the exertion to be modified and rationed. Knee Opening and Closing against Pressure. As described under No. 17 of exercises during pregnancy (Chapter XIII.). This exercise, and its cognate which will be described in No. 27, is mentioned in most of the available literature and recommended as specially strengthening to the pelvic floor. But, as I have already stated at length, these indirect perineal exercises have very limited effects and should be replaced or supplemented by conscious action of the perineal muscles. I prefer to recommend such direct exercise of the pelvic floor, after child-birth especially, because it is much less exhausting in itself and can, therefore, be performed more often. And it does not only tend to recovery from the distension of birth, but to mastery of the perineal muscles as well; an equally important gain !