Activation of Pelvic Floor Muscle During Ankle Posture Change on the Basis of a Three-Dimensional Motion Analysis System

Abstract

BackgroundWeak pelvic floor muscles (PFMs) is an important cause of stress urinary incontinence. Effective strengthening of PFMs is very helpful in improving lower urinary tract disease. The purpose of this study was to determine the activation of PFMs in accordance with movement of the pelvis and ankle.Material/MethodsFifty healthy adults who underwent PFM contraction in ankle posture change (dorsiflexion, neutral, and plantar flexion) while standing were simultaneously measured using electromyography and motion capture systems. Muscle activity at the tibialis anterior and gastrocnemius muscles was measured by surface electromyography electrodes and PFMs was measured using anal/vaginal probe. Motion analysis was captured by 3-dimensional motion trajectories of the retro-reflective markers.ResultsAt the ankle dorsiflexion, pelvic tilted anteriorly and PFMs were activated, but there was no pelvic movement in ankle plantar flexion. Significantly greater PFM activities were seen in ankle dorsiflexion.ConclusionsPFM exercises performed in active ankle dorsiflexion positions while standing may increase the effectiveness of these exercises. For an effective pelvic floor enhancement in patients with weak PFMs, we recommend a dorsiflexion of the ankle in the standing position.

Investigation of Electromyographic Activity of Pelvic Floor Muscles in Different Body Positions to Prevent Urinary Incontinence

“…In previous studies, artificial fixation with the ankle in PF and standing position kept the coccyx moving forward due to the posterior tilt of the pelvis, resulting in shortening of the muscle fibers of the pelvic floor [6,18–20]. However, Lee [12] found that there was no pelvic movement while moving in real time, rather than that in the fixed ankle position; that is, when moving the ankle from neutral position to PF. The problems caused by incontinence in daily life are more likely to occur during natural movements than in fixed positions [12].…”

“…However, Lee [12] found that there was no pelvic movement while moving in real time, rather than that in the fixed ankle position; that is, when moving the ankle from neutral position to PF. The problems caused by incontinence in daily life are more likely to occur during natural movements than in fixed positions [12]. This is because urine leakage occurs due to changes in posture and pressure during continuous movement.…”

“…According to the above observations, when the ankle is in PF, the pelvis is tilted posteriorly, and the coccyx moves forward to shorten the muscle fiber. However, there is no pelvic movement during PF [12]. Even without pelvic movement, PFMs are activated during PF rather than during neutral position of the ankle [12].…”

“…However, there is no pelvic movement during PF [12]. Even without pelvic movement, PFMs are activated during PF rather than during neutral position of the ankle [12]. This fails to explain PFM contraction with pelvic tilt and coccyx movement alone.…”

“…Most previous studies have measured PFM function in a fixed position [9,16]. However, in daily life, physical posture is a continuous movement; hence, real-time simultaneous analysis while moving will be more accurate [12].…”