Differences in muscle activation patterns during pelvic floor muscle contraction and Valsalva manouevre

Thompson, Judith; O’Sullivan, Peter; Briffa, N. Kathryn; Neumann, Patricia

doi:10.1002/nau.20203

Cited by 82 publications

(101 citation statements)

References 41 publications

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“…Specifically, ultrasound imaging has been shown to be more specific than intravaginal palpation for measurement of the lifting action of the pelvic floor muscles on the bladder neck 31 and base, 20,31 and it provides information about the supporting function of the pelvic floor muscles during various maneuvers. 20,57,85 As the use of rehabilitative ultrasound imaging for assessment of pelvic floor muscles function is a relatively new procedure, the goal of this commentary i t is well accepted that the pelvic floor muscles, specifically the levator ani, provide an important contribution to the continence mechanism.17 is to provide an understanding of current applications, the available quantitative and qualitative information, the associated limitations, and to show how rehabilitative ultrasound imaging can be incorporated as a form of biofeedback during rehabilitation. Furthermore, as the compilation and comparison of data depends on consistency of measurement techniques, this commentary highlights considerations for measurement accuracy and interpretation and provides generic guidelines for future investigation based upon international consensus.…”

mentioning

confidence: 99%

Rehabilitative Ultrasound Imaging of Pelvic Floor Muscle Function

Whittaker¹,

Thompson²,

Teyhen³

et al. 2007

J Orthop Sports Phys Ther

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found that 78% of women with LBP report concurrent UI. As such, there is a need for physical therapists to have access to tools that accurately evaluate the various aspects of pelvic floor muscle function (elevating and occlusion functions, as well as neuromuscular control, strength, and endurance) both in laboratory and clinical environments.Ultrasound imaging is a potential tool that has been used to evaluate the morphology 7,52 and certain components of the function 24,27,67,81,82,86 of these muscles. Specifically, ultrasound imaging has been shown to be more specific than intravaginal palpation for measurement of the lifting action of the pelvic floor muscles on the bladder neck 31 and base, 20,31 and it provides information about the supporting function of the pelvic floor muscles during various maneuvers. 20,57,85 As the use of rehabilitative ultrasound imaging for assessment of pelvic floor muscles function is a relatively new procedure, the goal of this commentary i t is well accepted that the pelvic floor muscles, specifically the levator ani, provide an important contribution to the continence mechanism.17 is to provide an understanding of current applications, the available quantitative and qualitative information, the associated limitations, and to show how rehabilitative ultrasound imaging can be incorporated as a form of biofeedback during rehabilitation. Furthermore, as the compilation and comparison of data depends on consistency of measurement techniques, this commentary highlights considerations for measurement accuracy and interpretation and provides generic guidelines for future investigation based upon international consensus. 80QuantitatiVe eVaLuation u ltrasound imaging has been used to measure the morphology 7,52 of the pelvic floor muscles. It has also been used to measure the impact of pelvic floor muscle contraction or increase in intra-abdominal pressure (straining, cough, sneeze, or leg-raising task) on the bladder from a variety of approaches (transperineal and transabdominal; Figure 1), planes (sagittal and transverse), and positions. 6,22,27,57,61,67,76,83,84,96 The transperineal approach (placement of the ultrasound transducer in a sagittal plane along the midline of the perineum) is considered advantageous to the transabdominal approach, as both the pubic symphysis and the proximal junction of the bladder neck and urethra are included within the field of view and can serve

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mentioning

confidence: 99%

Rehabilitative Ultrasound Imaging of Pelvic Floor Muscle Function

Whittaker¹,

Thompson²,

Teyhen³

et al. 2007

J Orthop Sports Phys Ther

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“…Further, increases in intraabdominal pressure due to splinting of the diaphragm and oblique abdominals can result in hypertonicity of the PFMs, causing further impaired function. 33,38,39 However, given that this patient's ASLR test improved with the provision of external compression by the therapist, hypertonicity of the PFMs was unlikely. Had this patient's SUI not improved with the treatment employed, referral to an urogynecological physical therapist for additional assessment would have been indicated.…”

Section: Limitationsmentioning

confidence: 96%

Lumbopelvic Dysfunction and Stress Urinary Incontinence: A Case Report Applying Rehabilitative Ultrasound Imaging

Painter¹,

Ogle²,

Teyhen³

2007

J Orthop Sports Phys Ther

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activity that increases intra-abdominal pressure.7 Bo et al 4 have reported that 20% of otherwise fit, healthy, nulliparous women have urine loss that caused social or hygienic problems. Prevalence in female athletes varies between 0% to 80%, 2 with a higher incidence reported in athletes participating in high-impact sports (eg, trampolinist, gymnast, track and field events).2 Further, 28% of nulliparous elite athletes reported urine loss while participating in athletic events. 29Davis et al 9 conducted a descriptive study at 3 United States Army training facilities to assess the prevalence of urinary incontinence among female soldiers. P revalence rates of stress urinary incontinence (SUI) vary between 10% to 55% in women between the ages of 15 to 64 years.2 Although SUI is a condition traditionally thought to occur in older, multiparous women, a number of descriptive studies have reported SUI in young, nulliparous women, [2][3][4]12,23 typically as an involuntary loss of urine that occurs when pressure is exerted on the bladder by sneezing, coughing, laughing, or any other physical t stuDy DEsign: Case report.t backgrOunD: It has been suggested that altered neuromuscular control of the transversus abdominis and pelvic floor muscles may contribute to sacroiliac joint (SIJ) region pain and stress urinary incontinence. There are limited examples describing the evaluation and management of individuals with both SIJ region pain and stress urinary incontinence in the literature. This case report describes a patient with both conditions and details the integration of rehabilitative ultrasound imaging (RUSI) during physical therapy evaluation. t casE DEscriPtiOn: A 35-year-old female soldier presented with a 6-week history of left buttock pain and 4-year history of stress urinary incontinence during activities that involved running, jumping, and fast walking. RUSI was used to supplement the physical assessment process, revealing altered motor control strategies of the transversus abdominis and pelvic floor muscles, and as a form of biofeedback during the rehabilitation process.t OutcOMEs: After completing a rehabilitation program that incorporated principles of lumbar stabilization and pelvic floor muscle re-education, this patient was able to complete all physical activities in basic combat training without SIJ region pain or urinary leakage.t DiscussiOn: This case demonstrates the importance of considering pelvic floor muscle dysfunction and training in a patient with primary complaints of SIJ region pain. It also highlights the potential role of RUSI as both an evaluation and biofeedback tool for the deep abdominal and pelvic floor muscles.

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“…O assoalho pélvico (AP) é o conjunto de tecidos que reveste a porção inferior da cavidade pélvica, cuja função é determinada pela interação de ligamentos, músculos e fáscias (Rocha, Fraga, 2005;Thompson, O'Sullivan, Briffa, 2006). Dentre as funções do AP podemos citar a sustentação dos órgãos abdominais e pélvicos, a estabilização do tronco, a participação na função sexual e a manutenção da continência urinária e fecal (Ciofu, Haab, 2005;Assis, 2013).…”

Section: Introductionunclassified

Força muscular perineal e incontinência urinária e anal em mulheres após o parto: estudo transversal

Zizzi¹

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DEDICATÓRIA Dedico esta dissertação à minha amada mãe, que nunca mediu esforços para proporcionar a mim e aos meus irmãos estrutura para alcançarmos nossos objetivos. Devo a você todas as minhas conquistas. AGRADECIMENTOS RESUMO Introdução:A gravidez e o parto são frequentemente associados à redução da força dos músculos do assoalho pélvico (FMAP) e à incontinência urinária (IU) e anal (IA), devido às alterações que ocasionam nos mecanismos de controle e suporte das estruturas do assoalho pélvico. Objetivos: O objetivo geral foi analisar a FMAP e a IU e IA no período pós-parto e os específicos foram verificar a associação da FMAP com a IU e a IA após o parto e identificar os fatores associados à FMAP, à IU e à IA após o parto e a interferência da IU na vida da puérpera. Método: Estudo transversal, com 128 mulheres nos primeiros 6 meses após o parto, conduzido em um serviço do setor suplementar de saúde, em Guarulhos, SP. Foram incluídas todas as mulheres integrantes da coorte "Cuidado perineal na gestação e após o parto: prevenção e morbidade relacionadas à força muscular perineal, função sexual e continência urinária", que compareceram ao menos a um retorno do pós-parto. O parto vaginal predispõe à redução da FMAP e a cesariana é fator protetor à sua redução. A IU durante a gestação é preditora da IU após o parto e em mulheres com gestação anterior e recém-nascido de maior peso a IU é mais frequente. A interferência da IU na vida da mulher foi moderada. Apenas a IA prévia teve associação com a IA após o parto. Não é possível concluir que há associação direta entre tempo de coabitação com o parceiro e FMAP e IU e atividade sexual após o parto. ABSTRACT Introduction: Pregnancy and childbirth are often associated with reduced pelvic floor muscles strength (PFMS), urinary (UI) and anal incontinence (AI) because of the changes in the mechanisms of control and support of the pelvic floor structures. Objectives: To analyse the PFMS, UI and AI during postpartum period. To verify the association of PFMS with UI and AI after birth. To identify factors associated with PFMS, UI and AI after birth and the interference of UI in the quality of life after birth. Methods: Cross-sectional study with 128 women in the first six months after birth, held in an insurance health care facility in Guarulhos, SP. All women participants of the cohort "Perineal care during pregnancy and after birth: prevention and morbidity related to PFMS, sexual function and UI" who attended at least one postpartum consultation were included. Data were collected through interviews, PFMS was measured by perineometry (Peritron™) and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) was applied to women who reported UI. Descriptive, inferential and multivariate analyses were performed. The research was approved by the Research Ethics Committee of School of Nursing of University of Sao Paulo. Results: The main score of PFMS was 33.1 cmH 2 O (SD=16.0). There was no statistically significant difference between PFMS during pregna...

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Differences in muscle activation patterns during pelvic floor muscle contraction and Valsalva manouevre

Cited by 82 publications

References 41 publications

Rehabilitative Ultrasound Imaging of Pelvic Floor Muscle Function

Rehabilitative Ultrasound Imaging of Pelvic Floor Muscle Function

Lumbopelvic Dysfunction and Stress Urinary Incontinence: A Case Report Applying Rehabilitative Ultrasound Imaging

Força muscular perineal e incontinência urinária e anal em mulheres após o parto: estudo transversal

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