Evaluation of Bioelectrical Activity of Pelvic Floor Muscles and Synergistic Muscles Depending on Orientation of Pelvis in Menopausal Women with Symptoms of Stress Urinary Incontinence: A Preliminary Observational Study

Abstract

Objectives. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles (PFM) and the synergistic muscles, depending on the orientation of the pelvis, in anterior (P1) and posterior (P2) pelvic tilt. Design. Preliminary, prospective observational study. Setting. Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Participants. Thirty-two menopausal and postmenopausal women with stress urinary incontinence were recruited. Based on inclusion and exclusion criteria, sixteen women aged 55 to 70 years were enrolled in the study. Primary Outcome Measures. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles by electromyography (sEMG) and vaginal probe. Secondary Outcome Measures. Evaluation of activity of the synergistic muscles by sEMG and surface electrodes. Results. No significant differences between orientations P1 and P2 were found in functional and resting sEMG activity of the PFM. During resting and functional PFM activity, higher electrical activity in P2 than in P1 has been recorded in some of the synergistic muscles. Conclusions. This preliminary study does not provide initial evidence that pelvic tilt influences PFM activation. Although different activity of synergistic muscles occurs in various orientations of the pelvic tilt, it does not have to affect the sEMG activity of the PFM.

The relation of the pelvis and the perineal function in incontinent women: A neglected subject

“…The results point to a possible association between pelvic positioning and urinary continence. However, the small sample sizes of the exploratory studies still do not allow definitive conclusions, and new investigations on the pelvic posture of women are recommended in longitudinal studies to establish causal factors …”

“…Studies evaluate the electrical activity of PFM and the positioning of the pelvis, actively performing the anteversion, and retroversion positions . A greater basal electrical activity is observed during the execution of a hypolordosis posture, that is, the pelvic retroversion in continent women .…”

“…The studies that evaluate the electrical activity of the PFM, used intravaginal probes to capture the electromyographic signal . However, these probes have different geometry to the vaginal canal of each woman, thus presenting difficulties in their fixation, mainly during functional tasks, and changes of position, which facilitates the capture of electrical signals from other muscle groups .…”

“…The relationship between pelvic posture and the presence of SUI is still controversial, however, studies have shown that changes in the pelvic positioning in continent women can influence the electrical activity of PFM . Findings indicate a relationship between pronounced lumbar lordosis, observed in dorsal decubitus, and a greater contraction capacity of PFM…”

Relationship between lower limb position and pelvic floor muscle surface electromyography activity in menopausal women: a prospective observational study

“…It is believed that the menopause plays the most significant role in this pathogenesis. Symptoms related to the urogenital system may affect 50% of women in this period 3,8–13. Many authors3,9,12,14–17 indicate a decreased level of estrogens as the main cause of the symptoms.…”