Morphological Changes After Pelvic Floor Muscle Training Measured by 3-Dimensional Ultrasonography

Brækken, Ingeborg Hoff; Majida, Memona; Engh, Marie Ellstrøm; Bø, Kari

doi:10.1097/aog.0b013e3181cbd35f

Cited by 145 publications

(56 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Considering the broad benefits of pelvic floor muscle training, we should not be discouraged by the findings presented in this paper. On one hand, in addition to increased muscle stiffness, pelvic floor muscle training also means a conscious pre-contraction of PFM during physical stress and a muscle volume increase [38, 39]. These changes are found to benefit the maintenance of continence and provide opportunities for future computer simulation work.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pelvic floor dynamics during high-impact athletic activities: A computational modeling study

Dias

Peng

Khavari

et al. 2017

Clinical Biomechanics

View full text Add to dashboard Cite

Background Stress urinary incontinence is a significant problem in young female athletes, but the pathophysiology remains unclear because of the limited knowledge of the pelvic floor support function and limited capability of currently available assessment tools. The aim of our study is to develop an advanced computer modeling tool to better understand the dynamics of the internal pelvic floor during highly transient athletic activities. Methods Apelvic model was developed based on high-resolution MRI scans of a healthy nulliparous young female. A jump-landing process was simulated using realistic boundary conditions captured from jumping experiments. Hypothesized alterations of the function of pelvic floor muscles were simulated by weakening or strengthening the levator ani muscle stiffness at different levels. Intra-abdominal pressures and corresponding deformations of pelvic floor structures were monitored at different levels of weakness or enhancement. Findings Results show that pelvic floor deformations generated during a jump-landing process differed greatly from those seen in a Valsalva maneuver which is commonly used for diagnosis in clinic. The urethral mobility was only slightly influenced by the alterations of the levator ani muscle stiffness. Implications for risk factors and treatment strategies were also discussed. Interpretation Results suggest that clinical diagnosis should make allowances for observed differences in pelvic floor deformations between a Valsalva maneuver and a jump-landing process to ensure accuracy. Urethral hypermobility may be a less contributing factor than the intrinsic sphincteric closure system to the incontinence of young female athletes.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Athletes may also demonstrate increased muscle thickness and diameter, and elevated bladder and rectum [11, 38]. These anatomical changes should also be considered to ensure the complete characterization of the pelvic floor structures of young female athletes.…”

Section: Discussionmentioning

confidence: 99%

Pelvic floor dynamics during high-impact athletic activities: A computational modeling study

Dias

Peng

Khavari

et al. 2017

Clinical Biomechanics

View full text Add to dashboard Cite

show abstract

“…Examiners obtained the following measurements in the axial plane image corresponding to the plane of minimal antero-posterior (AP) diameter of the levator hiatus: the AP diameter of the levator hiatus (LH AP ), the right-left transverse diameter of the levator hiatus (LH T ), and the area of the levator hiatus (LH area ) (see Figure 1) according to the protocol first described by Dietz and colleagues 18 and cited in several subsequent studies. [4][5][6][7][8][9][10][11][12][13][15][16][17][19][20][21][22][23][24][26][27][28][29][30] Examiners measured each of the three volumes acquired during each task (rest, contraction, Valsalva) with each participant and calculated average measurements for each measure according to each task. Statistical analyses were performed using Excel version 12.2.7 (Microsoft Corp., Redmond, WA) and SPSS version 18.0 (SPSS Inc., Chicago, IL).…”

Section: Discussionmentioning

confidence: 99%

“…4,7 Recent research has used 3D/4D transperineal US imaging to assess outcomes in an empirical investigation of the effectiveness of pelvic floor muscle training for POP. 13 The use of transperineal US imaging may also be of particular interest for therapists assessing women with urinary and fecal incontinence, given that the first line of treatment for these conditions is pelvic floor muscle training. 14 Compared to electromyography biofeedback, which is widely used clinically in rehabilitating pelvic floor muscle function, US offers a unique level of visual feedback to patients and therapists; it allows them to track changes in the morphology of the levator ani and the biometry of the levator hiatus during pelvic floor muscle contraction and relaxation.…”

mentioning

confidence: 99%

Pelvic Floor Ultrasound Imaging: Are Physiotherapists Interchangeable in the Assessment of Levator Hiatal Biometry?

Thibault-Gagnon

Gentilcore-Saulnier

Auchincloss

et al. 2014

Physiotherapy Canada

View full text Add to dashboard Cite

Purpose: To evaluate inter-examiner reliability in the ultrasound (US) assessment of levator hiatal dimensions when different physiotherapists perform independent data acquisition and analysis. Methods: In this cross-sectional observational study, 14 asymptomatic nulliparous women were imaged at rest, during pelvic floor muscle contraction, and during Valsalva manoeuvre by two physiotherapists using three-dimensional (3D) and four-dimensional (4D) transperineal US. Examiners each measured the dimensions of the levator hiatus (area and antero-posterior and transverse diameters) from the US volumes they respectively acquired. Inter-examiner reliability was determined using intra-class correlation coefficients (ICCs), and inter-examiner agreement was determined using Bland-Altman analyses. Results: The ICC results demonstrated very good inter-examiner reliability (ICC ¼ 0.84-0.98); Bland-Altman results showed high inter-examiner agreement across all measurements. Conclusions: Trained examiners may be considered interchangeable in the US assessment of levator hiatal biometry. Overall, trained physiotherapists using transperineal US imaging to assess levator hiatal biometry can be confident when comparing their own clinical findings to those of their colleagues and to findings published in the literature.Key Words: pelvic floor; reproducibility of results; three-dimensional imaging; ultrasonography. RÉ SUMÉObjectif : Examiner la fiabilité entre examinateurs de l'é valuation é chographique des dimensions hiatales du muscle releveur de l'anus lorsque des physiothé rapeutes diffé rents procè dent à l'acquisition et à l'analyse indé pendante de donné es. Mé thodes : Au cours de cette é tude par observation transversale, 14 femmes nullipares asymptomatiques ont subi un examen d'imagerie au repos, au cours d'une contraction des muscles du plancher pelvien et durant une manoeuvre de Valsalva, effectué par deux physiothé rapeutes utilisant l'é chographie transpé riné ale tridimensionnelle (3D) et quadridimensionnelle (4D). Chaque examinateur a mesuré les dimensions du hiatus du muscle releveur (superficie et diamè tre anté roposté rieur et transversal) à partir des volumes é chographiques qu'ils ont acquis respectivement. On a dé terminé la fiabilité entre examinateurs à partir des coefficients de corré lation intra-classe (CCI) et dé terminé l'uniformité entre examinateur au moyen des analyses de Bland et d'Altman. Ré sultats : Les ré sultats de l'application des CCI ont ré vé lé une trè s bonne fiabilité entre examinateurs pour toutes les mesures. (CCI ¼ 0.84-0.98); les ré sultats de Bland et Altman ont ré vé lé une grande uniformité entre examinateurs pour toutes les mesures. Conclusions : Les examinateurs qui ont rec¸u une formation peuvent ê tre considé ré s comme interchangeables dans l'é valuation é chographique de la biomé trie hiatale du muscle releveur. Dans l'ensemble, les physiothé rapeutes qui ont suivi une formation et utilisent l'imagerie é chographique transpé riné ale pour é valuer la biomé trie hiat...

show abstract

“…Supervised PFM training significantly narrowed the levator hiatus area by 4.6% in a group of middle-aged women with pelvic organ prolapse 10. To date, there are no data available on the effect of regular, supervised PFM training on the levator hiatus area during pregnancy.…”

Section: Discussionmentioning

confidence: 93%

Does general exercise training before and during pregnancy influence the pelvic floor “opening” and delivery outcome? A 3D/4D ultrasound study following nulliparous pregnant women from mid-pregnancy to childbirth

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

Morphological Changes After Pelvic Floor Muscle Training Measured by 3-Dimensional Ultrasonography

Abstract: I.

Cited by 145 publications

References 30 publications

Pelvic floor dynamics during high-impact athletic activities: A computational modeling study

Pelvic floor dynamics during high-impact athletic activities: A computational modeling study

Pelvic Floor Ultrasound Imaging: Are Physiotherapists Interchangeable in the Assessment of Levator Hiatal Biometry?

Does general exercise training before and during pregnancy influence the pelvic floor “opening” and delivery outcome? A 3D/4D ultrasound study following nulliparous pregnant women from mid-pregnancy to childbirth

Contact Info

Product

Resources

About