Phase-locked parallel movement of diaphragm and pelvic floor during breathing and coughing—a dynamic MRI investigation in healthy females

Abstract

in healthy women, real-time dynamic MRI demonstrates parallel cranio-caudal movement of the diaphragm and the PF during breathing and coughing and synchronous changes in abdominal wall diameter.

Pelvic floor muscle reflex activity during coughing – an exploratory and reliability study

“…Howard et al [9] investigated vesical neck descent by using ultrasonography during coughing in standing continent nulliparous women and found a mean downward movement of 8.2 AE 4.1 mm. Talasz et al [10] used real-time dynamic MRI and found a mean PFM downward movement of 7.4 AE 5.8 mm during coughing in healthy nulliparous women in the supine position.…”

Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review

“…Descent, ventral-dorsal/cranial-caudal, (dorso)-caudal direction were consistently found during coughing. One study confirmed the phase-locked parallel movement of the diaphragm and PFM during breathing by cranio-caudal movement of the diaphragm and pelvic floor in expiration and inspiration [33]. Wise et al [34] showed that the BN moves in an arc of a circle, thus indicating the multi-directional character of BN displacement.…”

“…Similar results followed in 2007 [35] and 2010 [36] with TPUS and motion tracking to analyse the dynamics of the ano-rectal angle, showing trajectories of movement and thus confirming the multi-directional displacement. Talasz et al [33] described the respiratory-related parallel vertical movement of the diaphragm and pelvic floor.…”

“…coughing Because of the dynamic character of the investigations no Bneutral position^of the lumbar spine and the os sacrum was defined, and changes in their positions during the different manoeuvres have been accepted to be adequate. disc L4/5 basis of the intervertebral disc L4/5, S pubic symphysis, C coccyx, R rectum, PCL pubo-coccygeal line, PRM pubo-rectalis muscle, AM anterolateral abdominal muscles LP ano-coccygeal raphe of the iliococcygeus muscle (levator plate) [33] • Movement of the bladder during PFMC in sagittal plane (mm, mean±SD): superior wall: 3.8±1.3/posterior wall: 7.0±2.8…”

Mechanical characterisation of porcine rectus sheath under uniaxial and biaxial tension

“…(2). Talasz et al (2011) used MRI to evaluate the change in these dimensions during coughing and found the length decreased to 304 mm, R1 remained the same and R2 reduced to 94.5 mm giving a new, reduced volume of 12.7 L. Applying Boyle's law (PV ¼ k), assuming the abdomen was sealed and gas filled, a reduction in volume of 3 L (19%) would create a 19% increase in pressure. Given a resting IAP of 1 kPa this would generate an IAP of only 1.19 kPa during coughing, much less than the average of 11 kPa reported (Cobb et al, 2005).…”