Postural response of the pelvic floor and abdominal muscles in women with and without incontinence

Smith, Michelle D.; Coppieters, Michel W.; Hodges, Paul W.

doi:10.1002/nau.20336

Cited by 156 publications

(161 citation statements)

References 56 publications

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“…1,28,34 Altered neuromuscular control is thought to be a contributing factor to the development of chronic lumbopelvic pain. 7,23,24,45,52,63 Exercises that preferentially target the transversus abdominis (TrA) are commonly incorporated into the rehabilitation t StuDy DeSigN: Controlled laboratory study.…”

Section: Changes In Lateral Abdominal Musclementioning

confidence: 99%

Changes in Lateral Abdominal Muscle Thickness During the Abdominal Drawing-in Maneuver in Those With Lumbopelvic Pain

Teyhen

Bluemle²,

Dolbeer³

et al. 2009

J Orthop Sports Phys Ther

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Section: Changes In Lateral Abdominal Musclementioning

confidence: 99%

Changes in Lateral Abdominal Muscle Thickness During the Abdominal Drawing-in Maneuver in Those With Lumbopelvic Pain

Teyhen

Bluemle²,

Dolbeer³

et al. 2009

J Orthop Sports Phys Ther

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“…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. 17,18 However, there is growing evidence from biomechanical models, 65 as well as neurophysiological 40,76,77 and epidemiological 28,66,78 studies, that this muscle group also plays an important role in postural control of the lumbopelvic region. Both low back pain (LBP) and urinary incontinence (UI) are prevalent…”

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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“…Overhearing from adjacent muscles has been suggested to be a possible source of cross-talk when recording EMG activity of the PFM (Bo andStein, 1994, Peschers et al, 2001;Sapsford and Hodges, 2001). However, no cross-talk has been observed from either the hip or the abdominal muscles when recording EMG activity of the PFM with the PeriformTM vaginal probe (Hodges et al, 2007;Smith et al, 2007b). We have also investigated the possibility of cross-talk between the abdominal muscles and the PFM as well as between the hip adductors and the PFM in a pilot study (unpublished).…”

Section: Discussionmentioning

confidence: 99%

The postural response of the pelvic floor muscles during limb movements: A methodological electromyography study in parous women without lumbopelvic pain

Sjödahl

Kvist

Gutke

et al. 2009

Clinical Biomechanics

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However, coordination of muscle activity by appropriate timing and amplitude is necessary for maintaining adequate stability in the lumbopelvic area. The aim was to develop a method using surface electromyography to detect a feed-forward response in the pelvic floor muscles during limb movements performed at a comfortable speed applicable in future studies for women with lumbopelvic pain.Methods: Ten parous women with no lumbopelvic pain in the past 12 months were included.Surface electromyographic activity was recorded from the pelvic floor muscles and unilaterally from transverses abdominis/internal oblique, rectus abdominis, erector spinae, hip adductors, rectus femoris and deltoid. The subjects performed leg lift in supine and arm lift from standing. The electromyographic onset was related to the initiation of the movement.Findings: In the majority of the women the electromyographic onsets of the pelvic floor muscles occurred before the movement was initiated, regardless of whether it was a leg or an arm lift. In addition, electromyographic onsets for the other muscles, except the rectus abdominis during the arm lift, also occurred prior to the movements. Interpretation:The findings suggest a feed-forward response in the pelvic floor muscles during leg and arm lifts in women who had previously given birth and were without lumbopelvic pain. Movements performed at a comfortable speed seem to be useful in order to detect such a response.

show abstract

Postural response of the pelvic floor and abdominal muscles in women with and without incontinence

Cited by 156 publications

References 56 publications

Changes in Lateral Abdominal Muscle Thickness During the Abdominal Drawing-in Maneuver in Those With Lumbopelvic Pain

Changes in Lateral Abdominal Muscle Thickness During the Abdominal Drawing-in Maneuver in Those With Lumbopelvic Pain

Rehabilitative Ultrasound Imaging of Pelvic Floor Muscle Function

The postural response of the pelvic floor muscles during limb movements: A methodological electromyography study in parous women without lumbopelvic pain

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