Proprioception in stress urinary incontinence: A narrative review

Abstract

Background: Urinary incontinence (UI) is more common than any other chronic disease. Stress urinary incontinence (SUI), among the various forms of urinary incontinence, is the most prevalent (50%) type of this condition. Female urinary continence is maintained through an integrated function of pelvic floor muscles (PFMs), fascial structures, nerves, supporting ligaments, and the vagina. In women with SUI, the postural activity of the PFMs is delayed and the balance ability is decreased. Many women, by learning the correct timing of a pelvic floor contraction during a cough, are able to eliminate consequent SUI. Timing is an important function of motor coordination and could be affected by proprioception. This study was conducted to review and outline the literature on proprioception as a contributory factor in SUI. Methods: PubMed, Scopus, and Google Scholar databases were systematically searched from 1998 to 2017 for articles on the topic of pathophysiology, motor control alterations, and proprioception role in women with SUI. Results: A total of 6 articles addressed the importance of proprioception in motor control and its alterations in women with SUI. There were also publications on postural control, balance, and timing alterations in women with SUI in the literature. However, there was no research on measuring proprioception in the pelvic floor in this group. Conclusion: Both the strength of the PFMs and the contraction timing and proprioception are important factors in maintaining continence. Thus, conducting research on PFMs proprioception in women with SUI, as a cause of incontinence, is encouraged.

Add-On Effect of Postural Instructions to Abdominopelvic Exercise on Urinary Symptoms and Quality of Life in Climacteric Women with Stress Urinary Incontinence. A Pilot Randomized Controlled Trial

“…Many studies have demonstrated the power and specificity of verbal instructions [18][19][20][21][22]. The single use of verbal instructions has been shown to have an impact on the distribution of activity in complementary muscles and postural muscles during different activities without any changes in the exercise performance [19].…”

“…The single use of verbal instructions has been shown to have an impact on the distribution of activity in complementary muscles and postural muscles during different activities without any changes in the exercise performance [19]. More specifically, several authors have studied the effect of verbal instructions on pelvic floor exercises performance, these studies were based in the influence of proprioceptive input in muscle activity timing, coordination, balance and posture [18,21,22]. In the study of Stafford et al [21], the activation pattern of the PFM in a sample of men was influenced by verbal instructions.…”

The Efficacy of Backward Walking on Static Stability, Proprioception, Pain, and Physical Function of Patients with Knee Osteoarthritis: A Randomized Controlled Trial

“…It had been proved that acupotomy was beneficial to reduce pain and improve joint function for KOA patients [ 45 ], which resulted in a better proprioception before intervention. On the other hand, the proprioception mainly includes the sense of position and movement and the sense of effort, force, and heaviness [ 46 ], and tendons and muscle spindles are the two major mechanoreceptors [ 47 ]. As was reported, muscle weakness or atrophy appeared in patients with OA as one of the earliest symptoms [ 48 ].…”

Effect of vitamin D supplementation on the severity of stress urinary incontinence in premenopausal women with vitamin D insufficiency: a randomized controlled clinical trial

“…Alongside this, weakened pelvic floor Open Access *Correspondence: M_kamali1984@yahoo.com muscles are linked with urinary incontinence, the most frequently reported symptom among pelvic floor disorders [2]. Stress urinary incontinence (SUI) is the most common type of urinary incontinence, with a prevalence of 50% [3]; its prevalence among Iranian women aged 40 to 50 is approximately 38.4% [4]. SUI occurs during times of elevated intraabdominal pressure (e.g., sneezing, coughing, and exercise) [5].…”