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

Abstract

ObjectivesIn physiotherapeutic practice, special attention is being given to the reciprocal anatomical, physiological, and biomechanical relationship of the pelvis and the structures connected to it. However, the scientific literature shows mainly the theoretical information about their mutual connections. The lack of information about these relations from a practical aspect coupled with the paucity of scientific papers on the impact of posture changes on the pelvic floor led the authors to conduct this study. The primary aim of this study was to compare the resting and functional bioelectrical activities of pelvic floor muscles (PFMs) depending on three different positions of the lower limbs (positions A, B, and C) in the supine position.Materials and methodsThis was a prospective observational study evaluating resting and functional activities of the PFM depending on the position of the lower limbs. The study was carried out at the Department and Clinic of Urology, University Hospital in Wroclaw, Poland and the target group were women in the menopausal period. Bioelectrical activity of PFM was recorded using a surface electromyographic instrument in the supine position. Results of the values obtained in A, B, and C positions were compared using a one-way analysis of variance.ResultsIn position A, the average resting surface electromyography (sEMG) activity of PFM was 6.9±2.6 µV; in position B, the result was 6.9±2.5 µV and in position C, the resting sEMG activity was 5.7±1.8 µV (P=0.0102). The results of the functional bioelectrical activity of PFM were as follows: position A – 20.3±11.8 µV, position B – 19.9±10.6 µV, and position C – 25.3±10.9 µV (P=0.0104).ConclusionThe results showed that in the supine position, the PFM achieved the lowest resting activity and the highest functional activity. Therefore, the supine position can be recommended for the diagnosis and therapy of weakened PFM.

Taking the Pressure Off the Patient – Understanding Digital Rectal Examinations on a Real Subject

“…Third, whilst the RTA was examined in the left lateral position, the MRI sequence from which the anatomical models were delineated from was conducted in the supine position. Whilst there is evidence in the literature that hip flexion alters the anorectal angle [15] as well as the activity and functionality of the pelvic floor [16], there is little to none empirically quantifying the degree or nature of alteration in the left lateral position when compared with the standard supine position. The complexity of this issue is compounded by the fact that merely moving the position of the body from left lateral to supine, even without flexion of the hips, has in itself been found to significantly move some elements of the abdominal and pelvic anatomy [17,18].…”

Investigation of Electromyographic Activity of Pelvic Floor Muscles in Different Body Positions to Prevent Urinary Incontinence

“…PFM activity increases when sitting from the supine position and increases further when standing [4,24,25]. The supine position is more stable than the standing or sitting position because it has a wide BOS and lower center of gravity [26].…”

“…Previous studies investigated the effect of pelvic tilt on PFMs activity [20] and synergistic muscles [19,23,24]. Ptaszkowski et al [19], Ptaszkowski et al [23], Halski et al [24] studies showed higher bioelectric activity of adductor magnus, rectus abdominis, and gluteus maximus muscles at the posterior pelvic tilt than at the anterior pelvic tilt.…”

“…Previous studies investigated the effect of pelvic tilt on PFMs activity [20] and synergistic muscles [19,23,24]. Ptaszkowski et al [19], Ptaszkowski et al [23], Halski et al [24] studies showed higher bioelectric activity of adductor magnus, rectus abdominis, and gluteus maximus muscles at the posterior pelvic tilt than at the anterior pelvic tilt. In addition, studies by Ptaszkowski et al [19], Ptaszkowski et al [23], Halski et al [24], and Ptaszkowski et al [20] found that the posterior pelvic tilt had the greatest effect on PFMs bioelectrical activity.…”

Factors Associated with Pelvic Floor Muscle Strength in Women with Pelvic Floor Dysfunction Assessed by the Brink Scale

“…20,21 Furthermore, a previous study in menopausal study reported that PFM function depends on various lower limb positions, and that the supine position is recommended for diagnosis of weakened PFM. 22 Therefore, assessing PFM and other synergists functions simultaneously in a supine position should be performed in further studies.…”