The Role of the Obturator Internus Muscle in Pelvic Floor Function

Tuttle, Lori J.; DeLozier, Elizabeth R.; Harter, Kimberly A.; Johnson, Stephanie A.; Plotts, Christine N.; Swartz, Jessica

doi:10.1097/jwh.0000000000000043

Cited by 27 publications

(16 citation statements)

References 18 publications

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“…A number of articles suggest that muscle performance of the trunk is associated with SIJ pain . Preliminary evidence exists to demonstrate that hip muscle performance, in particular the obturator internus, may be related to PFM performance . This literature is variable in design and descriptive definitions and thus difficult to compare.…”

Section: Discussionmentioning

confidence: 99%

A Narrative Review of Musculoskeletal Impairments Associated With Nonspecific Chronic Pelvic Pain

Harris‐Hayes

Spitznagle

Probst

et al. 2019

PM&R

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The purpose of this narrative review is to present the evidence relating to musculoskeletal impairments found in people with nonspecific chronic pelvic pain (CPP). The musculoskeletal impairments assessed in this review include pelvic floor muscle: performance, resting state, strength, activation, posture and movement patterns. A search was performed systematically using PubMed, Cochrane, CINAHL, Embase, and Web of Science databases from 1998 to 2018 to identify studies reporting the relationship between nonspecific CPP and musculoskeletal impairments of the hip, pelvis, and trunk. The search resulted in 2106 articles that were screened by two authors. Remaining articles were screened by an additional two authors for inclusion in this review. Thirty‐one articles remained after initial screening. Full‐text publications were reviewed and an additional 25 articles were excluded. Six additional articles were located through review of the reference lists of included articles. The final review included 12 publications. Seven of these studies were cross‐sectional cohorts or case‐control comparing patients with CPP to asymptomatic controls. The level of evidence for the studies included in this review was low at Levels 4 and 5. We were unable to draw clear conclusions regarding the relationships of musculoskeletal impairments and CPP because validity and use of terms and assessments were inconsistent. Further research is needed with standardized definitions and measurements to better understand the musculoskeletal system as it relates to nonspecific CPP.

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Section: Discussionmentioning

confidence: 99%

A Narrative Review of Musculoskeletal Impairments Associated With Nonspecific Chronic Pelvic Pain

Harris‐Hayes

Spitznagle

Probst

et al. 2019

PM&R

View full text Add to dashboard Cite

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“…Improvement of incontinence in patients after total hip arthroplasty has been attributed to better tensioning of obturator internus as a result of greater range of hip motion . Increase in PFM strength through a strengthening program for external hip rotators has been demonstrated …”

Section: Discussionmentioning

confidence: 99%

Evaluation of pelvic floor kinematics in continent and incontinent women during running: An exploratory study

Leitner

Moser

Eichelberger

et al. 2017

Neurourology and Urodynamics

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“…It is, therefore, feasible that mechanical loading of the levator ani can be achieved by augmenting the tension in the fascial connections between these muscles during OI contraction. This likely accounts for the improvements in PFM function through OI-targeted exercise programs in younger women [9]. Unfortunately, we do not yet know if this alternative method for PFM rehabilitation is suitable for older women with PFDs.…”

Section: Discussionmentioning

confidence: 99%

“…However, the OI shortens as the hip moves from flexion to extension, indicating its important role in providing and maintaining stability of the hip during weight bearing and propulsive motion [27]. Thus, more functional load-bearing exercises combining hip extension, external rotation and abduction appear to be better suited for OI strengthening than the commonly utilized non-weight-bearing training with a flexed hip [9]. PFM rehabilitation regimens that maximize the strength of OI contraction are likely to be especially important, when the predicted force-generating capacity of the OI is reduced with age.…”

Section: Discussionmentioning

confidence: 99%

“…To circumvent the above challenges, regimens targeting the surrounding appendicular and trunk muscles, including the obturator internus (OI), have been developed to strengthen the PFMs. Recent studies indicate that exercise programs focused on the OI reduce symptomatic urinary incontinence and improve PFM strength in younger women [9, 10]. …”

Section: Introductionmentioning

confidence: 99%

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Age-related alterations in female obturator internus muscle

et al. 2016

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Introduction and Hypothesis Pelvic floor muscle rehabilitation is a widely utilized, but often challenging therapy for pelvic floor disorders, which are prevalent in older women. Regimens involving the use of appendicular muscles, such as the obturator internus (OI), have been developed for strengthening of the levator ani muscle (LAM). However, changes that lead to potential dysfunction of these alternative targets in older women are not well known. We hypothesized that aging negatively impacts OI architecture, the main determinant of muscle function, and intramuscular extracellular matrix (ECM), paralleling age-related alterations in LAM. Methods OI and LAM were procured from three groups of female cadaveric donors (five per group): younger (20 – 40 years), middle-aged (41 – 60 years), and older (≥60 years). Architectural predictors of the excursional (fiber length, Lf), force-generating (physiological cross-sectional area, PCSA) and sarcomere length (Ls) capacity of the muscles, and ECM collagen content (measure of fibrosis) were determined using validated methods. The data were analyzed using one-way ANOVA and Tukey’s post-hoc test with a significance level of 0.05, and linear regression. Results The mean ages of the donors in the three groups were 31.2 ± 2.3 years, 47.6 ± 1.2 years, and 74.6 ± 4.2 years (P < 0.005). The groups did not differ with respect to parity or body mass index (P > 0.5). OI Lf and Ls were not affected by aging. Age >60 years was associated with a substantial decrease in OI PCSA and increased collagen content (P < 0.05). Reductions in OI and LAM force-generating capacities with age were highly correlated (r2 = 0.9). Conclusions Our findings of age-related decreases in predicted OI force production and fibrosis suggest that these alterations should be taken into consideration, when designing pelvic floor fitness programs for older women.

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The Role of the Obturator Internus Muscle in Pelvic Floor Function

Cited by 27 publications

References 18 publications

A Narrative Review of Musculoskeletal Impairments Associated With Nonspecific Chronic Pelvic Pain

A Narrative Review of Musculoskeletal Impairments Associated With Nonspecific Chronic Pelvic Pain

Evaluation of pelvic floor kinematics in continent and incontinent women during running: An exploratory study

Age-related alterations in female obturator internus muscle

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