The Use of Perineal Ultrasound to Quantify Levator Activity and Teach Pelvic Floor Muscle Exercises

Abstract

Perineal ultrasound was used to detect and quantify levator activity by measuring the displacement of the internal urethral meatus against the inferoposterior margin of the symphysis pubis. Women who had previously been instructed in pelvic floor muscle exercises were more likely to contract the levator muscle when asked to do so than were those without previous instruction (P<0.0001). Of the 56 women who were unable to contract the pelvic floor on request, 32 (57%) eventually succeeded with visual ultrasound biofeedback. Pelvic floor muscle assessment and teaching can be used as an adjunct to the ultrasound assessment of urogynecologic patients, requiring at most 5 minutes. It allows quantification of lavator activity and can provide visual biofeedback, which is easily understood and readily accepted by women.

Constriction of the levator hiatus during instruction of pelvic floor or transversus abdominis contraction: a 4D ultrasound study

“…It took approximately 16 seconds to perform each manoeuvre and recording was with 4D real time ultrasound. The ultrasound transducer was covered with a condom and directed cranially on the perineum [16]. Only a minor part of the PB was scanned in order to include the back sling of the puborectal muscle.…”

Test–retest reliability of pelvic floor muscle contraction measured by 4D ultrasound

“…The position of the structures were analysed in a horizontal (x-axis) and vertical position (yaxis) relative to a horizontal reference line, at the level of the inferio-posterior margin of the PS, as described by Dietz et al (10) (Fig III). The levator plate angle was defined as the angle between the horizontal reference line and the line from the inferio-posterior margin of the PS to the anorectal angle.…”

“…(10). The position of the cervix uteri was only detected in three pairs of 17 volumes, and therefore was not analyzed.…”

Improved Activation of Lumbar Multifidus Following Spinal Manipulation: A Case Report Applying Rehabilitative Ultrasound Imaging

“…RUSI has been shown to be a reliable and valid method to measure muscle size and architectural change of pelvic floor, 7 TrA, 26,32 rectus abdominis, 37 and tibialis anterior. 23 The majority of the RUSI literature to date related to the lumbar multifidus has been focused on measuring cross-sectional area.…”