Transabdominal ultrasound measurement of pelvic floor muscle activity when activated directly or via a transversus abdominis muscle contraction

Research background and hypothesis. The absolute dominance of the isolated muscle presentation as the first and last word in muscular anatomy leaves the current generation of therapists unlikely to think any other way (Myers, 2009). Hypothesis: functional relationships could be found between pelvic floor, diaphragm, and trunk muscles in men with prostate cancer.Research aim. The aim of the study was to evaluate functional associations between pelvic floor, diaphragm, and trunk muscles among men with prostate cancer. Research methods. The study included 81 male volunteers diagnosed with prostate cancer with measurements conducted one day before radical prostatectomy. Pelvic floor muscle strength and endurance were measured using “Peritron 9300” device, the strength of diaphragm – with “MicroRPM”, the strength of transversus abdominis muscle – with “Stabilizer”. Trunk muscles were tested using tests for static postural endurance of abdominal and back muscles. Associations were estimated using Pearson’s correlation coefficient (r). Research results. Analysis of functional indicators of muscles demonstrated high linear associations between strength of pelvic floor and diaphragm (r = 0.79), between strength of diaphragm and exhalation muscles (r = 0.78), and between static endurance of abdominal and back muscles (r = 0.72). We determined moderate correlations between endurance of pelvic floor and strength of transversus abdominis muscle (r = 0.59), between strength of transversus abdominis and static endurance of abdominal muscles (r = 0.69), between strength of diaphragm and static endurance of abdominal (r = 0.56) and back muscles (r = 0.51), between the strength of exhalation muscles and static endurance of abdominal muscles (r = 0.57) and strength of pelvic floor (r = 0.65), between strength of pelvic floor and static endurance of back muscles (r = 0.50). Low correlations were found between strength of pelvic floor and transversus abdominis (r = 0.31) and static endurance of abdominal muscles (r = 0.44), between endurance of pelvic floor and exhalation muscles (r = 0.37), and finally between transversus abdominis and static strength of back muscles (r = 0.39). All correlations were statistically significant (p < 0.01). Discussion and conclusions. The findings showed positive associations among different functional indicators of muscles: strength of pelvic floor correlates with endurance of pelvic floor muscles, static abdominal and back muscles, strength of diaphragm, and transversus abdominis muscles. The results of this study confirm that functional associations between pelvic floor, diaphragm, and trunk muscles exist.Keywords: abdominal muscles, static postural endurance, respiration, core stability.

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Vaginal palpation versus transabdominal ultrasound in the comprehension of pelvic floor muscle contraction after vaginal delivery: a randomised controlled trial

BMC Women s Health ◽

10.1186/s12905-021-01203-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mayumi Ikeda ◽

Akiko Mori

Keyword(s):

Pelvic Floor ◽

Muscle Contraction ◽

Vaginal Delivery ◽

Pelvic Floor Muscle ◽

Controlled Trial ◽

Transabdominal Ultrasound ◽

Pelvic Floor Muscle Contraction ◽

Bladder Base ◽

Before And After ◽

Base Displacement

Abstract Background Pelvic floor muscles support the pelvic organs and control voiding. The first choice in the repair of pelvic floor function that is damaged during pregnancy and delivery is pelvic floor muscle training, which involves repeated muscle relaxation and contraction. However, as muscle contractions cannot be visualised, it is difficult to assess whether patients understand how to contract them. Therefore, we assessed patients’ comprehension of pelvic floor muscle contraction by comparing two teaching methods, vaginal palpation and transabdominal ultrasound, following vaginal delivery. We hypothesised that vaginal palpation is better than transabdominal ultrasound in this regard. Methods This randomised controlled trial conducted in facilities in Tokyo, Japan between July 2018 and January 2019 included women aged ≥ 20 years at 4–6 weeks after vaginal delivery. The randomisation involved website-based centralised allocation. The primary outcome was a change in bladder base displacement during pelvic floor muscle contraction before and after training, which was measured using transabdominal ultrasound. Participants performed three contractions for 3 s, and the mean value was used for statistical analysis. The secondary outcome was a change in understanding the contraction before and after training, which was measured using a five-point Likert scale questionnaire. Outcomes were analysed using Welch’s t-test. Results Sixty-five participants were randomly allocated to the vaginal palpation group (n = 32) and transabdominal ultrasound group (n = 33). Baseline characteristics were similar between the groups. Changes in bladder base displacement were not significantly different between the groups (p = 0.181). Within-group analyses showed that bladder base displacement was large in both groups after the respective intervention. There were no significant differences in any of the outcomes between the two groups before and after the intervention. Conclusions Vaginal palpation and transabdominal ultrasound might be useful for comprehending pelvic floor muscle contraction after vaginal delivery. Trial registration: UMIN 000032304. Registered 18 April 2018, https://upload.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000036820.

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