Predictors of Pelvic Floor Muscle Dysfunction Among Women With Lumbopelvic Pain

Abstract Background There is evidence to suggest that a large proportion of individuals seeking care for lumbopelvic pain also have pelvic floor muscle dysfunction (PFMD). Because the majority of physical therapists do not have the requisite training to adequately assess pelvic floor musculature, determining predictors of PFMD could be clinically useful. Objective The objective was to establish a combination of factors (self-report and physical) predictive of PFMD in women with lumbopelvic pain. Design This was a cross-sectional study. Methods Participants completed a battery of self-report and physical assessments (masked assessors). Three clinical findings characterized PFMD: weakness of the pelvic floor, lack of coordination of the pelvic floor, and pelvic floor muscle tenderness on palpation (bilateral obturator internus). Univariate and multivariate logistic regression analyses were used to determine the extent to which different predictors were associated with PFMD. Results One hundred eight women with self-reported lumbopelvic pain (within the past week) were included in the study (mean age = 40.4 years; SD = 12.6 years). None of the examined factors predicted pelvic floor muscle weakness. Two factors independently predicted pelvic floor muscle tenderness on palpation: very strong and/or uncontrollable urinary urges (odds ratio [OR] = 2.93; 95% confidence interval [CI] = 1.13–7.59) and Central Sensitization Inventory scores of 40 or greater (OR = 3.13; 95% CI = 1.08–9.10). Limitations The sample consisted of young women, some of whom were not actively seeking care. Additionally, the technique for assessing pelvic floor muscle tenderness on palpation requires further validation. Conclusions Women who have lumbopelvic pain, uncontrollable urinary urgency, and central sensitization were, on average, 2 times more likely to test positive for pelvic floor muscle tenderness on palpation. Further studies are needed to validate and extend these findings.

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Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study

Sao Paulo Medical Journal ◽

10.1590/s1516-31802013000100019 ◽

2013 ◽

Vol 131 (2) ◽

pp. 95-99 ◽

Cited By ~ 13

Author(s):

Angélica Mércia Pascon Barbosa ◽

Gabriela Marini ◽

Fernanda Piculo ◽

Cibele Vieira Cunha Rudge ◽

Iracema Mattos Paranhos Calderon ◽

...

Keyword(s):

Urinary Incontinence ◽

Cesarean Section ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Cross Sectional Study ◽

Elective Cesarean Section ◽

Muscle Dysfunction ◽

Cross Sectional ◽

Elective Cesarean ◽

Weight Gain During Pregnancy

CONTEXT AND OBJECTIVE There is uncertainty in the literature regarding the theory that obstetric events and pelvic floor injuries give rise to lower risk of subsequent urinary incontinence among women delivering via cesarean section than among women delivering vaginally. The objective of this study was to assess the two-year postpartum prevalence of urinary incontinence and pelvic floor muscle dysfunction and the factors responsible for them. DESIGN AND SETTING Cross-sectional study, conducted in a public university. METHODS 220 women who had undergone elective cesarean section or vaginal childbirth two years earlier were selected. Their urinary incontinence symptoms were investigated, and their pelvic floor muscle dysfunction was assessed using digital palpation and a perineometer. RESULTS The two-year urinary incontinence prevalences following vaginal childbirth and cesarean section were 17% and 18.9%, respectively. The only risk factor for pelvic floor muscle dysfunction was weight gain during pregnancy. Body mass index less than 25 kg/m 2 and normal pelvic floor muscle function protected against urinary incontinence. Gestational urinary incontinence increased the risk of two-year postpartum urinary incontinence. CONCLUSION Gestational urinary incontinence was a crucial precursor of postpartum urinary incontinence. Weight gain during pregnancy increased the subsequent risk of pelvic floor muscle dysfunction, and elective cesarean section did not prevent urinary incontinence.

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Is pelvic floor muscle strength and thickness associated with pelvic organ prolapse in Nepali women? – A cross-sectional study

Brazilian Journal of Physical Therapy ◽

10.1016/j.bjpt.2020.05.011 ◽

2020 ◽

Author(s):

Delena Caagbay ◽

Friyan Turel Fatakia ◽

Hans Peter Dietz ◽

Camille Raynes-Greenow ◽

Natalia Martinho ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Muscle Strength ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Pelvic Organ ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pelvic Floor Muscle Strength ◽

Nepali Women

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Levator plate movement during voluntary pelvic floor muscle contraction in subjects with incontinence and prolapse: a cross-sectional study and review

International Urogynecology Journal ◽

10.1007/s00192-003-1036-5 ◽

2003 ◽

Vol 14 (2) ◽

pp. 84-88 ◽

Cited By ~ 75

Author(s):

Judith A. Thompson ◽

Peter B. O'Sullivan

Keyword(s):

Pelvic Floor ◽

Muscle Contraction ◽

Pelvic Floor Muscle ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pelvic Floor Muscle Contraction ◽

Plate Movement

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Pelvic floor muscle function and EMG in nulliparous women of different ages: a cross-sectional study

Climacteric ◽

10.1080/13697137.2018.1453493 ◽

2018 ◽

Vol 21 (5) ◽

pp. 462-466 ◽

Cited By ~ 10

Author(s):

D. A. S. Bocardi ◽

V. S. Pereira-Baldon ◽

C. H. J. Ferreira ◽

M. A. Avila ◽

A. C. S. Beleza ◽

...

Keyword(s):

Pelvic Floor ◽

Muscle Function ◽

Pelvic Floor Muscle ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pelvic Floor Muscle Function ◽

Nulliparous Women ◽

Different Ages

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Diastasis recti abdominis and pelvic floor muscle function. A cross sectional study of primiparous women during pregnancy and postpartum

Physiotherapy ◽

10.1016/j.physio.2015.03.313 ◽

2015 ◽

Vol 101 ◽

pp. e161-e162

Author(s):

K. Bø ◽

G. Hilde ◽

M. Tennfjord ◽

J. Sperstad ◽

M. Ellstrøm Engh

Keyword(s):

Pelvic Floor ◽

Muscle Function ◽

Pelvic Floor Muscle ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Diastasis Recti ◽

Pregnancy And Postpartum ◽

Diastasis Recti Abdominis ◽

Primiparous Women

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Biofeedback for Pelvic Muscle Dysfunction

Biofeedback ◽

10.5298/1081-5937-44.2.02 ◽

2016 ◽

Vol 44 (2) ◽

pp. 55-57

Author(s):

Debbie Callif

Keyword(s):

Pelvic Floor ◽

Pelvic Pain ◽

Control Strategies ◽

Pelvic Floor Muscle ◽

Pelvic Floor Dysfunction ◽

Bowel Function ◽

Pelvic Floor Muscles ◽

Muscle Dysfunction ◽

Reduction Techniques ◽

Obturator Internus

Biofeedback for pelvic floor muscle dysfunction provides a practical and effective intervention for elimination disorders. Dysfunction in the pelvic floor muscles can affect bladder and bowel function and can cause pelvic pain. According to the National Association of Continence, there are 25 million Americans affected by bladder or bowel incontinence. Surface electromyographic (sEMG) sensors monitor the electrical activity of the pelvic floor muscles. Additional muscle co-contractions of the obturator internus, hip adductors, and transverse abdominis can facilitate improvements in symptoms affected by pelvic floor dysfunction. Pelvic floor therapy incorporates urge reduction techniques and functional control strategies. Dietary and lifestyle recommendations are also provided. The Biofeedback Certification International Alliance (BCIA) is the primary certifying body in the fields of biofeedback and neurofeedback. BCIA has a Blueprint of Knowledge specific for certification in pelvic muscle dysfunction biofeedback (PMDB). The Blueprint outlines the fundamental science, history, and theory of sEMG biofeedback as used for elimination disorders and chronic pelvic pain. You can find more information on PMDB at www.bcia.org.

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