scholarly journals Task-specific differences in respiration-related activation of deep and superficial pelvic floor muscles

2019 ◽  
Vol 126 (5) ◽  
pp. 1343-1351 ◽  
Author(s):  
Rafeef Aljuraifani ◽  
Ryan E. Stafford ◽  
Leanne M. Hall ◽  
Wolbert van den Hoorn ◽  
Paul W. Hodges
Keyword(s):  
Pelvic Floor ◽  
Deep Layer ◽  
Pelvic Floor Dysfunction ◽  
Muscle Layer ◽  
Superficial Layer ◽  
Pelvic Floor Muscles ◽  
Abdominal Pressure ◽  
Quiet Breathing ◽  
Abdominal Organs ◽  
Deep Layers

The female pelvic floor muscles (PFM) are arranged in distinct superficial and deep layers that function to support the pelvic/abdominal organs and maintain continence, but with some potential differences in function. Although general recordings of PFM activity show amplitude modulation in conjunction with fluctuation in intra-abdominal pressure such as that associated with respiration, it is unclear whether the activities of the two PFM layers modulate in a similar manner. This study aimed to investigate the activation of the deep and superficial PFM during a range of respiratory tasks in different postures. Twelve women without pelvic floor dysfunction participated. A custom-built surface electromyography (EMG) electrode was used to record the activation of the superficial and deep PFM during quiet breathing, breathing with increased dead space, coughing, and maximal and submaximal inspiratory and expiratory efforts. As breathing demand increased, the deep PFM layer EMG had greater coherence with respiratory airflow at the frequency of respiration than the superficial PFM ( P = 0.038). During cough, the superficial PFM activated earlier than the deep PFM in the sitting position ( P = 0.043). In contrast, during maximal and submaximal inspiratory and expiratory efforts, the superficial PFM EMG was greater than that for the deep PFM ( P = 0.011). These data show that both layers of PFM are activated during both inspiration and expiration, but with a bias to greater activation in expiratory tasks/phases. Activation of the deep and superficial PFM layers differed in most of the respiratory tasks, but there was no consistent bias to one muscle layer.NEW & NOTEWORTHY Although pelvic floor muscles are generally considered as a single entity, deep and superficial layers have different anatomies and biomechanics. Here we show task-specific differences in recruitment between layers during respiratory tasks in women. The deep layer was more tightly modulated with respiration than the superficial layer, but activation of the superficial layer was greater during maximal/submaximal occluded respiratory efforts and earlier during cough. These data highlight tightly coordinated recruitment of discrete pelvic floor muscles for respiration.

scholarly journals Episiotomy: the biomechanical impact of multiple small incisions during a normal vaginal delivery

2019 ◽  
Vol 9 (5) ◽  
pp. 20190027 ◽  
Author(s):  
Dulce Oliveira ◽  
Maria Vila Pouca ◽  
João Ferreira ◽  
Teresa Mascarenhas
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Symphysis Pubis ◽  
Pelvic Floor Muscles ◽  
Point Of View ◽  
Normal Vaginal Delivery ◽  
Tissue Integrity ◽  
Levator Trauma ◽  
Reaction Forces

Childbirth-related injuries are one of the main causes of pelvic floor dysfunction. To attempt to avoid serious tears during delivery, an episiotomy can be performed. In this study, we intended to investigate the biomechanical performance of the pelvic floor muscles after performing different episiotomies using a physics-based computational model which includes the pelvic floor muscles and the fetus. Previous biomechanical studies have analysed the mechanical effects of single incisions of different lengths; in this study, we intend to analyse the implications of multiple small incisions, evaluating the reaction forces, the stress on the muscles and the loss of tissue integrity sustained by the pelvic floor. The obtained results predict that an episiotomy delivery reduces the likelihood of macroscopic levator trauma by decreasing the stress on the region of insertion of the rectal area of the levator ani in the symphysis pubis . From the mechanical point of view, multiple incisions do not bring benefits compared to larger incisions. However, nothing can be ascertained about the clinical benefit of such an approach.

2. VAGINISMUS, VULVODYNIA AND PELVIC FLOOR MUSCLE ACTIVITY

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 285
Author(s):  
R. Sapsford
Keyword(s):  
Pelvic Floor ◽  
Muscle Activity ◽  
Pelvic Floor Muscle ◽  
Normal Function ◽  
Pelvic Floor Muscles ◽  
Abdominal Pressure ◽  
Abdominal Muscles ◽  
Physiological Factors ◽  
Muscle Groups ◽  
Postural Support

The pelvic floor muscles form the base of the abdominal cylinder and work in synergy with other muscles around the cylinder - the abdominal muscles and the diaphragm. Activity in each muscle group affects the others. Coordinated recruitment of these muscle groups is necessary for generation and maintenance of intra-abdominal pressure, postural support of the trunk, and during functional tasks such as lifting, coughing and nose blowing. Coordinated release of these groups is required for micturition, while defaecation may need activity in some muscles and release in others. Vaginismus and vulvodynia both have a component of over activity of the pelvic floor muscles which impairs normal function, though this over activity may only occur at the time of attempted penetration. Some of the physiological factors that contribute to this overactivity come from outside the pelvic floor muscle complex itself and can be ameliorated by understanding and management of these muscle synergies. An EMG study of muscle activity of the abdominal and pelvic floor muscles during a simulated body posturing for female sexual arousal will help to explain how the pelvic floor muscle over activity in vaginismus arises. Treatment programmes that have been used to successfully address these problems will be explained.

scholarly journals Reeducation of pelvic floor muscles in volleyball athletes

2014 ◽  
Vol 60 (5) ◽  
pp. 428-433 ◽  
Author(s):  
Silvia Ferreira ◽  
Margarida Ferreira ◽  
Alice Carvalhais ◽  
Paula Clara Santos ◽  
Paula Rocha ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Female Athletes ◽  
Rehabilitation Program ◽  
Pelvic Floor Muscles ◽  
Control Group ◽  
Abdominal Pressure ◽  
Assessment Instruments ◽  
Urinary Leakage ◽  
Significant Difference ◽  
Before And After

Objective: to verify the effectiveness of the pelvic floor muscles rehabilitation program (PFMRP) in female volleyball athletes, analyzing the amount and frequency of urinary leakage. Methods: experimental study. The sample consisted of 32 female athletes from Famalicão Athletic Volleyball Club (Portugal). The athletes were selected by convenience and distributed randomly into two groups: experimental group (EG = 16 athletes) and the control group (CG = 16 athletes). The EG underwent PFMRP for three months. The PFMRP was the awareness and identification of the pelvic floor muscles (PFM), pre-timed PFM contraction prior to occasions of increased intra-abdominal pressure, and 30 daily contractions of MPP at home. The CG had only access to the pamphlet. The assessment instruments included the questionnaires, the Pad Test (amount of urinary leakage) and frequency record of urinary leakage (7-day diary) before and after PFMRP. Results: the amount of urine leakage decreased in 45.5% of athletes under PFMRP intervention, and in 4.9% of athletes in CG, with statistical differences between the groups (p < 0.001). The reduction in the frequency of urinary leakage was 14.3% in EG, and 0.05% in CG, a statistically significant difference between the groups (p < 0.001). Conclusion: PFMRP in this study was effective to reduce stress urinary incontinence in female volleyball athletes. The program allowed significant improvement of symptoms of quantity and frequency of urinary leakage.

Biofeedback for Pelvic Muscle Dysfunction

Biofeedback ◽  
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.

scholarly journals Simultaneous production of diverse neuronal subtypes during early corticogenesis

2018 ◽  
Author(s):  
E. Magrinelli ◽  
R. J. Wagener ◽  
D. Jabaudon
Keyword(s):  
Deep Layer ◽  
Ventricular Zone ◽  
Neuronal Cell ◽  
Cell Types ◽  
Superficial Layer ◽  
High Temporal Resolution ◽  
Fine Grained ◽  
Molecular Identity ◽  
Deep Layers ◽  
Successive Generations

AbstractThe circuits of the neocortex are composed of a broad diversity of neuronal cell types, which can be distinguished by their laminar location, molecular identity, and connectivity. During embryogenesis, successive generations of glutamatergic neurons are sequentially born from progenitors located in germinal zones below the cortex. In this process, the earliest-born generations of neurons differentiate to reside in deep layers, while later-born daughter neurons reside in more superficial layers. Although the aggregate competence of progenitors to produce successive subtypes of neurons progresses as corticogenesis proceeds, a fine-grained temporal understanding of how neuronal subtypes are sequentially produced is still missing. Here, we use FlashTag, a high temporal resolution labeling approach, to follow the fate of the simultaneously-born daughter neurons of ventricular zone progenitors at multiple stages of corticogenesis. Our findings reveal a bimodal regulation in the diversity of neurons being produced at single time points of corticogenesis. Initially, distinct subtypes of deep-layer neurons are simultaneously produced, as defined by their laminar location, molecular identity and connectivity. Later on, instead, instantaneous neuronal production is homogeneous and the distinct superficial-layer neurons subtypes are sequentially produced. These findings suggest that early-born, deep-layer neurons have a less determined fate potential than later-born superficial layer neurons, which may reflect the progressive implementation of pre-and/or post-mitotic mechanisms controlling neuronal fate reliability.

scholarly journals Influence of a protocol of Pilates exercises on the contractility of the pelvic floor muscles of non-institutionalized elderly persons

2017 ◽  
Vol 20 (4) ◽  
pp. 484-492 ◽  
Author(s):  
Ligia Muniz de Souza ◽  
Ana Beatriz Gomes de Souza Pegorare ◽  
Gustavo Christofoletti ◽  
Suzi Rosa Miziara Barbosa
Keyword(s):  
Pelvic Floor ◽  
Elderly Women ◽  
Paired Comparison ◽  
Pelvic Floor Dysfunction ◽  
Voluntary Contraction ◽  
Pelvic Floor Muscles ◽  
Elderly Persons ◽  
Mato Grosso ◽  
Significant Difference ◽  
Pilates Method

Abstract Objective: To investigate the influence of a protocol of Pilates exercises on the functionality and contractility of the pelvic floor muscles (PFM) of older women living in the city of Campo Grande, Mato Grosso, Brazil. Method: Ten women (median age of 63.4±4.5 years) with little or no pelvic floor dysfunction were subjected to 24 sessions of Pilates exercises lasting one hour each, for 12 weeks. The pressure of the pelvic floor muscles (PFM) was assessed using a perineometer (cmH20) and contractility was assessed with the PERFECT scheme. Data were described as median ± interquartile range and inferential analysis was performed using the Wilcoxon paired test, with a significance level of 5%. Results: In view of the proposed treatment, the degree of voluntary contraction of the PFM of the participants increased from 79.0±83.5 to 90.0±82.0 cmH20, with a statistically significant difference in paired comparison (p=0.012). According to the PERFECT scheme, there was an increase in contraction time (from 5.0±0.1 to 7.0±4.7 seconds) and in the number of fast repetitions (from 7.0±4.5 to 8.0±4.7), with a statistically significant difference for both variables (p=0.017 and p=0.008, respectively). Conclusion: The results indicate that the Pilates method increased the contractility and pressure of the PFM of elderly women with little or no PFM impairment. Further studies are required to determine whether the Pilates method is an effective method for the treatment of women with severe pelvic floor dysfunction.

On the role of the constitution and the angle of inclination of the pelvis in the etiology of prolapse of the female genital organs

1930 ◽  
Vol 26 (10) ◽  
pp. 996-1001
Author(s):  
V. I. Davydov
Keyword(s):  
Adipose Tissue ◽  
Spina Bifida ◽  
Pelvic Floor ◽  
Pelvic Floor Muscles ◽  
Hard Work ◽  
Abdominal Pressure ◽  
Sacral Nerves ◽  
Poor Nutrition ◽  
Female Genital

If all authors agree that the direct cause of prolapse of the genitals in a woman is increased intra-abdominal pressure, then regarding the anatomical moments contributing to the occurrence of this anomaly, the opinions of the authors differ sharply: some attribute here an important role to innate moments, which may be - spina bifida lumbo -sacralis, in which there is a paralysis of the sacral nerves innervating the pelvic floor, then congenital hypoplasia of the pelvic floor muscles, excessive depth of the posterior Doug-Jas'ova pocket, observed in infantilism and accompanied by a very low position of the levator'a ani, etc .; others see the main reason for prolapse in acquired relaxations and violations of the integrity of the musculo-fascial base of the pelvic floor, especially the levator'a ani and the urogenital diaphragm; still others, considering the prolapse as a hernia, see the main predisposing reason for its development in the excessive width of the hiatus genitalis; fourth, on the basis of the fact that prolapse of the uterus, especially complete, is observed mainly in old women, in the first place among the etiological moments leading to prolapse, put climacteric changes in the ligamentous apparatus of the uterus, walls of the genital canal, etc.; fifths put forward retroflection of the uterus as an important etiological moment of prolapse, sixth - insufficiency of parametric, paravaginal and especially paravesical tissue, which failure is sometimes the result of poor nutrition, hard work, etc., moments that cause the disappearance of adipose tissue, altering the elasticity of the muscle-fascial septum pelvic floor, etc.

The lateral wall of the cavernous sinus

1982 ◽  
Vol 56 (2) ◽  
pp. 228-234 ◽  
Author(s):  
Felix Umansky ◽  
Hilel Nathan
Keyword(s):  
Cavernous Sinus ◽  
Deep Layer ◽  
Lateral Wall ◽  
Superficial Layer ◽  
Content Type ◽  
Deep Layers ◽  
Fine Print

✓ In a study of the cavernous sinus in 70 specimens, the lateral wall of the sinus was found to be formed by two layers: a superficial, dural layer and a deep layer. The latter was formed by the sheaths of nerves III, IV, and V1,2 plus a reticular membrane extending between the sheaths. This membrane was often incomplete, particularly beween the sheaths of nerves III and IV above, and V1 below. These findings do not conform with the descriptions of a single dural layer of the lateral wall, with nerves III, IV, and V1,2 embedded in it, nor to other descriptions showing the cavity of the sinus divided into two compartments by a septum close to the lateral wall, with nerves III, IV, and V1 located within the septum. In the present study, the superficial and the deep layers of the lateral wall were found to be loosely attached to each other and easy to separate. In no case was a superficial compartment of the sinus found to be present between the two layers, and the nerves were never found to be running embedded in the superficial layer.

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