Effect of combined actions of hip adduction/abduction on the force generation and maintenance of pelvic floor muscles in healthy women

Chronic pelvic pain (CPP) is a complex condition with a high economic and social burden. Although it is usually treated with botulinum neurotoxin type A (BoNT/A) injected into the pelvic floor muscles (PFM), its effect on their electrophysiological condition is unknown. In this study, 24 CPP patients were treated with BoNT/A. Surface electromyographic signals (sEMG) were recorded at Weeks 0 (infiltration), 8, 12 and 24 from the infiltrated, non-infiltrated, upper and lower PFM. The sEMG of 24 healthy women was also recorded for comparison. Four parameters were computed: root mean square (RMS), median frequency (MDF), Dimitrov’s index (DI) and sample entropy (SampEn). An index of pelvic electrophysiological impairment (IPEI) was also defined with respect to the healthy condition. Before treatment, the CPP and healthy parameters of almost all PFM sides were significantly different. Post-treatment, there was a significant reduction in power (<RMS), a shift towards higher frequencies (>MDF), lower fatigue index (<DI) and increased information complexity (>SampEn) in all sites in patients, mainly during PFM contractions, which brought their electrophysiological condition closer to that of healthy women (<IPEI). sEMG can be used to assess the PFM electrophysiological condition of CPP patients and the effects of therapies such as BoNT/A infiltration.

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Synergism between abdominal and pelvic floor muscles in healthy women: a systematic review of observational studies

Fisioterapia em Movimento ◽

10.1590/0103-5150.029.002.ao19 ◽

2016 ◽

Vol 29 (2) ◽

pp. 399-410 ◽

Cited By ~ 5

Author(s):

Lia Ferla ◽

Caroline Darski ◽

Luciana Laureano Paiva ◽

Graciele Sbruzzi ◽

Adriane Vieira

Keyword(s):

Systematic Review ◽

Pelvic Floor ◽

Observational Studies ◽

Pelvic Floor Dysfunction ◽

Cochrane Collaboration ◽

Pelvic Floor Muscles ◽

Abdominal Muscles ◽

Healthy Women ◽

Muscle Groups ◽

Starting Date

Abstract Introduction: The training of the pelvic floor muscles is widely used for treating pelvic floor dysfunctions, like urinary incontinence. During the training, abdominal contractions are avoided; however several studies support the use of the synergy between these muscle groups. Objective: Carrying out a systematic review of studies that seek to identify the presence of synergy between the muscles of the abdomen and the pelvic floor and its functionality in women without pelvic floor dysfunction. Methodology: To conduct the review, we have followed the recommendations proposed by the Cochrane Collaboration for systematic reviews. The literature search included the databases SCIELO, PEDro, MEDLINE, Cochrane CENTRAL and EMBASE, and manual research, the starting date of the databases until August 2013. We included cross observational studies with healthy women who were assessed to find the presence of synergy between the abdominal muscles and the pelvic floor. Results: We included 10 articles and they all showed the existence of synergy between the abdominal and pelvic floor muscles in healthy women in the supine, sitting and standing positions. Conclusion: Thus, we can conclude that there is synergy between the muscles of the abdomen and the pelvic floor in healthy women. Better understanding the behavior of these muscles and synergy may favor the development of strategies for the prevention and treatment of disorders of the female pelvic floor muscles.

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Absolute and Relative Reliability of the Assessment of the Muscle Mechanical Properties of Pelvic Floor Muscles in Women with and without Urinary Incontinence

Diagnostics ◽

10.3390/diagnostics11122315 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2315

Author(s):

Daiana Priscila Rodrigues-de-Souza ◽

Sandra Alcaraz-Clariana ◽

Lourdes García-Luque ◽

Cristina Carmona-Pérez ◽

Juan Luis Garrido-Castro ◽

...

Keyword(s):

Mechanical Properties ◽

Urinary Incontinence ◽

Pelvic Floor ◽

Intraclass Correlation ◽

Study Groups ◽

Pelvic Floor Muscles ◽

Mean Values ◽

Relative Reliability ◽

Healthy Women ◽

Nulliparous Women

An analysis of the muscle mechanical properties (MMPs) of the pelvic floor muscles (PFMs) is relevant for understanding the physiopathology of urinary incontinence (UI). However, there is no objective and reliable methodology currently available for quantifying the MMPs of PFMs. Thus, the objective was to determine the intra-rater and inter-rater reliability of the MMPs of PFM assessment with a hand-held tonometer device, called the MyotonPRO, in young women with and without UI. Sociodemographic and pelvic floor questionnaires, plus MMPs of PFMs were assessed in 38 nulliparous women with UI and 40 matched healthy women by two trained physiotherapists on two different occasions, 48–72 h apart. Good to excellent absolute reliability was found for tone, stiffness, and decrement of both intra- and inter-rater analyses in both study groups (Intraclass Correlation Coefficient ranged from 0.75 to 0.92), with a trend of lower values for relaxation and creep. The standard error of measurement (SEM) did not achieve 10% of the mean values for any MMPs. The minimum detectable change (MDC) values were also provided for clinical applications. In conclusion, the relative reliability of tone, stiffness, and the assessment of the decrement of PFMs with MyotonPRO is good to excellent for UI and healthy women. The SEM and MDC values were acceptable for their application in clinical settings.

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Coccygeal Movement Test: An Objective, Non-Invasive Test for Localization of the Pelvic Floor Muscles in Healthy Women

Medical Principles and Practice ◽

10.1159/000362337 ◽

2014 ◽

Vol 23 (4) ◽

pp. 318-322 ◽

Cited By ~ 4

Author(s):

Stine H. Stensgaard ◽

Karl Moeller Bek ◽

Khaled M.K. Ismail

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Muscles ◽

Non Invasive ◽

Healthy Women ◽

Invasive Test ◽

Movement Test

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Faculty Opinions recommendation of Neural control of the female urethral and anal rhabdosphincters and pelvic floor muscles.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.8136970.8536081 ◽

2011 ◽

Author(s):

Wilfrid Jänig

Keyword(s):

Pelvic Floor ◽

Neural Control ◽

Pelvic Floor Muscles

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

Interface Focus ◽

10.1098/rsfs.2019.0027 ◽

2019 ◽

Vol 9 (5) ◽

pp. 20190027 ◽

Cited By ~ 1

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.

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