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Contraction of the pelvic floor muscles during abdominal maneuvers☆1,☆2,☆3,☆4,☆5,☆6,☆7,☆8,☆9,☆10,☆11,☆12,☆13,☆14

https://doi.org/10.1053/apmr.2001.24297Get rights and content

Abstract

Sapsford RR, Hodges PW. Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med Rehabil 2001;82:1081-8. Objective: To determine whether voluntary abdominal muscle contraction is associated with pelvic floor muscle activity. Design: Pelvic floor muscle activity was recorded during contractions of the abdominal muscles at 3 different intensities in supine and standing positions. Setting: Research laboratory. Participants: Six women and 1 man with no histories of lower back pain. Intervention: Not applicable. Main Outcome Measures: Electromyographic activity of the pelvic floor muscles was recorded with surface electrodes inserted into the anus and vagina. These recordings were corroborated by measurements of anal and vaginal pressures. Gastric pressure was recorded in 2 subjects. Results: Pelvic floor muscle electromyography increased with contraction of the abdominal muscles. With strong abdominal contraction, pelvic floor muscle activity did not differ from that recorded during a maximal pelvic floor muscle effort. The pressure recordings confirmed these data. The increase in pressure recorded in the anus and vagina preceded the pressure in the abdomen. Conclusions: In healthy subjects, voluntary activity in the abdominal muscles results in increased pelvic floor muscle activity. The increase in pelvic floor pressure before the increase in the abdomen pressure indicates that this response is preprogrammed. Dysfunction of the pelvic floor muscles can result in urinary and fecal incontinence. Abdominal muscle training to rehabilitate those muscles may be useful in treating these conditions. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Section snippets

Subjects

Electromyographic recordings were made from the muscles of the pelvic floor in 6 women and 1 man. The demographic details are presented in table 1.

Table 1: Demographics of Study Sample

Empty CellWomenMan
Age (yr)45.7 (35-63)30
Height (m)1.66 (160-173)1.82
Weight (kg)58.7 (54-61)85
Maximum birth weight (gm)2950-4300

*Data given as mean (range).

Subjects were excluded if they had any history of neurologic or respiratory pathology or low back pain that limited function. One woman was nulliparous and the other 5

Results

Figure 3 presents group and individual data for abdominal muscle activity recorded with surface electrodes and ultrasound imaging in all subjects, and fine-wire electrodes in 1 subject for each of the abdominal maneuvres.

. Abdominal muscle activity during the experimental tasks in supine. Abdominal (Abd) muscle activity with each level of contraction are shown as (A) the mean change in width recorded using ultrasound, (B) mean change in electromyographic activity for all subjects recorded with

Discussion

This study of healthy subjects shows that vaginal and anal surface electromyographic activity increases with voluntary activation of the abdominal muscles. Furthermore, the extent of increase in pelvic floor muscle activity was related to the extent of the increase in abdominal muscle activity, with greatest pelvic floor muscle activity recorded with the strongest abdominal maneuver. The electromyography findings were supported by similar increases in vaginal and anal pressure measurements when

Conclusion

The findings of this study indicate that exercise of the abdominal muscles may be beneficial in maintaining pelvic floor muscle coordination, support, endurance, and strength. Similar exercise has the potential to be useful in the rehabilitation of persons with symptoms of dysfunction. For instance, contraction of the abdominal muscles may provide an efficient mechanism with which to initiate and train contraction of the pelvic floor muscles, particularly for patients who have difficulty

Acknowledgements

We thank Elizabeth McDonald and Merryn Hodges for assistance with data collection, Ms. McDonald for subject recruitment, Helen MacDevitt for training the subjects to perform the abdominal maneuvres, and Arthur Algate, Advantage Health Care Pty Ltd, for supplying equipment.

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  • Cited by (0)

    ☆1

    Supported by the National Health and Medical Research Council of Australia. Equipment provided by Arthur Algate, Advantage Health Care, Pty Ltd.

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    The author(s) has/have chosen not to select a disclosure statement.

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    Reprint requests to Ruth R. Sapsford, DipPhty, Dept of Physiotherapy, Mater Misericordiae Hospital, Raymond Ter, South Brisbane, QLD 4101 Australia, e-mail: [email protected].

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