Altered muscle activation patterns in symptomatic women during pelvic floor muscle contraction and Valsalva manouevre

被引:69
作者
Thompson, JA
O'Sullivan, PB
Briffa, NK
Neumann, P
机构
[1] Curtin Univ Technol, Sch Physiotherapy, Perth, WA 6845, Australia
[2] Univ S Australia, Sch Physiotherapy, Adelaide, SA 5001, Australia
关键词
abdominal muscles; diaphragm; EMG; incontinence; intra-abdominal pressure; pelvic floor muscles; ultrasound; vaginal pressure;
D O I
10.1002/nau.20183
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Aims: To investigate the muscle activation patterns of the abdomino-pelvic region used by incontinent women during a pelvic floor muscle (PFM) contraction and a Valsalva manouevre compared to healthy, asymptomatic subjects. Methods: Thirteen incontinent (symptomatic) women, identified using ultrasound to be consistently depressing the bladder base during PFM contraction, and thirteen continent women (asymptomatic) able to perform an elevating PFM contraction were assessed using surface electromyography (EMG) of the PFM, abdominal and chest wall muscles and vaginal and intra-abdominal pressure (IAP) measurements during PFM contraction and Valsalva under ultrasound surveillance. Results: There were no differences between groups in age, parity or BMI. There was a difference in muscle activation patterns between groups (P = 0.001). During PFM contraction the PFM were less active and the abdominal and chest wall muscles were more active in the symptomatic group. During Valsalva, the PFM and EO were more active in the symptomatic group but there was no difference in the activation of the other muscles between groups. There was a significant interaction (group x pressure) for change in IAP (P = 0.047) but no significant interaction for change in vaginal pressure (VP) (P = 0.324). Conclusions: The symptomatic women displayed altered muscle activation patterns when compared to the asymptomatic group. The symptomatic women were unable to perform a voluntary PFM contraction using a localized muscle strategy, instead activating all the muscles of the abdomino-pelvic cavity. The potential for muscle substitution strategies reinforces the need for close attention to specificity when prescribing PFM exercise programs.
引用
收藏
页码:268 / 276
页数:9
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