Influence of a Distraction Task on Pelvic Floor Muscle Contraction

AimsAttention may play a key role in the contraction of pelvic floor muscles in stressful situations, meaning that mental distraction may be involved in urinary incontinence. MethodsInformed consent was obtained from 20 healthy volunteers. The electromyographic (EMG) activity of the external anal sphincter (EAS) was recorded during voluntary contraction elicited by local stimulation. The trials were carried out twice: combined (or not) with a mental distraction task (PASAT), Paced auditory serial additional test. Reaction time, latency between the stimulus and maximum EAS EMG activity, duration of the contraction, maximum EAS EMG activity, and the area under the EAS EMG activity curve were measured. ResultsThe mental distraction task led to a 3.98 times greater reaction time (RT), (P=0.00001 Wilcoxon's test). The RT increased from 217 (IQR: 170-270) to 779msec (IQR: 550-1,025, P<0.0001) when the EAS contraction was combined with PASAT. However, the maximum EAS EMG activity was weaker during PASAT than in the absence of a mental distraction task: 0.0850mv versus 0.0701mv, that is, 1.21 times weaker (P=0.00077, Wilcoxon's test). Finally, when the two conditions (respectively with and without the mental distraction task) were compared, no significant difference was found in the area under the EAS EMG activity curve (0.0157mvsec vs. 0.0162mvsec, ratio 1.01, P=0.52). ConclusionsThe mental distraction task altered voluntary contraction of the pelvic floor muscles. Neurourol. Urodynam. 34:139-143, 2015. (c) 2014 Wiley Periodicals, Inc.