Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study
Received 4 June 2015
Accepted for publication 7 July 2015
Published 23 September 2015 Volume 2015:10 Pages 1521—1528
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Supriya Swarnkar
Peer reviewer comments 2
Editor who approved publication: Dr Richard Walker
Kuba Ptaszkowski,1 MaĹ‚gorzata Paprocka-Borowicz,2 Lucyna SĹ‚upska,2 Janusz Bartnicki,1,3 Robert Dymarek,4 Joanna RosiĹ„czuk,4 Jerzy Heimrath,5 Janusz Dembowski,6 Romuald Zdrojowy6
1Department of Obstetrics, 2Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Wroclaw Medical University, Wroclaw, Poland; 3Department of Obstetrics and Gynecology, Health Center Bitterfeld/Wolfen gGmbH, Bitterfeld-Wolfen, Germany; 4Department of Nervous System Diseases, 5Department of Gynaecology and Obstetrics, Faculty of Health Science, 6Department and Clinic of Urology, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wroclaw, Poland
Objective: Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman’s ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI.
Materials and methods: This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity.
Results: Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups.
Conclusion: In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the mechanism of continence.
Keywords: pelvic floor muscles, postmenopausal period, stress urinary incontinence, surface electromyography, synergistic muscle
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