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European Journal of Physical and Rehabilitation Medicine 2017 August;53(4):564-74

DOI: 10.23736/S1973-9087.17.04475-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Assessment of bioelectrical activity of pelvic floor muscles depending on the orientation of the pelvis in menopausal women with symptoms of stress urinary incontinence: continued observational study

Kuba PTASZKOWSKI 1 , Romuald ZDROJOWY 2, Lucyna SLUPSKA 3, Janusz BARTNICKI 4, 5, Janusz DEMBOWSKI 2, Tomasz HALSKI 3, Malgorzata PAPROCKA-BOROWICZ 1

1 Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland; 2 Department and Clinic of Urology, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wroclaw, Poland; 3 Department of Physiotherapy, Public Higher Medical Professional School in Opole, Opole, Poland; 4 Department of Obstetrics, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland; 5 Department of Gynecology and Obstetrics, Hospital Maerkisch Oderland, Strausberg, Germany


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BACKGROUND: Menopausal women often experience the prolapse of the uterus, bladder and rectum resulting from the failure and weakening of the pelvic floor muscles (PFM). Strengthening of the PFM through the standard exercises is recognized as an effective way of preventive measures and conservative treatment of the symptoms listed above, but still need to be improved.
AIM: The goal was the objective assessment of resting and functional bioelectrical activity of PFM in women during menopause and its comparison in three different positions of the pelvis: anterior pelvic tilt - position 1 (P1), posterior pelvic tilt - position 2 (P2), and neutral pelvic tilt - position 3 (P3).
DESIGN: Prospective, cross-sectional observational study.
SETTING: Department and Clinic of Urology of a University Hospital.
POPULATION: The target group of this study included women in the menopausal period (inpatient and outpatient).
METHODS: The study evaluating resting and functional activity of the PFM depending on the orientation of pelvis. Bioelectric activity was assessed with an electromyographic instrument (sEMG) and endovaginal electrodes. The inclination angle was measured with an inclinometer. The comparisons of results between the values obtained in P1, P2, and P3 were performed using one-way Analysis of Variance (ANOVA).
RESULTS: One hundred thirty-one registered for the study were screened for inclusion and exclusion criteria and on the basis of the results 82 participants were enrolled for analysis. The highest mean resting activity of sEMG PFM (µV) was observed in P2 and it amounted to 11.6 µV (SD=5.5 µV) in P1 the value equaled 9.8 µV (SD=4.8 µV) and P3-9.0 µV (SD=4.2 µV). The results revealed a significant statistical difference (main effect: P=0.0007). Considering the functional sEMG activity of PFM (µV), the highest mean value was recorded in P2.
CONCLUSIONS: Posterior pelvic tilt position determines higher resting and functional bioelectric activity of PFM. Additionally, electromyographic activity of PFM increases during the pelvic movement backwards.
CLINICAL REHABILITATION IMPACT: These positions should be implemented in therapy in order to improve the effectiveness of the effect on the pelvic floor.


KEY WORDS: Pelvic floor - Muscles - Menopause - Electromyography

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