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Women with SUI demonstrate motor control differences during voluntary pelvic floor muscle contractions

Abstract

Introduction and hypothesis

To compare maximum abdominal and pelvic floor muscle (PFM) electromyographic (EMG) and intravaginal pressure (IVP) amplitudes and muscle activation patterns during voluntary PFM contractions between women with and without stress urinary incontinence (SUI).

Methods

Twenty-eight continent women and 44 women with SUI performed single and repeated PFM contractions in supine. Surface EMG data were recorded simultaneously with IVP. Maximum EMG and IVP amplitudes and ensemble average IVP versus EMG curves were determined from the single contractions. Muscle activation timing was determined with cross-correlation functions from the repeated contractions.

Results

The continent group produced higher PFM EMG amplitudes than the SUI group; there were no between group differences in IVP. The women with SUI delayed activating rectus abdominus. The IVP versus EMG curves’ shapes were similar between the groups, however the SUI group had higher abdominal muscle y-intercepts than the continent women.

Conclusions

These findings suggest that women with SUI demonstrate altered motor control strategies during voluntary PFM contractions.

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Abbreviations

AD:

analog to digital

ANOVA:

analysis of variance

BMI:

body mass index

CI:

confidence interval

EMG:

electromyography or electromyographic

EO:

external obliques muscle

IO:

internal obliques muscle

IVP:

intravaginal pressure

MVC:

maximum voluntary contraction

MVE:

maximum voluntary electrical activity

PFM:

pelvic floor muscle

RA:

rectus abdominis muscle

RMS:

root mean square

SUI:

stress urinary incontinence

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Acknowledgements

Financial support for this work was provided by Physicians’ Services Inc. Foundation of Ontario, Canada and the Physiotherapy Foundation of Canada. Infrastructure support was provided by the Canadian Foundation for Innovation and the Ontario Innovation Trust. The authors wish to thank Cindy Brown B.Sc.(PT), M.Sc., Lorraine Chick RN(EC), M.Sc.N., Fabiola Gonçalves B.Sc.(PT), M.Sc., and Roy Young CBET for their assistance with technical support, data collection, and volunteer screening.

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Correspondence to Linda McLean.

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Madill, S.J., Harvey, MA. & McLean, L. Women with SUI demonstrate motor control differences during voluntary pelvic floor muscle contractions. Int Urogynecol J 20, 447–459 (2009). https://doi.org/10.1007/s00192-008-0800-y

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Keywords

  • Electromyography
  • Intravaginal pressure
  • Motor control
  • Pelvic floor muscles
  • Stress urinary incontinence