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Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review

Abstract

Introduction

Investigations of the dynamic function of female pelvic floor muscles (PFM) help us to understand the pathophysiology of stress urinary incontinence (SUI). Displacement measurements of PFM give insight into muscle activation and thus help to improve rehabilitation strategies. This systematic review (PROSPERO 2013: CRD42013006409) was performed to summarise the current evidence for PFM displacement during voluntary and involuntary activation in continent and incontinent women.

Methods

MEDLINE, EMBASE, Cochrane and SPORTDiscus databases were searched using selected terminology reflecting the PICO approach. Screening of Google Scholar and congress abstracts added to further information. Original articles investigating PFM displacement were included if they reported on at least one of the aims of the review, e.g., method, test position, test activity, direction and quantification of displacement, as well as the comparison between continent and incontinent women. Titles and abstracts were screened by two reviewers. The papers included were reviewed by two individuals to ascertain whether they fulfilled the inclusion criteria and data were extracted on outcome parameters.

Results

Forty-two predominantly observational studies fulfilled the inclusion criteria. A variety of measurement methods and calculations of displacement was presented. The sample was heterogeneous concerning age, parity and continence status. Test positions and test activities varied among the studies.

Conclusions

The findings summarise the present knowledge of PFM displacement, but still lack deeper comprehension of the SUI pathomechanism of involuntary, reflexive activation during functional activities. We therefore propose that future investigations focus on PFM dynamics during fast and stressful impact tasks.

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Acknowledgements

We would like to thank Jacqueline Bürki for proofreading the article.

Conflicts of interest

None.

Authors’ contributions

LM conceived and designed the review, performed the literature search, collected studies and drafted the article. MH, as the second reviewer, supported the screening and data extraction process. TJ contributed to the design of the study, confirmed the methodological assessment and customised the data extraction form. KA contributed with additional literature and supported the draft. RL advised in cases of disagreement between the two reviewers and supported the final draft. All authors edited the article and approved its publication.

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Correspondence to Monika Leitner.

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Leitner, M., Moser, H., Taeymans, J. et al. Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review. Int Urogynecol J 26, 1587–1598 (2015). https://doi.org/10.1007/s00192-015-2700-2

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Keywords

  • Activities of daily living
  • Diagnostics
  • Stress urinary incontinence