Impact of Lumbar Postures on the Functioning of Pelvic Floor Muscles Among Osteoporotic Post-Menopausal Women.

Abstract

Introduction Maintaining continence and providing support to the abdominal contents and sexual functioning are among the primary roles of pelvic floor muscles. The pelvic floor muscles work in synergy with the abdominal muscle to perform these functions. Abdominal muscle activation in the sagittal plane is influenced by the lumbar spine posture. As pelvic floor dysfunction is common among post-menopausal women, this study aims to find out the relationship between lumbar posture and electromyographic (EMG) activity of the rectus abdominis (RA) muscle and vaginal pressure (VP) as a functioning of the pelvic floor muscles among osteoporotic post-menopausal females. Methods A total of 78 osteoporotic post-menopausal women were recruited and allocated into three groups depending on lumbar lordotic angle, namely normal lordosis (n=26) hyperlordosis (n=26), and hypolordosis (n=26). All the subjects were recorded for RA EMG activity and VP for pelvic floor function in the quiet standing (QS) position, and voluntary dynamic tasks such as maximal coughing (MC) and Valsalva maneuver (VM). Data were analyzed using one-way analysis of variance (ANOVA) and post hoc analysis. A 5% probability level was considered statistically significant, i.e., p<0.05. Results The results showed a significant reduction in the RA activity and VP during the dynamic tasks (MC and VM) among subjects with the altered lumbar lordotic angle (p<0.05). The reduction in RA activity and VP was found to be significantly higher (p<0.05) in subjects with hyperlordotic lumbar spine than in those with hypolordotic lumbar spine as compared to normal lordosis during QS, MC, and VM. Conclusion We conclude that osteoporotic post-menopausal women with different lumbar lordotic angle show variations in RA activity and pressure generated by the vagina as a function of the pelvic floor during voluntary dynamic tasks.