Abstract
ABSTRACTIntroduction and objectives:Several studies have been investigated co-activation can enhance the effectveness of PFM training protocols allowing preventive and therapeutic goals in pelvic floor dysfunctions. The objective of the present study was to investigate if an abdominal-pelvic protocol of training (APT) using gametherapy would allow co-activation of PFM and transversus abdominis/oblique internal (TrA/OI) muscles.Patients and methods:Twenty-five nulliparous, continent, young females, with median age 24.76 (±3.76) years were evaluated using digital palpation (DP) of PFM and surface electromyography of PFM and TrA/OI simultaneously, during maximal voluntary contraction (MVC), alternating PFM and TrA/OI contraction requests. All women participated on a supervised program of APT using gametherapy, that included exercises of pelvic mobilization associated to contraction of TrA/OI muscles oriented by virtual games, for 30 minutes, three times a week, in a total of 10 sessions. Electromyographic data were processed and analyzed by ANOVA - analysis of variance.Results:When MVC of TrA/OI was solicited, it was observed simultaneous increase of electromyographic activity of PFM (p=0.001) following ATP. However, EMG activity did not change significantly during MVC of PFM.Conclusion:Training using gametherapy allowed better co-activation of pelvic floor muscles in response to contraction of TrA, in young nulliparous and continent women.
Highlights
Pelvic floor muscles (PFM) are responsible for urinary and fecal continence mechanisms, and participate at sexual relations and delivery [1, 2]
Some studies [3,4,5] have demonstrated an intimate relation between PFM and the abdomen, transversus abdominis muscle (Tra) whose impact on continence mechanisms and on pelvic floor functionality is being investigated in different phases of female vital cycle
The objective of the present study was to identify simultaneous electrical activity of PFM and transversus abdominis/oblique internal (TrA/ OI) in order to verify if a protocol of abdominal training (PAT) using gameteraphy would provide co-activation of those muscles
Summary
Pelvic floor muscles (PFM) are responsible for urinary and fecal continence mechanisms, and participate at sexual relations and delivery [1, 2]. They are important for pelvic stabilization, along with abdominal and lumbar muscles. Some studies [3,4,5] have demonstrated an intimate relation between PFM and the abdomen, transversus abdominis muscle (Tra) whose impact on continence mechanisms and on pelvic floor functionality is being investigated in different phases of female vital cycle. Pregnancy, delivery, hormonal alterations of female cycle as well as biomechanical and postural modifications [7] can influence PFM function
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