Pelvic Floor Muscle Activity Research Articles

Negative impact of gestational diabetes mellitus on progress of pelvic floor muscle electromyography activity: Cohort study.

Background and objectivePelvic floor muscles are involved in postural stability, in maintenance intra-abdominal pressure, and on mechanical support for pelvic organ. Gestational Diabetes Mellitus’ (GDM) pregnancies complicated by fetal macrosomia, large placenta and polyhydramnios contribute for abrupt and intense increase in maternal intra-abdominal pressure. Our objective was analyze the impact of GDM on pelvic floor muscle (PFM) electromyography (EMG) activity progress from 24–30 to 36–38 weeks of gestation. We conducted a prospective cohort study. PFM EMG was performed in nulliparous or primiparous women with one previous elective cesarean delivery and with or not GDM diagnosed by the American Diabetes Association criteria. A careful explanation of the muscle anatomy and functionality of the PFM was given before EMG assessment. The outcome measures were PFM recruitment and progress from 24–30 to 36–38 weeks of gestation analyzed by the normalized root mean square (RMS) during rest-activity, fast and hold pelvic floor muscle contraction.ResultsFifty-two pregnant women were assigned to 2 groups: the GDM (n = 26) and normoglycemic (NG) (n = 26). The demographic and obstetric data showed homogeneity between the groups. PFM activity progress was decreased in rest-activity (P = 0.042) and hold contraction (P = 0.044) at 36–38 weeks of gestation in the GDM group relative to that in the NG group.ConclusionGDM group showed a progressive decrease in EMG-PFM activity during rest-activity and hold contractions from 24–30 to 36–38 weeks of gestation.

Bladder and urethral dysfunction in multiparous and mature rabbits correlates with abnormal activity of pubococcygeus and bulbospongiosus muscles.

To evaluate the combined effect of age and multiparity on the micturition reflex, includingpelvic floor muscle activation. Young and mature nulliparous rabbits were compared to young and mature multiparas (n = 6 per group). Cystometrograms and urethral pressure (UP) were performed while simultaneously recording the electromyogram (EMG) activity of the pubococcygeus and bulbospongiosus muscles to establish their functional correlation to urological function. Multiparity and age significantly influence the bladder and UP affecting the voiding efficiency and intercontraction interval. Such interaction also reduced the UP threshold, timing, and duration. Other bladder and urethral variables were predominantly affected only by age. Urodynamic alterations correlated with abnormal patternsor absent EMG activity of the pubococcygeus and bulbospongiosus muscles. The present findings strongly suggest that multiparity and age affects specific pelvic floor muscle reflex activation during micturition, andmay contribute to alterations in bladder and urethral function. This data broadens our understanding of the critical role of the appropriate activity of the individual pelvic floor muscles in micturition.

Pelvic floor muscle displacement during jumps in continent and incontinent women: An exploratory study.

The prevalence of stress urinary incontinence during high-impact activities is high. Enhanced comprehension of pelvic floor muscle (PFM) displacement and activity is clinically relevant for the development of specific approaches in rehabilitation. The aim of the study is to investigate and to compare PFM displacement between the continent and incontinent women during jumps. A cross-sectional, exploratory design was applied to investigate PFM displacement during drop jumps (DJ) and countermovement jumps (CMJ). PFM displacement was assessed in craniocaudal translation and forward-backward rotation with an electromagnetic tracking system. Twenty-eight continent and 22 incontinent women were included. During the first landing of DJ, a primary caudal, during the second landing of DJ/CMJ a primary cranial translation and during all jump a primary backward rotation was observed. No significant difference between the groups was found. PFM displacement during running demonstrated caudal translation/forward rotation before and cranial translation/backward rotation after heel strike. During the second landing of DJ/CMJ a cranial translation/backward rotation and during the first landing of DJ a caudal translation/backward rotation has been observed after ground contact. This may be due to the longer lasting bodyweight force in the first landing of DJ. No eccentric-concentric stretch-shortening cycle could be seen. This study indicates that during jumps two opposite reactions of involuntary PFM displacement happen, but no stretch-shortening cycle with an eccentric-concentric contraction could be found. Jumping stimuli inducing involuntary PFM displacement should be used for future investigations to consider a beneficial effect concerning continence.

Comparisons of Electromyography and Digital Palpation Measurement of Pelvic Floor Muscle Strength in Postpartum Women with Stress Urinary Incontinence and Asymptomatic Parturients: A Cross-Sectional Study

Aims: Early evaluation of pelvic floor muscle (PFM) in postpartum women is important for the treatment of stress urinary incontinence (SUI). Digital vaginal palpation and electromyography (EMG) evaluation based on Glazer protocol are widely used for the assessment of PFM. However, the correlation among digital palpation, EMG, and morbidity of postpartum SUI is still unclear. This study aims to investigate the relationship between postpartum SUI and PFM examinations. Methods: This hospital-based cross-sectional study included 1,380 parturients during September 2016 to January 2018. We collected the clinical characteristics, PFM strength, and EMG variables of parturients 6–8 weeks after birth. Then the correlation among the results of EMG, digital palpation, and the occurrence of SUI was analyzed. Results: There is no significant difference in digital palpation scores of PFM strength between SUI and non-SUI parturients. The EMG values were closely related to SUI: the multivariate logistic regression revealed that the most reliable evaluation indicators of postpartum SUI were pelvic floor contractile amplitude of endurance contraction (B = 0.021, p = 0.019) and pretest resting baseline (B = 0.056, p = 0.019). Correlation analysis demonstrated that the contraction variables of EMG had a significant correlation with the digital palpation PFM strength in postpartum women (r = 0.467–0.545, p < 0.001). Conclusion: The EMG proved to be reliable in assessing the PFM function in postpartum women. The decreased PFM activity, according to EMG, was correlated with postpartum SUI. Although digital palpation scores were positively correlated with EMG results, no correlation was observed with SUI incidence.

Lifestyle and Exercise Interventions for Lumbopelvic Pain and Pelvic Floor Dysfunction: A New Protocol

PURPOSE: The purpose of this study was to evaluate whether a protocol that included the implementation of lifestyle modifications and a specialized exercise program would improve the symptoms of pelvic floor dysfunction and mild pelvic organ prolapse in women. METHODS: The five-week IRB-approved study included 23 female subjects aged 43.0 + 9.0 years (Mean + S.D.) who exhibited symptoms of pelvic floor dysfunction as defined by 3 assessments (the Pelvic Floor Distress Inventory [PFIQ-7], the Oswestry Low Back Pain Disability, and the Pelvic Floor Impact [PFDI-SF20] questionnaires). The study also included InBody570 body composition measurements, pelvic alignment assessments, diastasis recti assessments, and manual external pelvic floor muscle activation assessments. Participants were instructed in specific lifestyle modifications and participated in an exercise program over the course of seven live group sessions, 45 minutes each, led by one or both of the investigator clinicians. They were also taught to perform a home exercise program at least 5 days per week and completed compliance forms that were returned at the next live group session. The clinicians were a licensed physical therapist and a clinical exercise physiologist. RESULTS: IBM SPSS version 24 statistical programming was utilized and non-parametric Wilcoxon “related-items” analyses were employed. A 0.05 level of significance was applied. The study results of the pre- and post- values indicated significant improvements of lower back pain (Oswestry, z(23) = -3.67, p < .05), significant improvements of the quality of life subjective emotional gauge (PFDI -20, z(23) = -4.11, p < .05), and significant improvements of bladder, bowel, and prolapse symptoms (PFIQ - 7, z(23) = -3.74, p < .05). CONCLUSIONS: The study was highly labor- and time-intensive, and the sample was not large enough to eliminate statistical bias. However, the successful results warranted a continuation of the study to include 40 female volunteers with no modifications to the study’s protocol using the same clinicians. Researchers are currently recruiting volunteers to complete the study.

Electromyographic Response of the Pelvic Floor Muscles in Female Sex Workers [23I

INTRODUCTION: Sex workers are exposed to situations of vulnerability and may have intercourse many times a day. This intense, constant sexual activity may result in changes to the vagina, overburdening the perineum and other pelvic muscles. Various studies have evaluated PF muscle function in different groups of women. METHODS: A cross-sectional, observational study was conducted with 30 female sex workers aged 18-56 years. The study was approved by local IRB. All the women underwent electromyographic evaluation. RESULTS: A negative correlation was found between electromyographic activity of the pelvic floor muscles and age (r = -0.369; p=0.045), weight (r = -0.401; p=0.028), body mass index (r = -0.412; p=0.024) and number of pregnancies (r = -0.399; p=0.029). Electromyographic activity of the external pelvic floor muscles was greater in the women who worked longer hours compared to those working fewer hours/day (p<0.001). No statistically significant difference was found in relation to skin color, time working in the profession or number of partners per day. CONCLUSION: No correlation was found between the frequency and intensity of sexual activity and electromyographic activity of the pelvic floor muscles in this group of female sex workers; however, electromyographic activity of the external pelvic floor muscles was greater in the women who worked longer hours.

Motor cortical neuromodulation of pelvic floor muscle tone: Potential implications for the treatment of urologic conditions.

In the human brain, supplementary motor area (SMA) is involved in the control of pelvic floor muscles (PFMs). SMA dysfunction has been implicated in several disorders involving PFMs, including urinary incontinence and urologic pain. Here, we aimed to provide a proof-of-concept study to demonstrate the feasibility of modulating resting PFM activity (tone) as well as SMA activity with noninvasive stimulation of SMA. We studied six patients (3 women + 3 men) with Urologic Chronic Pelvic Pain Syndrome. Repetitive transcranial magnetic stimulation (rTMS) was applied to SMA immediately after voiding. We tested two rTMS protocols: high-frequency (HF-rTMS) which is generally excitatory, and low-frequency (LF-rTMS) which is generally inhibitory. PFM activity was measured during rTMS using electromyography. Brain activity was measured immediately before and after rTMS using functional magnetic resonance imaging. The rTMS protocols had significantly different effects on resting activity in PFMs (P = 0.03): HF-rTMS decreased and LF-rTMS increased pelvic floor tone. SMA activity showed a clear trend ( P = 0.06) toward the expected differential changes: HF-rTMS increased and LF-rTMS decreased SMA activity. We interpret the differential effects of rTMS at the brain and muscle level as novel support for an important inhibitory influence of SMA activity on pelvic floor tone after voiding. This preliminary study provides a framework for designing future studies to determine if neuromodulation of SMA could augment therapy for chronic urologic conditions.

Stabilization exercise affects function of transverse abdominis and pelvic floor muscles in women with postpartum lumbo-pelvic pain: a double-blinded randomized clinical trial study.

Lumbo-pelvic pain (LPP) is a common disorder in women after pregnancy due to ligament laxity and postural changes. Transverse abdominis (TrA) and pelvic floor muscle (PFM) activity is important for lumbo-pelvic stability. The purpose of this study was to compare the effect of stabilization exercise (SE) and general exercise (GE) on TrA and PFM muscle activity and pain intensity in women with postpartum LPP. A randomized controlled trial study was conducted on 68 women with postpartum LPP. Patients were randomly divided into two groups of stabilization exercise (SE) and general exercise (GE) and received either SE or GE exercise for 8weeks three times a week. Ultrasound imaging was utilized to measure the thickness change of TrA muscles during abdominal hollowing (AH) and bladder base displacement. These measurements were used as an indicator of TrA and PFM muscle activity. Pain intensity, thickness changes of the TrA muscle and bladder base displacement were measured pre- and post-intervention. The results showed that there was no significant difference in pain relief after intervention between groups. The differences in TrA and PFM activity between groups were significant (P < 0.05). PFM and TrA muscle activity was significantly increased after SE in women with postpartum LPP (P < 0.05). SE improved both PFM and TrA muscle function more than GE in women with postpartum LPP. However, the clinical outcome of pain relief was not greater in the SE group.

The effects of pelvic floor muscle therapy on symptoms, voiding, and pelvic floor muscle activity parameters in children with overactive bladder.

Refractory overactive bladder (OAB) in children can be treated with second line modalities such as as biofeedback, transcutaneous electrical stimulation (TENS), and botulinum toxin. In this study, we aimed to investigate the efficacy of biofeedback-assisted pelvic floor muscle therapy (PFMT) on symptoms, bladder capacity, uroflowmetry, and pelvic floor muscle activity (PFMA) in children with resistant OAB or dysfunctional voiding (DV) with associated seconder bladder overactivity (DV/SBO). A total of 24 children with resistant OAB were included in the study. Patients were divided into two groups as: group-1 pure OAB and group-2 DV/SBO. Children were evaluated with voiding diary, uroflowmetry-EMG, PFMA before and after treatment. All patients were treated with PFMT. Urgency cured or improved in 12 of 17 (71%) of children in group-1 and in six of seven (86%) children in group-2 (P < 0.0001 and 0.031, respectively). Other symptoms cured or improved with 64%-100% recovery rates in group-1 and 50%-80% in group-2. Maximum voided volume (maxVV) in voiding diary increased from 81.6 to 150.9 mL in group-1 and from 115.6 to 175.7 mL in group-2 (P < 0.0001 and 0.063, respectively). Mean work value of PFMA increased and mean rest value of PFMA decreased significantly (P < 0.0001, 0.018 and P = 0.002 and 0.018, respectively). The measurement of PFMA in children with refractory OAB or DV/SBO gives information on the strength and endurance of PFMs. In children with refractory OAB or DV/SBO, biofeedback-assisted PFMT provides symptomatic improvement and increases functional bladder capacity.

Activity of Deep and Superficial Pelvic Floor Muscles in Women in Response to Different Verbal Instructions: A Preliminary Investigation Using a Novel Electromyography Electrode

IntroductionVerbal instructions are used clinically to encourage activation of the pelvic floor muscles (PFM). Whether separate layers of PFM activate differently in response to instructions remains unknown. AimTo test the hypotheses that (i) instructions that aimed to bias activity of a specific muscle layer would increase activation of the targeted layer to a greater extent than the other layer, (ii) activity of individual PFM layers would differ between instructions, and (iii) PFM activity would be symmetrical for all instructions. MethodPFM electromyography (EMG) was recorded using custom-designed surface electrodes in 12 women without PFM dysfunction. The electrode included 4 pairs of recording surfaces orientated to measure EMG from deep and superficial PFM on each side. 3 submaximal contractions were performed for 5 seconds in response to 7 verbal instructions. Root-mean-squared EMG amplitude was calculated for 1 second during the period when participants most closely matched the target activation level. A repeated-measures anova was used to test whether PFM EMG differed between instructions and between regions. The EMG increase of individual muscles relative to that of the reference muscle [deep/right PFM] was compared to no change with t-tests for single samples. Main Outcome MeasurePFM EMG amplitude. ResultsSuperficial PFM EMG was greater than deep PFM for all instructions (P = .039). 2 instructions induced the greatest amplitude of EMG for the superficial PFM: “squeeze the muscles around the vaginal opening as if to purse lips of your mouth” and “draw the clitoris in a posterior direction” (P = .036). Asymmetry was found in the deeper PFM in 3 instructions designed to bias the superficial PFM. Strength & LimitationsThis preliminary study recorded activation of deep and superficial PFM layers in females with a custom-designed novel electrode. Some cross-talk of recording between muscle layers is possible but unlikely to impact the major findings. ConclusionVerbal instructions used to teach PFM contractions can influence their pattern of activity. This study provides preliminary evidence that, in a selection of verbal instructions, the superficial PFM activates more than the deep PFM, and that the deep PFM can have asymmetrical activation.Aljuraifani R, Stafford RE, Hall LM, et al. Activity of Deep and Superficial Pelvic Floor Muscles in Women in Response to Different Verbal Instructions: A Preliminary Investigation Using a Novel Electromyography Electrode J Sex Med 2019;16:673–679.

Task-specific differences in respiration-related activation of deep and superficial pelvic floor muscles.

The female pelvic floor muscles (PFM) are arranged in distinct superficial and deep layers that function to support the pelvic/abdominal organs and maintain continence, but with some potential differences in function. Although general recordings of PFM activity show amplitude modulation in conjunction with fluctuation in intra-abdominal pressure such as that associated with respiration, it is unclear whether the activities of the two PFM layers modulate in a similar manner. This study aimed to investigate the activation of the deep and superficial PFM during a range of respiratory tasks in different postures. Twelve women without pelvic floor dysfunction participated. A custom-built surface electromyography (EMG) electrode was used to record the activation of the superficial and deep PFM during quiet breathing, breathing with increased dead space, coughing, and maximal and submaximal inspiratory and expiratory efforts. As breathing demand increased, the deep PFM layer EMG had greater coherence with respiratory airflow at the frequency of respiration than the superficial PFM (P = 0.038). During cough, the superficial PFM activated earlier than the deep PFM in the sitting position (P = 0.043). In contrast, during maximal and submaximal inspiratory and expiratory efforts, the superficial PFM EMG was greater than that for the deep PFM (P = 0.011). These data show that both layers of PFM are activated during both inspiration and expiration, but with a bias to greater activation in expiratory tasks/phases. Activation of the deep and superficial PFM layers differed in most of the respiratory tasks, but there was no consistent bias to one muscle layer. NEW & NOTEWORTHY Although pelvic floor muscles are generally considered as a single entity, deep and superficial layers have different anatomies and biomechanics. Here we show task-specific differences in recruitment between layers during respiratory tasks in women. The deep layer was more tightly modulated with respiration than the superficial layer, but activation of the superficial layer was greater during maximal/submaximal occluded respiratory efforts and earlier during cough. These data highlight tightly coordinated recruitment of discrete pelvic floor muscles for respiration.

430 - A new evaluation method for children with bladder bowel dysfunction: Pelvic floor muscle activity (PFMA)

430 - A new evaluation method for children with bladder bowel dysfunction: Pelvic floor muscle activity (PFMA)

Pelvic floor muscle activity during impact loads in continent and incontinent women: A systematic review

Introduction: Investigating electromyographic activity of female pelvic floor muscle (PFM) during impact loads helps to clarify the pathophysiology of stress urinary incontinence (SUI).

Pelvic floor muscle activity during fast voluntary contractions in continent and incontinent women.

Stress urinary incontinence (SUI) has also been attributed to a lower speed of contraction of the pelvic floor muscles (PFM). Therefore, PFM assessment and training implement fast voluntary contractions (FVC). The purpose of the study was to explore FVC regarding feasibility, on-/offset and rate of activity determination, as well as differences between continent (CON) and stress urinary incontinent (SUI) women. Fifty women were included and examined by means of PFM EMG during rest, maximum voluntary contractions (MVC), and five FVC. MVC-peak activity was used to normalize EMG-data. On-/offset of muscle activity was determined as mean of rectified rest activity plus 1 standard deviation. Linear regression was calculated for rate of activity from onset to peak, peak to offset, and within 200 ms after both onset and peak. Peak activity and time variables related to onset, peak, and offset were calculated. On-/offsets were evaluable for 234/222 of 250 FVC by a computer-based algorithm, 16/28 on-/offsets had to be determined manually. There was no significant difference between groups (CON/SUI) regarding FVC peak (92.1/99.3 %MVC), time to peak (514.2/525.6 ms), and increase of activity (182.8/182.1 %MVC/s). The SUI group showed a significantly slower activity decrease (-120.7/-74.4 %MVC/s). FVC analyses were shown to be feasible. The significant difference observed between the groups did not refer to activity increase but instead to a prolonged relaxation phase in the SUI group. This prompts to reconsider the interpretation of FVC in PFM testing and training.

The effect of different breathing method and abdominal contraction time on pelvic floor muscles activity

The effect of different breathing method and abdominal contraction time on pelvic floor muscles activity

Is Pelvic Floor Dysfunction Associated With Development of Transient Low Back Pain During Prolonged Standing? A Protocol.

Background:Prolonged standing has been associated with an increased prevalence of low back pain (LBP) and is recognized as a potential workplace hazard for employees such as retail staff, assembly line workers, and healthcare personnel. Low back pain is more prevalent in women than in men, and disability due to LBP is worse in women with severe urinary incontinence. However, it is unclear whether pelvic floor dysfunction observed in stress urinary incontinence is a risk factor for LBP. The main purpose of this study is to determine whether co-activation patterns between the pelvic floor and abdominal muscles during a 2-hour prolonged standing task predict transient LBP in women with and without stress urinary incontinence.Methods:In this is prospective cohort study, 60 female volunteers will stand in a confined area for 2 hours (120 minutes) while performing tasks such as, ‘computer work’ and ‘small object assembly’. The primary outcome measure is transient LBP, which will be monitored every 10 minutes using a numeric pain rating scale. Surface electromyography (EMG) will be collected from the gluteus medius and internal oblique/transverse abdominis muscles, and an intravaginal electrode will be used to monitor pelvic floor muscle activity. The EMG signals will be divided into 12 10-minute blocks to assess changes in co-activation over time. Cross-correlation analyses will be used to quantify co-activation between the muscle pairs (e.g. pelvic floor and internal oblique/transverse abdominis), and the coefficient of co-activation will be expressed as a percentage for each block. A mixed-model regression analysis will be used to determine whether co-activation patterns can predict transient LBP during the prolonged standing task.Discussion:The primary objective of this research is to improve current understanding regarding the role of pelvic floor muscles in the onset of LBP and the potential association between stress urinary incontinence and LBP. These findings have the potential to inform prevention and rehabilitation programmes for women with stress urinary incontinence and LBP.Trial registration:ACTRN12618000446268 [Protocol Version 2].

Effectiveness of Intra-anal Biofeedback and Electrical Stimulation in the Treatment of Children With Refractory Monosymptomatic Nocturnal Enuresis: A Comparative Randomized Controlled Trial.

PurposeTo compare the effects of intra-anal biofeedback (BF) and intra-anal electrical stimulation (ES) on pelvic floor muscles (PFMs) activity, nocturnal bladder capacity, and frequency of wet night episodes in children with refractory primary monosymptomatic nocturnal enuresis (PMNE).MethodsNinety children of both sexes aged 8–12 years with refractory PMNE participated in this study. They were randomly assigned to 3 groups of equal number: control group (CON) that underwent behavioral therapy and PFM training, and 2 study groups (BF and ES) that underwent the same program in addition to intra-anal BF training and intra-anal ES, respectively. PFMs activity was assessed using electromyography, nocturnal bladder capacity was evaluated by measuring the first morning voided volume, and a nocturnal enuresis diary was used for documenting wet night episodes before treatment and after 3 months of treatment.ResultsAfter training, all groups showed statistically significant improvements in all measured outcomes compared to their pretreatment findings. The ES group showed significantly greater improvements in all measured outcomes than the CON and BF groups.ConclusionsBoth intra-anal BF training and ES combined with behavioral therapy and PFMs training were effective in the treatment of PMNE, with intra-anal ES being superior to BF training.

Individualization of Musculoskeletal Model for Analyzing Pelvic Floor Muscles Activity Based on Gait Motion Features

Stress urinary incontinence (SUI) is a typical quality of life disease in women. The strengthening of the pelvic floor muscle (PFM) is considered effective to prevent this. Specifically, PFM activity is affected by individual pelvic shape and posture. Therefore, it is necessary to analyze muscle activity by considering the individual differences. In this study, individual pelvic alignment was estimated from the feature values of natural gait via multiple regression analysis. In addition, individual pelvic feature points were derived from X-ray images and used to deform the standard model to obtain individual pelvic shapes. Results indicate that the residual averages of the estimated feature angles were less than 2° in most cases. Subsequently, measurements of the pelvis were obtained via MRI to evaluate the estimated pelvis shape. The results indicate that individual adaptation leads to muscle attachment positions, which are important in the muscle activity analysis, and closer to the true MRI value when compared to that of the standard pelvic model.

Is Pelvic Floor sEMG a Measure of Women’s Sexual Response?

IntroductionPelvic floor surface electromyography (sEMG) is often used in the assessment and treatment of individuals with pelvic floor abnormalities to measure muscle tone and neural control of the pelvic floor muscles (PFM); however, little is known about the role of the PFM in sexual arousal. AimThe aim of this pilot study was to examine whether changes in deep and superficial PFM activity—assessed with sEMG—can be observed during the presentation of sexual stimuli. MethodsDeep PFM sEMG activity was assessed with a vaginal probe. Superficial PFM activity was assessed with sEMG electrodes placed over the bulbocavernosus and perianal muscles. 15 sexually healthy women (mean age 27 years) watched a series of neutral, anxiety-evoking, and sexually explicit films. Continuous subjective sexual arousal was measured using a handheld arousometer. Main Outcome MeasureChanges in microvolts were measured by sEMG sensors, from neutral to anxiety-evoking and neutral to sexually explicit films. ResultsThere was an increase in intravaginal and perianal sEMG for both the erotic and anxiety films. Bulbocavernosus sEMG responses did not differ among the 3 films. Concordance between self-reported continuous sexual arousal for the erotic film and bulbocavernosus sEMG (r = 0.349) was not significantly different than concordance using intravaginal sEMG (r = 0.293) or perianal sEMG (r = 0.236). Clinical ImplicationsUnderstanding more about which parts of the PFM respond specifically to sexual stimuli may have implications for measuring the effects of treatments aimed at improving sexual response in women. Strength & LimitationsThe results of this pilot study provide a preliminary understanding of which pelvic floor muscles respond to sexual stimuli. A limitation of this study was the small sample size. ConclusionTaken together, these findings suggest that intravaginal and perianal sEMG respond to erotic stimuli, whereas bulbocavernosal sEMG responses do not.Hannan-Leith MN, Dayan M, Hatfield G, et al. Is Pelvic Floor Surface Electromyography a Measure of Women’s Sexual Response? A Pilot Study. J Sex Med 2019;16:70–82.

Effects of low- vs high-volume swimming training on pelvic floor muscle activity in women.

This study examined the effects of different training loads on pelvic floor muscle (PFM) activity in swimming. Twelve female swimmers were included in this study (23.71±1.44 y.o.; 167±5.89 cm; 62.05±8.89 kg). They took part in an experiment with two different stages of load in swimming training. For the pelvic floor muscle assessment the Glazer Protocol was used. To assess swimming technique, David Pyne’s Stroke Mechanics Test was used. A statistically significant increase in surface electromyography (sEMG) values appeared in the fifth R (rest after contraction) in the quick flick stage of the measurement protocol of PFM at the third measurement time (7.71±4.49 μV) compared to the first measurement time (6.25±4.43 μV) with p≤0.05. Increasing the training load may cause unwanted changes in the level of electrical activity of pelvic floor muscles.