Synergism between abdominal and pelvic floor muscles in healthy women: a systematic review of observational studies

Abstract

Introduction: The training of the pelvic floor muscles is widely used for treating pelvic floor dysfunctions, like urinary incontinence. During the training, abdominal contractions are avoided; however several studies support the use of the synergy between these muscle groups. Objective: Carrying out a systematic review of studies that seek to identify the presence of synergy between the muscles of the abdomen and the pelvic floor and its functionality in women without pelvic floor dysfunction. Methodology: To conduct the review, we have followed the recommendations proposed by the Cochrane Collaboration for systematic reviews. The literature search included the databases SCIELO, PEDro, MEDLINE, Cochrane CENTRAL and EMBASE, and manual research, the starting date of the databases until August 2013. We included cross observational studies with healthy women who were assessed to find the presence of synergy between the abdominal muscles and the pelvic floor. Results: We included 10 articles and they all showed the existence of synergy between the abdominal and pelvic floor muscles in healthy women in the supine, sitting and standing positions. Conclusion: Thus, we can conclude that there is synergy between the muscles of the abdomen and the pelvic floor in healthy women. Better understanding the behavior of these muscles and synergy may favor the development of strategies for the prevention and treatment of disorders of the female pelvic floor muscles.

Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis

“…Although previous systematic reviews have shown evidence of cocontraction between PFMs and AbMs (41,42), investigators had not previously conducted a comparison between women with a normal pelvic floor and those with PFD involving all four muscles of the abdominal wall (TrA, RA, OI, and OE). Furthermore, to our knowledge, there is no published meta-analysis of the cocontraction between PFMs and the four AbMs.…”

“…The first systematic review related to this theme focused only on the combined training of the TrA and PFMs to treat UI and included five studies (41). Another previous systematic review focused only on healthy women and included ten studies (42). In contrast, our search found 20 studies, and only five could be included in the meta-analyses.…”

"Heavy lifting and urinary incontinence" top read or toss into the bias list?

“…The no-leakage observation for the UI participants suggests that this factor may be a compensatory mechanism revealed in contractions of the abdominal muscles to prevent urinary leakage. Due to the possible synergies of the abdominal and pelvic floor muscles in the prevention of the UI, 26 an electromyography measurement of these muscles can further investigate this hypothesis. The detrusor pressure, as an indicator for the UI, between control and morbid groups was only significantly different in full bladder condition.…”

Synergistic Activities of Abdominal Muscles Are Required for Efficient Micturition in Anesthetized Female Mice

“…Altogether, our results and those of the reports discussed above further the idea that abdominal muscles are required for micturition in rodents, as ‘chemical silencing’ with pancuronium significantly affected voiding efficiency. In addition to its supportive role in facilitating urination, a seemingly contradictory function of abdominal straining in maintaining urinary continence has been reported [ 26 , 27 ]. The specific contraction pattern of abdominal muscles, as well as the coactivation of pelvic floor muscles, can contribute to controlling urine flow by, on the contrary, increasing urethral pressure [ 28 , 29 ].…”