Lumbopelvic Dysfunction and Stress Urinary Incontinence: A Case Report Applying Rehabilitative Ultrasound Imaging

Abstract

activity that increases intra-abdominal pressure.7 Bo et al 4 have reported that 20% of otherwise fit, healthy, nulliparous women have urine loss that caused social or hygienic problems. Prevalence in female athletes varies between 0% to 80%, 2 with a higher incidence reported in athletes participating in high-impact sports (eg, trampolinist, gymnast, track and field events).2 Further, 28% of nulliparous elite athletes reported urine loss while participating in athletic events. 29Davis et al 9 conducted a descriptive study at 3 United States Army training facilities to assess the prevalence of urinary incontinence among female soldiers. P revalence rates of stress urinary incontinence (SUI) vary between 10% to 55% in women between the ages of 15 to 64 years.2 Although SUI is a condition traditionally thought to occur in older, multiparous women, a number of descriptive studies have reported SUI in young, nulliparous women, [2][3][4]12,23 typically as an involuntary loss of urine that occurs when pressure is exerted on the bladder by sneezing, coughing, laughing, or any other physical t stuDy DEsign: Case report.t backgrOunD: It has been suggested that altered neuromuscular control of the transversus abdominis and pelvic floor muscles may contribute to sacroiliac joint (SIJ) region pain and stress urinary incontinence. There are limited examples describing the evaluation and management of individuals with both SIJ region pain and stress urinary incontinence in the literature. This case report describes a patient with both conditions and details the integration of rehabilitative ultrasound imaging (RUSI) during physical therapy evaluation. t casE DEscriPtiOn: A 35-year-old female soldier presented with a 6-week history of left buttock pain and 4-year history of stress urinary incontinence during activities that involved running, jumping, and fast walking. RUSI was used to supplement the physical assessment process, revealing altered motor control strategies of the transversus abdominis and pelvic floor muscles, and as a form of biofeedback during the rehabilitation process.t OutcOMEs: After completing a rehabilitation program that incorporated principles of lumbar stabilization and pelvic floor muscle re-education, this patient was able to complete all physical activities in basic combat training without SIJ region pain or urinary leakage.t DiscussiOn: This case demonstrates the importance of considering pelvic floor muscle dysfunction and training in a patient with primary complaints of SIJ region pain. It also highlights the potential role of RUSI as both an evaluation and biofeedback tool for the deep abdominal and pelvic floor muscles.

Associations between low back pain, urinary incontinence, and abdominal muscle recruitment as assessed via ultrasonography in the elderly

“…Physical therapists use ultrasound measurements to assess muscle function and soft tissue morphology during movement or while performing specific tasks 20 , 22 . Ultrasound imaging is also used to assist therapeutic approaches intended to improve neuromuscular function 14 , 20 , 23 , 24 .…”

What is known from the existing literature about the available interventions for pelvic floor dysfunction among female athletes? A scoping review

“…As presented in the PRISMA 2020‐flow diagram (Figure 1 ), from 2625 records identified by the initial literature searches, 2590 were excluded and 35 articles were included. 3 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 The reasons for exclusion and the corresponding references are reported in online Supporting Information File S 2 .…”