Pattern of activation of pelvic floor muscles in men differs with verbal instructions

Stafford, Ryan E.; Ashton‐Miller, James A.; Constantinou, Christos E.; Coughlin, Geoff; Lutton, Nicholas; Hodges, Paul W.

doi:10.1002/nau.22745

Cited by 45 publications

(50 citation statements)

References 28 publications

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“…Non‐invasive transperineal ultrasound imaging provides an alternative method to study pelvic floor muscle function and recent investigations using this method have provided new insights . Using this technique muscle activation is quantified by displacement of landmarks in the ultrasound images, and this has been validated against measurement of muscle activation using invasive EMG recordings of SUS, PR, and BC . These studies have confirmed a relation between motion observed on ultrasound and activation of individual pelvic floor muscles in healthy men, thus enabling non‐invasive investigation of the continence mechanism in men with PPI.…”

Section: Introductionmentioning

confidence: 82%

Postprostatectomy incontinence is related to pelvic floor displacements observed with trans‐perineal ultrasound imaging

Stafford

Hoorn

Coughlin

et al. 2017

Neurourology and Urodynamics

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Section: Introductionmentioning

confidence: 82%

Postprostatectomy incontinence is related to pelvic floor displacements observed with trans‐perineal ultrasound imaging

Stafford

Hoorn

Coughlin

et al. 2017

Neurourology and Urodynamics

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“…Men were trained to contract pelvic floor muscles without activation of the abdominal muscles using B‐mode image to provide biofeedback of dorsal displacement of the mid‐urethra. Participants performed a 3‐s maximal voluntary contraction (MVC) of the pelvic floor muscles for two repetitions using the instruction to ‘retract the penis into the body as strongly as possible', which we have shown previously leads to optimal activation of the SUS . The peak MVC EMG amplitude was used to calculate contraction intensity targets set at 5%, 10%, and 15% MVC.…”

Section: Methodsmentioning

confidence: 99%

Application of shear‐wave elastography to estimate the stiffness of the male striated urethral sphincter during voluntary contractions

et al. 2016

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ObjectivesTo investigate whether increases in stiffness can be detected in the anatomical region associated with the striated urethral sphincter (SUS) during voluntary activation using shear-wave elastography (SWE); to identify the location and area of the stiffness increase relative to the point of greatest dorsal displacement of the mid urethra (i.e. SUS); and to determine the relationship between muscle stiffness and contraction intensity. Subjects and MethodsIn all, 10 healthy men participated. A linear ultrasound (US) transducer was placed mid-sagittal on the perineum adjacent to a pair of electromyography electrodes that recorded nonspecific pelvic floor muscle activity. Stiffness in the area expected to contain the SUS was estimated via US SWE at rest and during voluntary pelvic floor muscles contractions to 5%, 10% and 15% maximum. Still image frames were exported for each repetition and analysed with software that detected increases in stiffness above 150% of the resting stiffness. ResultsPelvic floor muscle contraction elicited an increase in stiffness above threshold within the region expected to contain the SUS for all participants and contraction intensities. The mean (SD) ventral-dorsal distance between the centre of the stiffness area and region of maximal motion of the midurethra (caused by SUS contraction) was 5.6 (1.8), 6.2 (0.8), and 5.8 (0.7) mm for 5%, 10% and 15% maximal voluntary contraction, respectively. Greater pelvic floor muscle contraction intensity resulted in a concomitant increase in stiffness, which differed between contraction intensities (5% vs 10%, P < 0.001; 5% vs 15%, P < 0.001; 10% vs 15%, P = 0.003). ConclusionVoluntary contraction of the pelvic floor muscles in men is associated with an area of stiffness increase measured with SWE, which concurs with the expected location of the SUS. The increase in stiffness occurred in association with an increase in perineal surface electromyography activity, providing evidence that stiffness amplitude relates to general pelvic floor muscle contraction intensity. Future applications of SWE may include investigations of patient populations in which dysfunction of the SUS is thought to play an important role, or investigation of the effect of rehabilitation programmes that target this muscle.

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“…Similarly, Sapsford et al [7] reported that the PFMs was activated during contraction of the abdominal muscles. Anal contraction is focused on anal muscle contraction [19]. The anal muscle consists of urethral support with PFMs.…”

Section: Discussionmentioning

confidence: 99%

Effect of different contraction methods on pelvic floor muscle contraction in middle-aged women

Kim

Choi

Shin

2015

PTRS

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Objective: Pelvic floor muscles (PFMs) form the base of the abdomino-pelvic cavity and also the PFMs function is important for urinary continence. PFMs training (PFMT) is considered to be the first method for PFM dysfunction. This study demonstrated correct PFMs contraction among commonly used different contraction methods for PFMT. Design: Cross-sectional study. Methods: In this study, nineteen middle-aged (40-70 years) women participated. To evaluate PFM function, ultrasonography was used to measure the distance of the bladder base movement. The distance of the PFM movements were calculated at rest and during the other contractions. The following four different contraction methods were performed randomly: (1) PFM contraction, (2) abdominal drawing-in maneuver (ADIM), (3) anal contraction, and (4) hip adductor muscle contraction. The participants held the contraction for 3 seconds for a total of 3 times with a 30 seconds rest period between each trial. The mean of three measurements in each position were obtained and compared with that in the resting position. Results: The bladder base movement values were significantly greater when comparing PFM with ADIM and hip adductor contractions (p<0.05). The bladder base movement values were significantly greater when comparing ADIM and anal contractions with hip adductor contractions (p<0.05). Conclusions:The results of this study suggest that performing PFM contractions is the best method among the common methods for PFMT. Performing PFM contractions was more effective than the other contraction methods.

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Pattern of activation of pelvic floor muscles in men differs with verbal instructions

Cited by 45 publications

References 28 publications

Postprostatectomy incontinence is related to pelvic floor displacements observed with trans‐perineal ultrasound imaging

Postprostatectomy incontinence is related to pelvic floor displacements observed with trans‐perineal ultrasound imaging

Application of shear‐wave elastography to estimate the stiffness of the male striated urethral sphincter during voluntary contractions

Effect of different contraction methods on pelvic floor muscle contraction in middle-aged women

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