Pelvic floor activity patterns: comparison of nulliparous continent and parous urinary stress incontinent women. A kinesiological EMG study

Abstract

Childbirth appeared to induce both quantitative and qualitative changes in the pelvic floor which jeopardized the continence mechanism. Sphincter weakness appeared to result not only from the loss of motor units but also from altered activation patterns in the remaining units: shorter activation periods, lack of response or paradoxical inhibition. Kinesiological EMG recordings revealed behavioural abnormalities which appeared relevant for planning treatment.

Ultrasound Evaluation of Dynamic Responses of Female Pelvic Floor Muscles

“…In continent women there is recruitment of PFM motor units (Deindl et al 1993) and an increase in intra-urethral pressure (Constantinou & Govan 1982) prior to an increase in intra-abdominal pressure (IAP) during a cough. However there are altered PFM activation patterns during a cough, measured by EMG in women with SUI compared to healthy volunteers (Deindl et al 1994), with shorter activation periods, lack of response or paradoxical inhibition.…”

A Study of Pelvic Floor Function Pre– and Postradical Prostatectomy Using Clinical Neurourological Investigations, Urodynamics and Electromyography

“…There are no previous investigations of the fine motoric aspects of pelvic floor muscle function after pelvic surgery. However, there are reports about pathological pelvic floor EMG patterns in neurological patients [14, 15]and stress incontinent women [16]. …”

Rehabilitative Ultrasound Imaging: Understanding the Technology and Its Applications

“…This is due to an accumulation of evidence pointing to altered neuromuscular control in individuals with persistent and recurring symptoms. 5,15,24,56,60,62,126 Moreover, investigations indicate that these deficits do not consistently recover with the resolution of pain 49,51 and are not addressed with traditional exercise programs focused on increasing strength and functional capacity. 125 The extrapolation of this work is that the initial focus of rehabilitation may need to address these motor control alterations through a therapeutic intervention rooted in motor learning.…”

“…Although these frame rates are capable of detecting deformation (thickness) and changes in the depth of a muscle, they are not high enough to provide information related to the normal anticipatory response demonstrated by certain muscles 23,54,60,89 and the loss of this response with dysfunction. 24,55,58,79 In fact, to be able to record anticipatory muscle response (defined as a contraction occurring from 100 milliseconds before and up to 50 milliseconds after activation of a prime mover 3,59,89 ), frame rates need to be on the order of 500 frames per second. 140 Although intramuscular EMG is considered the gold standard for evaluating onset of muscle activity, high-frame-rate m-mode USI is a promising noninvasive alternative, as it allows for the visualization of the onset of deformation of muscle as it starts to contract.…”