Pelvic floor and abdominal muscle responses during hypopressive exercises in women with pelvic floor dysfunction

Abstract

Aim: To measure the neuromuscular activation of the pelvic floor and abdominal muscles concurrently with vaginal closure forces induced during a hypopressive exercise (HE) and to identify the contribution of the HEs sequences (posture and maneuver) in the muscle's activation. Methods:A cross-sectional study design was employed. Sixty-six women who had participated in a physical therapy program focused on HEs were recruited.Pelvic floor muscle (PFM) activation was measured using surface electromyography (sEMG) in supine and in the orthostatic position, and vaginal closure force was measured through vaginal dynamometry in supine. Activation of the abdominal, gluteal, and hip adductor muscles was measured using sEMG. Maximum effort voluntary contractions (MVCs) of the PFMs and reference contractions of the abdominal and hip muscles were acquired for normalization purposes. A HE was then performed in a supine position with one leg raised, then in an orthostatic position. Results: During the supine HE, the peak PFM sEMG amplitude was 74.4% to 86.5% (49.6%-109.6%) of MVC, the peak vaginal closure force was between 51.2% and 55.7% (95.5%-382.9%) of MVC, and the muscles of the lateral abdominal wall were activated between 25.4% and 35.3% of the reference contraction. During the orthostatic HE, PFM activation was 61.4% (40.1%-105.6%) of MVC, and the lateral abdominal wall muscles contracted at 22.8% of the reference activation level.Conclusions: The PFMs, abdominal, gluteal, and adductor muscles are activated during the performance of a HE. The activation level of the PFMs and abdominal muscles is likely insufficient to result in strength gains; however, they could have an endurance effect. K E Y W O R D Sdeep abdominal muscles, hypopressive exercises, pelvic floor dysfunction, pelvic floor muscles strength, surface electromyography, therapeutic exercise

Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy

“…HE relies on the reflex activation of PFM through adequate breathing and body position changes. They also activate the transverse abdominal muscle, increase PFM endurance, but do not lead to their hypertrophy [73]. An important factor affecting the effectiveness of PFM training is the proper positioning of the pelvis and ankle.…”

The Effects of Abdominal Hypopressive Training on Postural Control and Deep Trunk Muscle Activation: A Randomized Controlled Trial

“…Caufriez et al, in 1980 [11], proposed Abdominal Hypopressive Training (AHT) as a method to prevent pelvic floor dysfunction after pregnancy [12], then as training to improve postural control [13]. It consists of postural and breathing techniques [14,15] which decrease the pressure in three compartments: the thoracic, abdominal, and perineal [11]. It has been hypothesized that complete exhalation, followed by apnea, blocks the glottis and opens the chest cavity in such a way that the diaphragm is stretched, causing involuntary trunk deep muscle activation [12][13][14].…”

Can abdominal hypropressive technique improve stress urinary incontinence? an assessor‐blinded randomized controlled trial

“…With respect to the effects of AHT in PFM, some studies demonstrated that these muscles are activated in healthy nulliparous 12,13 and in women with PFM dysfunction, 14 but it seems that this activation is insufficient to strength gains 14 …”