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D.R.A. Reyes1, C. Prudencio1, F. Pinheiro1, R. Hallur1, C. Pedroni2, S. Nunes1, M. Orlandi1, M. Jacomin2, M. Rudge1, I. Calderon1, A. Barbosa2,1
1Botucatu Medical School (FMB), São Paulo State University (UNESP), Department of Gynecology and Obstetrics, Botucatu, Brazil, 2School of Philosophy and Sciences, São Paulo State University (UNESP), Department of Physiotherapy and Occupational Therapy, Marilia, Brazil
Background: Pelvic floor muscles (PFM) are impacted are overloaded during pregnancy, which contribute to the pregnancy specific urinary incontinence (PSUI). The electromyography and digital palpation are important tools to evaluate pelvic floor muscle functionality.
Purpose: Aim of this study was to compare pelvic floor function by digital palpation and electromyography among pregnant women with and without PSUI.
Methods: A total of 44 primiparous pregnant women, between 24-28 and 36-38 weeks of gestation, between 18-40 years, without previous urinary incontinence and/or muscular degenerative diseases, without previous pelvic floor training. The data collection was performed in two moments, between 24-28 and 36-38 weeks of gestation. Participants initially answered the survey that consisted of personal, demographic and anthropometric data. Then, they were instructed on the sequence of the composite protocol, the first step was the digital palpation and after the electromyographic evaluation sequence using the Glazer protocol. The raw signal was processed by using MiotecSuite software by an examiner blinded to the women’s clinical data. The electrical data of the recruitment root mean square (RMS) from the period of five hold contractions were performed by using Hanning window processing, after calculation of each RMS arithmetic mean was performed to determine a mean single value for each contraction type. To normalize the EMG recruitment signal, we used the maximal voluntary contraction at 24–30 weeks of gestation because that was considered base data for analysis of changes in PFM activity.
Results: Twenty pregnant women composed the continent group (C-G) and 24 pregnant women composed incontinent group (UI-G). Concerning the pelvic floor recruitment, the UI-G showed a decreased function compared to C-G (P=0.027) and the endurance assessed by digital palpation were lower in UI-G (P=0.024).
Conclusion(s): PFM recruitment in UI-G were decreased during fast contractions when evaluated with electromyography and during palpation the ability to hold the contraction (endurance) where worst in UI-G when compared with C-G. The C-G group reacted to the pregnancy overload with an increase of pelvic floor recruitment.
Implications: Although, the lower levels of pelvic floor function are well known in women with UI, but little is known about pelvic floor recruitment in PSUI. So, this study brings the information about the recruitment decrement along pregnancy impacted by PSUI. Further studies are warranted to evaluate the muscle behavior during post-partum.
Funding, acknowledgements: This work was supported by grant #2012/25060-3, 2018/10661-8 and #2016/01743-5, São Paulo Research Foundation (FAPESP), Brazil.
Keywords: Electromyography, Urinary incontinence, Physical therapy
Topic: Musculoskeletal
Did this work require ethics approval? Yes
Institution: Botucatu Medical School-UNESP
Committee: The Research Ethics Committee of Botucatu Medical School
Ethics number: CAAE 20639813.0.0000.5411
All authors, affiliations and abstracts have been published as submitted.
