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Brandt C1, Van Wyk E2
1University of the Witwatersrand, Physiotherapy, Johannesburg, South Africa, 2University of the Free State, Physiotherapy, Bloemfontein, South Africa
Background: Motor control dysfunction seems to be associated with low back pain (LBP) and pelvic floor dysfunction (PFD). Dysfunction of the core muscles may cause loss of spinal stability, incontinence, and pelvic organ prolapse. Few studies have investigated a possible interaction between PFD, LBP and motor control.
Purpose: The aim was therefore to investigate pelvic floor and abdominal muscle function; and severity of chronic LBP and PFD in parous, South African women.
Methods: Parous women (n=45) (aged 30-50) were conveniently sampled for an analytical study (28 with and 17 without chronic LBP). Measuring instruments included the Australian Pelvic Floor Questionnaire, Oswestry Low Back Pain Disability Questionnaire, the Active Straight Leg Raise Test, Sahrmann test, PERFECT score and electromyography of the pelvic floor muscles.
The Mann-Whitney and chi-square tests, 95% confidence intervals, and the Spearmans` rank correlation were used for statistical analysis.
Results: The chronic LBP group had statistically significant higher levels of PFD (p0.01; 95% CI [3-11.9]) when compared to the control group. This PFD was moderately negatively correlated with pelvic floor muscle strength (rho= -0.42; p=0.03) and endurance (r= -0.43; p=0.02); but weakly positively correlated with abdominal stabiliser function (r= 0.12; p= 0.56).
The chronic LBP group had slightly weaker abdominal stabiliser muscle function than the control group (p=0.18).
Increased severity of chronic LBP showed increased levels of PFD (p=0.04), decreased abdominal stabiliser strength (p=0.78), and decreased pelvic floor muscle strength (p=0.04) and endurance (p=0.10).
Conclusion(s): Abdominal stabiliser and pelvic floor muscle dysfunction was found in patients with chronic LBP when compared with a control group. Associated changes in muscle behaviour with increased severity of LBP, might be attributed to inhibition and compensation strategies, which in turn may cause or increase the severity of PFD such as incontinence or pelvic organ prolapse. Clinical studies are necessary to substantiate these findings.
Implications: The findings may implicate that pelvic floor muscle function and motor control should be assessed and managed in patients with LBP to prevent/ treat PFD and associated complications. It may also implicate, on the other hand, that patients with PFD should be screened for the presence of LBP.
Keywords: Pelvic floor dysfunction, chronic low back pain, motor control
Funding acknowledgements: None
Purpose: The aim was therefore to investigate pelvic floor and abdominal muscle function; and severity of chronic LBP and PFD in parous, South African women.
Methods: Parous women (n=45) (aged 30-50) were conveniently sampled for an analytical study (28 with and 17 without chronic LBP). Measuring instruments included the Australian Pelvic Floor Questionnaire, Oswestry Low Back Pain Disability Questionnaire, the Active Straight Leg Raise Test, Sahrmann test, PERFECT score and electromyography of the pelvic floor muscles.
The Mann-Whitney and chi-square tests, 95% confidence intervals, and the Spearmans` rank correlation were used for statistical analysis.
Results: The chronic LBP group had statistically significant higher levels of PFD (p0.01; 95% CI [3-11.9]) when compared to the control group. This PFD was moderately negatively correlated with pelvic floor muscle strength (rho= -0.42; p=0.03) and endurance (r= -0.43; p=0.02); but weakly positively correlated with abdominal stabiliser function (r= 0.12; p= 0.56).
The chronic LBP group had slightly weaker abdominal stabiliser muscle function than the control group (p=0.18).
Increased severity of chronic LBP showed increased levels of PFD (p=0.04), decreased abdominal stabiliser strength (p=0.78), and decreased pelvic floor muscle strength (p=0.04) and endurance (p=0.10).
Conclusion(s): Abdominal stabiliser and pelvic floor muscle dysfunction was found in patients with chronic LBP when compared with a control group. Associated changes in muscle behaviour with increased severity of LBP, might be attributed to inhibition and compensation strategies, which in turn may cause or increase the severity of PFD such as incontinence or pelvic organ prolapse. Clinical studies are necessary to substantiate these findings.
Implications: The findings may implicate that pelvic floor muscle function and motor control should be assessed and managed in patients with LBP to prevent/ treat PFD and associated complications. It may also implicate, on the other hand, that patients with PFD should be screened for the presence of LBP.
Keywords: Pelvic floor dysfunction, chronic low back pain, motor control
Funding acknowledgements: None
Topic: Women's & men's pelvic health; Musculoskeletal: spine
Ethics approval required: Yes
Institution: University of the Free State
Ethics committee: Ethics Committee of the University of the Free State
Ethics number: ECUFS nr 173/2011
All authors, affiliations and abstracts have been published as submitted.
