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Moser H1,2, Leitner M3, Eichelberger P3,4, Kuhn A5, Baeyens J-P6, Radlinger L3
1Free University Brussels, Department of Physiotherapy, Human Physiology and Anatomy, Brussels, Belgium, 2Bern University of Applied Sciences, Division of Physiotherapy, Department of Health Professions, Bern, Switzerland, 3Bern University of Applied Sciences, Bern, Switzerland, 4University of Bern, Graduate School for Cellular and Biomedical Sciences, Bern, Switzerland, 5Bern University Hospital, Department of Gynecology, Bern, Switzerland, 6Free University Brussels, Brussels, Belgium
Background: Urinary incontinence, is worldwide a very common condition and it shows a negative impact on quality of life. Among several forms of incontinence, stress urinary incontinence (SUI) is the most prevalent type. The overall costs generated by patients with SUI to society are tremendous. Even in female athletes SUI is a widespread problem. According to the International Continence Society SUI is defined as the complaint of involuntary leakage on effort or exertion or on sneezing or coughing [1]. SUI-provoking activities have a rise of intra-abdominal pressure and impact loading on the pelvic floor in common. To date, PFM activity during whole-body movements that potentially provoke urinary leakage is increasingly explored. The mode of muscle contraction during impact activities for the PFM is still unclear, especially during jumps. However, the importance of involuntary reflex activity of the PFM for continence has been recognized.
Purpose: This study investigated PFM activity during jumps, by means of electromyographic (EMG) measurement to clarify the involuntary reflex activity of the PFMs. Women with SUI and continent women (CON) were tested during drop jumps (DJ) and counter movement jumps (CMJ).
Methods: Twenty-eight continent and twenty-two incontinent women aged between 18 and 60 years were included. A vaginal probe was used to record surface EMG activity of the PFMs during DJ and CMJ. Six time intervals of 30 ms were used to parameterize data from 30 ms before (pre-activity) to 150 ms after ground contact (reflex activity) on a force plate during the landing and take-off phase. All EMG signals were normalized to the mean of the peak values of two maximal voluntary contractions (MVC) and expressed in percentage (%MVC).
Results: The measurement of PFM activation during vertical jumps for continent and incontinent women showed no significant difference between the groups (P 0.05). EMG values exceeded 100 %MVC for all time intervals during all landing and take-off phases. The mean of maximal PFM activation during the first landing of DJ was 404.1 SD 164.1 %MVC at 142 SD 53 ms after ground contact for SUI and 370.2 SD 139.1 %MVC at 155 SD 62 ms after ground contact for CON. The mean of minimal PFM activation between the take-off and second landing phase of DJ was 57.9 SD 42.6 %MVC at 210 SD 96 ms after take-off for SUI and 50.0 SD 29.4 %MVC at 214 SD 82 ms after take-off for CON. For CMJ it was 61.4 SD 43.4 %MVC at 238 SD 102 ms for SUI and 51.1 SD 23.3 %MVC at 252 SD 85 ms for CON.
Conclusion(s): Vertical jumps seem to stimulate pre-activity before and reflex activity after ground contact during the landing phase and activate PFMs up to 400 %MVC.
Implications: Jumping stimuli inducing involuntary PFM contraction should be used for future investigations to consider a beneficial effect concerning continence.
Keywords: Activation, Electromyography, Reflex activity
Funding acknowledgements: Bern University of Applied Sciences, Bern, Switzerland , no financial relationships
Purpose: This study investigated PFM activity during jumps, by means of electromyographic (EMG) measurement to clarify the involuntary reflex activity of the PFMs. Women with SUI and continent women (CON) were tested during drop jumps (DJ) and counter movement jumps (CMJ).
Methods: Twenty-eight continent and twenty-two incontinent women aged between 18 and 60 years were included. A vaginal probe was used to record surface EMG activity of the PFMs during DJ and CMJ. Six time intervals of 30 ms were used to parameterize data from 30 ms before (pre-activity) to 150 ms after ground contact (reflex activity) on a force plate during the landing and take-off phase. All EMG signals were normalized to the mean of the peak values of two maximal voluntary contractions (MVC) and expressed in percentage (%MVC).
Results: The measurement of PFM activation during vertical jumps for continent and incontinent women showed no significant difference between the groups (P 0.05). EMG values exceeded 100 %MVC for all time intervals during all landing and take-off phases. The mean of maximal PFM activation during the first landing of DJ was 404.1 SD 164.1 %MVC at 142 SD 53 ms after ground contact for SUI and 370.2 SD 139.1 %MVC at 155 SD 62 ms after ground contact for CON. The mean of minimal PFM activation between the take-off and second landing phase of DJ was 57.9 SD 42.6 %MVC at 210 SD 96 ms after take-off for SUI and 50.0 SD 29.4 %MVC at 214 SD 82 ms after take-off for CON. For CMJ it was 61.4 SD 43.4 %MVC at 238 SD 102 ms for SUI and 51.1 SD 23.3 %MVC at 252 SD 85 ms for CON.
Conclusion(s): Vertical jumps seem to stimulate pre-activity before and reflex activity after ground contact during the landing phase and activate PFMs up to 400 %MVC.
Implications: Jumping stimuli inducing involuntary PFM contraction should be used for future investigations to consider a beneficial effect concerning continence.
Keywords: Activation, Electromyography, Reflex activity
Funding acknowledgements: Bern University of Applied Sciences, Bern, Switzerland , no financial relationships
Topic: Women's & men's pelvic health; Sport & sports injuries; Human movement analysis
Ethics approval required: Yes
Institution: Ethics committee of the Canton of Bern, Switzerland
Ethics committee: Ethics committee of the Canton of Bern, Switzerland
Ethics number: No. 391/14
All authors, affiliations and abstracts have been published as submitted.
