the main objective of this study was to investigate abdominal, diaphragm, and PFM activity using ultrasonography during deep respiration and ASLR with and without using a pelvic belt between women with and without PLPP.
Thirty women with and 30 women without PLPP participated in this case–control study. Ultrasound imaging was used to assess the abdominal, diaphragm, and PFMs during rest, active straight leg raising (ASLR) with and without a pelvic belt, and deep respiration. An ultrasound unit (SONOACE R7; Samsung Medison, Korea) with a bandwidth frequency of
9–12 MHz (resolution frequency) was used as a diagnosticmeasure. The data were collected by one physiotherapistunder the supervision of a sonographer. Women in both groups were assessed under the following test conditions: at rest, during deep respiration, while
performing ASLR, and while performing ASLR with a pelvic belt. Tests were performed in a random manner usingcomputer-generated random number codes
The bladder base descent was significantly greater in the PLPP group than in the controls during deep respirationand ASLR without a belt (p = 0.026; Chi-squared = 6.40). No significant differences were observed between the groups inthe abdominal muscles' activity and diaphragm muscle thickness. There was a significant interaction effect of the group and
the task for diaphragm excursion (F (2, 116) = 6.08; p = 0.00) and PFM activity (F (2, 116) = 5.22; p = 0.00). In the PLPPgroup, wearing a belt compromised altered PFM activation and direction of bladder base displacement.
The PFM activity, direction of bladder base displacement, and diaphragm excursion differed between groups during postural and respiratory tasks. Therefore, it is recommended to involve retraining of the PFMs and diaphragm muscle in the rehabilitation of women with PLPP.Also, wearing a pelvic belt may be recommendable for women with PLPP to prevent bladder base descent and improve PFM activity. It is recommended that future studies investigate trunk muscle activity in women with PLPP duringstanding postural tasks, which are more functional postures.
It is recommended to consider the retraining of the PFMs in the rehabilitation of women with PLPP. Also, wearing a pelvic belt may be recommendable for women with PLPP to prevent bladder base descent and improve PFM activity. Moreover, women with PLPP may benefit from diaphragm retraining and respiratory exercises.
Lumbopelvic pain
Ultrasonography
