Greene G1, Jecketts J1
1Coventry University, Physiotherapy, Coventry, United Kingdom
Background: Research surrounding the pelvic floor (PF) within Men's Health is an important, but often overlooked, aspect of physiotherapy. Due to the high incidence of prostate cancer and it´s post operative side effects of urinary incontinence and erectile dysfunction , there is a need for further research into the instructional phrases that guide pelvic floor recruitment in this patient group.
Purpose: Currently, there is a research gap surrounding the most effective instructional phrase for male PF muscle contraction. Anecdotal evidence suggests that the phrase 'nuts to guts' is widely used in the clinical setting. However, 'shorten the penis' has high quality research to support it´s use. This study aimed to compare the effectiveness of both phrases on male pelvic floor recruitment in a functional position using transabdominal ultrasound imaging in a healthy male population.
Methods: Sixteen healthy, male, physiotherapy students participated within the repeated measures experimental study. Measurement of slow pelvic floor contractions at 50% maximum effort was taken three times in standing using transabdominal US imaging to measure bladder base excursion. The time taken to complete 10 maximal contractions and full relaxations (seconds) was recorded, also in standing, using transabdominal ultrasound to monitor bladder base excursion. This was repeated for both 'nuts to guts' and 'shorten the penis' phrases. Ethical approval was granted by Coventry University ethics committee.
Results: All of the sixteen participants who progressed onto the research conditions were able to produce PF contraction with both instructional phrases. There was no significant difference between contraction ability for either instructional phrase, during 50% contraction and time elapsed for 10 maximal contractions (p=0.257 and p=0.286 respectively).
Conclusion(s): There was no statistically significant difference between both phrases suggesting that 'nuts to guts' produces the same degree of PFM recruitment as measured on transabdominal ulrasound imaging as 'shorten the penis' in the functional position of standing in a healthy male population. The choice of instructional phrase used should be based around patient needs and understanding. Radical prostatectomy leads to penile retraction and loss of penile lenght and "nuts to guts" may be more psychological acceptting to these men post surgery. However further research is required within the prostate cancer survivor population.
Implications: The role of specialist men´s health physiotherapy guided functional weight bearing pelvic floor rehab in prostate cancer survivors is continuing to develop. This study may provide some early evidence that "nuts to guts" and "shorten the penis" achieve similar levels of pelvic floor recuitment offering the clinician and patient a choice of what phrase to focus rehab around.
Keywords: Men's Health Physiotherapy, Male pelvic floor recruitment, prostate cancer
Funding acknowledgements: Coventry University, Coventry UK
Purpose: Currently, there is a research gap surrounding the most effective instructional phrase for male PF muscle contraction. Anecdotal evidence suggests that the phrase 'nuts to guts' is widely used in the clinical setting. However, 'shorten the penis' has high quality research to support it´s use. This study aimed to compare the effectiveness of both phrases on male pelvic floor recruitment in a functional position using transabdominal ultrasound imaging in a healthy male population.
Methods: Sixteen healthy, male, physiotherapy students participated within the repeated measures experimental study. Measurement of slow pelvic floor contractions at 50% maximum effort was taken three times in standing using transabdominal US imaging to measure bladder base excursion. The time taken to complete 10 maximal contractions and full relaxations (seconds) was recorded, also in standing, using transabdominal ultrasound to monitor bladder base excursion. This was repeated for both 'nuts to guts' and 'shorten the penis' phrases. Ethical approval was granted by Coventry University ethics committee.
Results: All of the sixteen participants who progressed onto the research conditions were able to produce PF contraction with both instructional phrases. There was no significant difference between contraction ability for either instructional phrase, during 50% contraction and time elapsed for 10 maximal contractions (p=0.257 and p=0.286 respectively).
Conclusion(s): There was no statistically significant difference between both phrases suggesting that 'nuts to guts' produces the same degree of PFM recruitment as measured on transabdominal ulrasound imaging as 'shorten the penis' in the functional position of standing in a healthy male population. The choice of instructional phrase used should be based around patient needs and understanding. Radical prostatectomy leads to penile retraction and loss of penile lenght and "nuts to guts" may be more psychological acceptting to these men post surgery. However further research is required within the prostate cancer survivor population.
Implications: The role of specialist men´s health physiotherapy guided functional weight bearing pelvic floor rehab in prostate cancer survivors is continuing to develop. This study may provide some early evidence that "nuts to guts" and "shorten the penis" achieve similar levels of pelvic floor recuitment offering the clinician and patient a choice of what phrase to focus rehab around.
Keywords: Men's Health Physiotherapy, Male pelvic floor recruitment, prostate cancer
Funding acknowledgements: Coventry University, Coventry UK
Topic: Women's & men's pelvic health; Musculoskeletal
Ethics approval required: Yes
Institution: Coventry University Ethics Committee, Coventry, CV1 5FB, UK
Ethics committee: See above
Ethics number: See above
All authors, affiliations and abstracts have been published as submitted.
