Monika Leitner1,2, Helene Moser3, Jan Taeymans3,4,5, Annette Kuhn6, Lorenz Radlinger3. 1. Health Division/Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland. monika.leitner@bfh.ch. 2. Graduate School for Health Sciences, University of Bern, Bern, Switzerland. monika.leitner@bfh.ch. 3. Health Division/Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland. 4. Faculty of Sport and Rehabilitation Sciences, Vrije Universiteit Brussel, Brussels, Belgium. 5. Faculty of Health Sciences, Antwerp University, Antwerp, Belgium. 6. Gynaecology, Bern University Hospital, Bern, Switzerland.
Abstract
INTRODUCTION: Investigations of the dynamic function of female pelvic floor muscles (PFM) help us to understand the pathophysiology of stress urinary incontinence (SUI). Displacement measurements of PFM give insight into muscle activation and thus help to improve rehabilitation strategies. This systematic review (PROSPERO 2013: CRD42013006409) was performed to summarise the current evidence for PFM displacement during voluntary and involuntary activation in continent and incontinent women. METHODS: MEDLINE, EMBASE, Cochrane and SPORTDiscus databases were searched using selected terminology reflecting the PICO approach. Screening of Google Scholar and congress abstracts added to further information. Original articles investigating PFM displacement were included if they reported on at least one of the aims of the review, e.g., method, test position, test activity, direction and quantification of displacement, as well as the comparison between continent and incontinent women. Titles and abstracts were screened by two reviewers. The papers included were reviewed by two individuals to ascertain whether they fulfilled the inclusion criteria and data were extracted on outcome parameters. RESULTS: Forty-two predominantly observational studies fulfilled the inclusion criteria. A variety of measurement methods and calculations of displacement was presented. The sample was heterogeneous concerning age, parity and continence status. Test positions and test activities varied among the studies. CONCLUSIONS: The findings summarise the present knowledge of PFM displacement, but still lack deeper comprehension of the SUI pathomechanism of involuntary, reflexive activation during functional activities. We therefore propose that future investigations focus on PFM dynamics during fast and stressful impact tasks.
INTRODUCTION: Investigations of the dynamic function of female pelvic floor muscles (PFM) help us to understand the pathophysiology of stress urinary incontinence (SUI). Displacement measurements of PFM give insight into muscle activation and thus help to improve rehabilitation strategies. This systematic review (PROSPERO 2013: CRD42013006409) was performed to summarise the current evidence for PFM displacement during voluntary and involuntary activation in continent and incontinent women. METHODS: MEDLINE, EMBASE, Cochrane and SPORTDiscus databases were searched using selected terminology reflecting the PICO approach. Screening of Google Scholar and congress abstracts added to further information. Original articles investigating PFM displacement were included if they reported on at least one of the aims of the review, e.g., method, test position, test activity, direction and quantification of displacement, as well as the comparison between continent and incontinent women. Titles and abstracts were screened by two reviewers. The papers included were reviewed by two individuals to ascertain whether they fulfilled the inclusion criteria and data were extracted on outcome parameters. RESULTS: Forty-two predominantly observational studies fulfilled the inclusion criteria. A variety of measurement methods and calculations of displacement was presented. The sample was heterogeneous concerning age, parity and continence status. Test positions and test activities varied among the studies. CONCLUSIONS: The findings summarise the present knowledge of PFM displacement, but still lack deeper comprehension of the SUI pathomechanism of involuntary, reflexive activation during functional activities. We therefore propose that future investigations focus on PFM dynamics during fast and stressful impact tasks.
Entities:
Keywords:
Activities of daily living; Diagnostics; Stress urinary incontinence
Authors: Judith A Thompson; Peter B O'Sullivan; Kathy Briffa; Patricia Neumann; Sarah Court Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2005-03-22
Authors: Roberto Pregazzi; Andrea Sartore; Paolo Bortoli; Eva Grimaldi; Luigi Troiano; Secondo Guaschino Journal: BJOG Date: 2002-07 Impact factor: 6.531