Irene Koenig1,2, Patric Eichelberger3, Helena Luginbuehl3, Annette Kuhn4, Corinne Lehmann5, Jan Taeymans3,6, Lorenz Radlinger3. 1. Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Murtenstrasse 10, 3008, Bern, Switzerland. irene.koenig@bfh.ch. 2. Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium. irene.koenig@bfh.ch. 3. Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Murtenstrasse 10, 3008, Bern, Switzerland. 4. University Hospital and University of Bern, University Clinic of Gynecology, Bern, Switzerland. 5. Department of Physiotherapy, University Hospital Bern, Bern, Switzerland. 6. Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
Abstract
INTRODUCTION AND HYPOTHESIS: Running is known to cause urinary leakage in women with stress urinary incontinence (SUI). Task-specific fiber-type recruitment while running can be estimated using wavelets. The aim of this study was to compare the effect of a new physiotherapy program including involuntary, reflexive training with a standard physiotherapy program on pelvic floor muscle (PFM) activation patterns and fiber-type recruitment behavior while running. METHODS: In this triple-blinded randomized controlled trial, women with SUI were randomly allocated to the control group (CON), which performed a standard physiotherapy program, or the experimental group (EXP), which received additional involuntary, reflexive training. PFM electromyography (EMG) was recorded during 10 s at three running speeds and analyzed using Morse wavelets. The relative distribution of power (%) over the frequencies from 20 to 200 Hz was extracted and analyzed within six-time intervals of 30 ms. Statistical nonparametric mapping was performed to identify power spectra differences. RESULTS:Thirty-nine (CON) and 38 (EXP) women were included. The power spectra showed no statistically significant group differences. The time intervals from 30 ms before to 30 ms after initial contact showed significantly lower intensities than the intervals from 30 to 150 ms after initial contact in the lowest and higher intensities in the highest frequencies for all running speeds and both groups. CONCLUSIONS: Power spectra shifts toward higher frequency bands in the pre-initial contact phase could indicate a feed-forward anticipation and a muscle tuning for the expected impact of initial contact event in order to maintain continence.
RCT Entities:
INTRODUCTION AND HYPOTHESIS: Running is known to cause urinary leakage in women with stress urinary incontinence (SUI). Task-specific fiber-type recruitment while running can be estimated using wavelets. The aim of this study was to compare the effect of a new physiotherapy program including involuntary, reflexive training with a standard physiotherapy program on pelvic floor muscle (PFM) activation patterns and fiber-type recruitment behavior while running. METHODS: In this triple-blinded randomized controlled trial, women with SUI were randomly allocated to the control group (CON), which performed a standard physiotherapy program, or the experimental group (EXP), which received additional involuntary, reflexive training. PFM electromyography (EMG) was recorded during 10 s at three running speeds and analyzed using Morse wavelets. The relative distribution of power (%) over the frequencies from 20 to 200 Hz was extracted and analyzed within six-time intervals of 30 ms. Statistical nonparametric mapping was performed to identify power spectra differences. RESULTS: Thirty-nine (CON) and 38 (EXP) women were included. The power spectra showed no statistically significant group differences. The time intervals from 30 ms before to 30 ms after initial contact showed significantly lower intensities than the intervals from 30 to 150 ms after initial contact in the lowest and higher intensities in the highest frequencies for all running speeds and both groups. CONCLUSIONS: Power spectra shifts toward higher frequency bands in the pre-initial contact phase could indicate a feed-forward anticipation and a muscle tuning for the expected impact of initial contact event in order to maintain continence.
Authors: Ingrid Nygaard; Matthew D Barber; Kathryn L Burgio; Kimberly Kenton; Susan Meikle; Joseph Schaffer; Cathie Spino; William E Whitehead; Jennifer Wu; Debra J Brody Journal: JAMA Date: 2008-09-17 Impact factor: 56.272