Are clinically recommended pelvic floor muscle relaxation positions really efficient for muscle relaxation?

doi:10.1007/s00192-022-05119-3

. 2022 Sep;33(9):2391-2400.

doi: 10.1007/s00192-022-05119-3. Epub 2022 Feb 24.

Are clinically recommended pelvic floor muscle relaxation positions really efficient for muscle relaxation?

Özge Çeliker Tosun¹, Damla Korkmaz Dayıcan², İrem Keser³, Sefa Kurt⁴, Meriç Yıldırım¹, Gökhan Tosun⁵

Affiliations

¹ Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
² Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey. kkorkmazdamla@gmail.com.
³ Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey.
⁴ Department of Obstetrics and Gynecology, Dokuz Eylül University, Izmir, Turkey.
⁵ Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey.

PMID: 35201370
DOI: 10.1007/s00192-022-05119-3

Are clinically recommended pelvic floor muscle relaxation positions really efficient for muscle relaxation?

Özge Çeliker Tosun et al. Int Urogynecol J. 2022 Sep.

. 2022 Sep;33(9):2391-2400.

doi: 10.1007/s00192-022-05119-3. Epub 2022 Feb 24.

Authors

Özge Çeliker Tosun¹, Damla Korkmaz Dayıcan², İrem Keser³, Sefa Kurt⁴, Meriç Yıldırım¹, Gökhan Tosun⁵

Affiliations

¹ Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
² Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey. kkorkmazdamla@gmail.com.
³ Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey.
⁴ Department of Obstetrics and Gynecology, Dokuz Eylül University, Izmir, Turkey.
⁵ Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey.

PMID: 35201370
DOI: 10.1007/s00192-022-05119-3

Abstract

Introduction and hypothesis: Various positions for pelvic floor muscle (PFM) relaxation are recommended during PFM training in physiotherapy clinics. To our knowledge, there is no study addressing the most effective position for PFM and abdominal muscle relaxation. Therefore, the current study aimed to investigate the effect of different relaxation positions on PFM and abdominal muscle functions in women with urinary incontinence (UI).

Methods: Sixty-seven women diagnosed with UI were enrolled in the study. The type, frequency, and amount of UI were assessed with the International Incontinence Questionnaire-Short Form and bladder diary. Superficial electromyography was used to assess PFM and abdominal muscle functions during three relaxation positions: modified butterfly pose (P1), modified child pose (P2), and modified deep squat with block (P3). Friedman variance analyses and Wilcoxon signed rank test with Bonferroni corrections were used to evaluate the difference between positions.

Results: The most efficient position for PFM relaxation was P1 and followed by P3 and P2, respectively. The order was also the same for abdominal muscles (p < 0.001), P1 > P3 > P2. The rectus abdominis (RA) was the most affected muscle during PFM relaxation. The extent of relaxation of RA muscle increased as the extent of PFM relaxation increased (r = 0.298, p = 0.016). No difference was found between different types of UI during the same position in terms of PFM relaxation extents (p > 0.05).

Conclusions: Efficient PFM relaxation is maintained during positions recommended in physiotherapy clinics. The extent of PFM and abdominal muscle relaxation varies according to the positions.

Keywords: Abdominal muscle; Electromyography; Pelvic floor muscle; Relaxation position.

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References

1. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26. https://doi.org/10.1007/s00192-009-0976-9 . - DOI - PubMed
1. Mazur-Bialy AI, Kołomańska-Bogucka D, Nowakowski C, Tim S. Urinary incontinence in women: modern methods of physiotherapy as a support for surgical treatment or independent therapy. J Clin Med. 2020;9(4):1211. https://doi.org/10.3390/jcm9041211 . - DOI - PMC
1. Eickmeyer SM. Anatomy and physiology of the pelvic floor. Phys Med Rehabil Clin N Am. 2017;28(3):455–60. https://doi.org/10.1016/j.pmr.2017.03.003 . - DOI - PubMed
1. Messelink B, Benson T, Berghmans B, Bo K, Corcos J, Fowler C, Nijeholt GA. Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the international continence society. Int Urogynecol J. 2005;24(4):374. https://doi.org/10.1007/s00192-016-3123-4 . - DOI
1. Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, Wells A. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J. 2017;28(2):191–213. https://doi.org/10.1007/s00192-016-3123-4 . - DOI - PubMed

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[1] Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26. https://doi.org/10.1007/s00192-009-0976-9 . - DOI - PubMed

[2] Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26. https://doi.org/10.1007/s00192-009-0976-9 . - DOI - PubMed

[3] Mazur-Bialy AI, Kołomańska-Bogucka D, Nowakowski C, Tim S. Urinary incontinence in women: modern methods of physiotherapy as a support for surgical treatment or independent therapy. J Clin Med. 2020;9(4):1211. https://doi.org/10.3390/jcm9041211 . - DOI - PMC

[4] Mazur-Bialy AI, Kołomańska-Bogucka D, Nowakowski C, Tim S. Urinary incontinence in women: modern methods of physiotherapy as a support for surgical treatment or independent therapy. J Clin Med. 2020;9(4):1211. https://doi.org/10.3390/jcm9041211 . - DOI - PMC

[5] Eickmeyer SM. Anatomy and physiology of the pelvic floor. Phys Med Rehabil Clin N Am. 2017;28(3):455–60. https://doi.org/10.1016/j.pmr.2017.03.003 . - DOI - PubMed

[6] Eickmeyer SM. Anatomy and physiology of the pelvic floor. Phys Med Rehabil Clin N Am. 2017;28(3):455–60. https://doi.org/10.1016/j.pmr.2017.03.003 . - DOI - PubMed

[7] Messelink B, Benson T, Berghmans B, Bo K, Corcos J, Fowler C, Nijeholt GA. Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the international continence society. Int Urogynecol J. 2005;24(4):374. https://doi.org/10.1007/s00192-016-3123-4 . - DOI

[8] Messelink B, Benson T, Berghmans B, Bo K, Corcos J, Fowler C, Nijeholt GA. Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the international continence society. Int Urogynecol J. 2005;24(4):374. https://doi.org/10.1007/s00192-016-3123-4 . - DOI

[9] Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, Wells A. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J. 2017;28(2):191–213. https://doi.org/10.1007/s00192-016-3123-4 . - DOI - PubMed

[10] Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, Wells A. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J. 2017;28(2):191–213. https://doi.org/10.1007/s00192-016-3123-4 . - DOI - PubMed

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Are clinically recommended pelvic floor muscle relaxation positions really efficient for muscle relaxation?

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Are clinically recommended pelvic floor muscle relaxation positions really efficient for muscle relaxation?

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