Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Urogynecology Journal
Published in: International Urogynecology Journal 11/2018

01-11-2018 | Original Article

Can maximal voluntary pelvic floor muscle contraction reduce vaginal resting pressure and resting EMG activity?

Authors: Ingrid Naess, Kari Bø

Published in: International Urogynecology Journal | Issue 11/2018

Login to get access

Abstract

Introduction and hypothesis

The purpose of the present study was to assess whether attempts at a maximal voluntary pelvic floor muscle (PFM) contraction can reduce vaginal resting pressure (VRP) and surface EMG activity in women with and without provoked vestibulodynia (PVD).

Method

An assessor blinded comparison study included 35 women with and 35 women without PVD. VRP and PFM strength were measured with a high precision pressure transducer connected to a vaginal balloon (Camtech AS, Sandvika Norway). PFM activity was measured before and after three MVCs with surface EMG (NeuroTrac ETS™; Verity Medical, Romsey, UK). Paired sample t test was used to analyze differences within groups and independent sample t test to analyze differences between groups. p value was set at <0.05.

Results

Mean age of the participants was 24.3 years (SD 4.7) and mean BMI was 22.0 kg/m2 (SD 2.6). There were no significant differences between the groups in any background variables. PFM contraction led to a statistically significant reduction of VRP in both the PVD (p = 0.001) and the control group (p = 0.027). Surface EMG activity was significantly reduced in the PVD group only (p = 0.001).

Discussion

Young, nulliparous women with PVD had significantly lower vaginal resting pressure and sEMG activity after three maximum contractions of the PFM. The results indicate that attempts at voluntary maximal contractions may be investigated as a method of reducing PFM hypertonicity.
Literature
1.
Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. 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;28:191–213.CrossRef
2.
Butrick CW. Pathophysiology of pelvic floor hypertonic disorders. Obstet Gynecol Clin N Am. 2009;36:699–705.CrossRef
3.
Glazer HI, Jantos M, Hartmann EH, Swencionis C. Electromyographic comparisons of the pelvic floor in women with dysesthetic vulvodynia and asymptomatic women. J Reprod Med. 1998;43:959–62.
4.
Reissing ED, Brown C, Lord MJ, Binik YM, Khalife S. Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome. J Psychosom Obstet Gynaecol. 2005;26:107–13.CrossRef
5.
Gentilcore-Saulnier E, McLean L, Goldfinger C, Pukall CF, Chamberlain S. Pelvic floor muscle assessment outcomes in women with and without provoked vestibulodynia and the impact of a physical therapy program. J Sex Med. 2010;7:1003–22.CrossRef
6.
Engman M, Lindehammar H, Wijma B. Surface electromyography diagnostics in women with partial vaginismus with or without vulvar vestibulitis and in asymptomatic women. J Psychosom Obstet Gynaecol. 2004;25:281–94.CrossRef
7.
Jantos M. Vulvodynia: a psychophysiological profile based on electromyographic assessment. Appl Psychophysiol Biofeedback. 2008;33:29–38.CrossRef
8.
Naess I, Bo K. Pelvic floor muscle function in women with provoked vestibulodynia and asymptomatic controls. Int Urogynecol J. 2015;26(10):1467–73.CrossRef
9.
Morin M, Binik YM, Bourbonnais D, Khalife S, Ouellet S, Bergeron S. Heightened pelvic floor muscle tone and altered contractility in women with provoked Vestibulodynia. J Sex Med. 2017;14:592–600.CrossRef
10.
Jacobson E. Progressive relaxation. Chicago: University of Chicago Press; 1938.
11.
Sharman MJ, Cresswell AG, Riek S. Proprioceptive neuromuscular facilitation stretching : mechanisms and clinical implications. Sports Med. 2006;36:929–39.CrossRef
12.
Haylen BT, De RD, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4–20.
13.
Bø K, Kvarstein B, Hagen R, Larsen S. Pelvic floor muscle exercise for the treatment of female stress urinary incontinence. II. Validity of vaginal pressure measurements of pelvic floor muscle strength and the necessity of supplementary methods for control of correct contraction. Neurourol Urodyn. 1990;9:479–87.CrossRef
14.
Tennfjord MK, Engh ME, Bo K. An intra- and interrater reliability and agreement study of vaginal resting pressure, pelvic floor muscle strength, and muscular endurance using a manometer. Int Urogynecol J. 2017;28(10):1507–14.CrossRefPubMed
15.
Braekken IH, Majida M, Ellstrom EM, Holme IM, Bo K. Pelvic floor function is independently associated with pelvic organ prolapse. BJOG. 2009;116:1706–14.CrossRefPubMed
16.
Grape HH, Dedering A, Jonasson AF. Retest reliability of surface electromyography on the pelvic floor muscles. Neurourol Urodyn. 2009;28:395–9.CrossRefPubMed
17.
Polpeta NC, Giraldo PC, Juliato CR, Yoshida LP, Do Amaral RL, Eleuterio J Jr. Electromyography and vaginal pressure of the pelvic floor muscles in women with recurrent vulvovaginal candidiasis and vulvodynia. J Reprod Med. 2012;57:141–7.PubMed
18.
Goetsch MF. Surgery combined with muscle therapy for dyspareunia from vulvar vestibulitis: an observational study. J Reprod Med. 2007;52:597–603.PubMed
19.
Bergeron S, Binik YM, Khalife S, Pagidas K, Glazer HI, Meana M, et al. A randomized comparison of group cognitive--behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Pain. 2001;91:297–306.CrossRefPubMed
20.
McLean L, Thibault-Gagnon S, Brooks K, Goldfinger C, Pukall C, Chamberlain S. Differences in pelvic morphology between women with and without provoked Vestibulodynia. J Sex Med. 2016;13:963–71.CrossRef
21.
Morin M, Carroll MS, Bergeron S. Systematic review of the effectiveness of physical therapy modalities in women with provoked vestibulodynia. Sex Med Rev. 2017;5:295–322.CrossRef
22.
Bo K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength. Phys Ther. 2005;85:269–82.PubMed
23.
Morin M, Bergeron S, Khalife S, Mayrand MH, Binik YM. Morphometry of the pelvic floor muscles in women with and without provoked vestibulodynia using 4D ultrasound. J Sex Med 2014;11(3):776–785.CrossRef
24.
Frawley HC. Pelvic floor pain and the overactive pelvic floor. In Bo K, Berghmans B, Morkved S, Van Kampen M (eds): Evidence-based physical therapy for the pelvic floor, 2nd edn. London: Churchill Livingstone. 2015; pp 333–54.
25.
Hindle KB, Whitcomb TJ, Briggs WO, Hong J. Proprioceptive neuromuscular facilitation (PNF): its mechanisms and effects on range of motion and muscular function. J Hum Kinet. 2012;31:105–13.CrossRefPubMed
26.
Chmielewska D, Stania M, Smykla A, Kwasna K, Blaszczak E, Sobota G, et al. Bioelectrical activity of the pelvic floor muscles after 6-week biofeedback training in nulliparous continent women. Acta Bioeng Biomech. 2016;18:105–13.
27.
Bø K, Kvarstein B, Hagen R, Larsen S. Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: I. reliability of vaginal pressure measurements of pelvic floor muscle strength. Neurourol Urodyn. 1990;9:471–7.CrossRef
28.
Johannessen HH. Anal insufficiency and the reliability of surface electromyography—Master of Science Dissertation, Master of Science programme in physiotherapy, section for physiotherapy science, Department of Public Health and Primary Health Care, University of Bergen, Norway; 2007.
29.
Auchincloss CC, McLean L. The reliability of surface EMG recorded from the pelvic floor muscles. J Neurosci Methods. 2009;182:85–96.CrossRef
Metadata
Title
Can maximal voluntary pelvic floor muscle contraction reduce vaginal resting pressure and resting EMG activity?
Authors
Ingrid Naess
Kari Bø
Publication date
01-11-2018
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 11/2018
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-018-3599-1

Other articles of this Issue 11/2018

International Urogynecology Journal 11/2018 Go to the issue

IUJ Video

Concurrent pelvic reconstruction and minimally invasive pelvic cancer surgery

Original Article

Effectiveness of a continuous-use ring-shaped vaginal pessary without support for advanced pelvic organ prolapse in postmenopausal women

Clinical Opinion

Uterine prolapse: a hidden tragedy of women in rural Nepal

Original Article

Effect of subsequent vaginal delivery on bowel symptoms and anorectal function in women who sustained a previous obstetric anal sphincter injury

Original Article

Systematic review of definitions for success in pelvic organ prolapse surgery

Original Article

Recovering sexual satisfaction after prolapse surgery: a secondary analysis of surgical recovery