Subscribe to RSS
DOI: 10.1055/a-0596-7531
Association Between Physical Activity Level and Pelvic Floor Muscle Variables in Women
Publication History
accepted 11 March 2018
Publication Date:
16 October 2018 (online)
Abstract
In order to investigate the potential impact of physical activity (PA) on pelvic floor muscle (PFM) function, a cross-sectional study was made to analyse the association between PA level and vaginal resting pressure (VRP) and PFM strength and endurance. Thirty-eight continent women and 20 women with stress urinary incontinence (SUI) aged 19 to 49 years were enrolled in the study. PFM variables were assessed by manometry. The PA level was assessed through the International Physical Activity Questionnaire – Short Form. The International Consultation on Incontinence Questionnaire-Urinary Incontinence – Short Form was applied to identify SUI. Pearson’s correlation coefficients were applied to estimate the association between PA and PFM variables. Incontinent women were classified as having a high PA level compared to the continent ones (65.0% vs 34.2%, respectively; p=0.030). There was a positive weak association between PA and VRP in continent (r=0.377) and an inverse association in incontinent women (r=−0.458). No associations were found between PA and PFM strength and endurance. Further studies are needed in order to identify a causal association between PA and SUI.
-
References
- 1 American College of Sports Medicine position stand . Progression models in resistance training for healthy adults. Med Sci Sports Exerc 2009; 41: 687-708
- 2 Alves JO, Luz STD, Brandão S, Da Luz CM, Natal Jorge R, Da Roza T. Urinary incontinence in physically active young women: Prevalence and related factors. Int J Sports Med 2017; 38: 937-941
- 3 Ashton-Miller JA, DeLancey JOL. Functional anatomy of the female pelvic floor. Ann NY Acad Sci 2007; 1101: 266-296
- 4 Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: A brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 2004; 23: 322-330
- 5 Bø K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work?. Int Urogynecol J Pelvic Floor Dysfunct 2004; 15: 76-84
- 6 Bø K. Urinary incontinence, pelvic floor dysfunction, exercise and sport. Sports Med 2004; 34: 451-464
- 7 Bø K, Finckenhagen HB. Is there any difference in measurement of pelvic floor muscle strength in supine and standing position?. Acta Obstet Gynecol Scand 2003; 82: 1120-1124
- 8 Bø K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, Bortolini M, Dumoulin C, Gomes M, McClurg D, Meijlink J, Shelly E, Trabuco E, Walker C, 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. Neurourol Urodyn 2017; 36: 221-244
- 9 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: 479-487
- 10 Bø K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength. Phys Ther 2005; 85: 269-282
- 11 Borin LC, Nunes FR, Guirro EC. Assessment of pelvic floor muscle pressure in female athletes. PM R 2013; 5: 189-193
- 12 Burti JS, Hacad CR, Zambon JP, Polessi EA, Almeida FG. Is There any difference in pelvic floor muscles performance between continent and incontinent women?. Neurourol Urodyn 2015; 34: 544-548
- 13 Carvalhais A, Natal Jorge R, Bø K. Performing high-level sport is strongly associated with urinary incontinence in elite athletes: a comparative study of 372 elite female athletes and 372 controls. Br J Sports Med 2017; DOI: 10.1136/bjsports-2017-097587.
- 14 Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Rep 1985; 100: 126-131
- 15 Chmielewska D, Stania M, Sobota G, Kwasna K, Blaszczak E, Taradaj J, Juras G. Impact of different body positions on bioelectrical activity of the pelvic floor muscles in nulliparous continent women. Biomed Res Int 2015; 2015: 905897
- 16 Constantinou CE, Govan DE. Spatial distribution and timing of transmitted and reflexly generated urethral pressures in the healthy female. J Urol 1982; 127: 964-969
- 17 Craig CL, Marshall AL, Sjostrom M, Bauman A, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003; 35: 1381-1395
- 18 Da Roza T, Brandão S, Mascarenhas T, Natal Jorge R, Duarte JA. Urinary incontinence and levels of regular physical exercise in young women. Int J Sports Med 2015; 36: 776-780
- 19 Dietz HP, Erdmann M, Shek KL. Reflex contraction of the levator ani in women symptomatic for pelvic floor disorders. Ultrasound Obstet Gynecol 2012; 40: 215-218
- 20 Dietz HP, Shek KL. The quantification of levator muscle resting tone by digital assessment. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 1489-1493
- 21 Eliasson K, Nordlander I, Larson B, Hammarström M, Mattsson E. Influence of physical activity on urinary leakage in primiparous women. Scand J Med Sci Sports 2005; 15: 87-94
- 22 Ferreira CH, Barbosa PB, Oliveira Souza F, Antônio FI, Franco MM, Bø K. Inter-rater reliability study of the modified Oxford Grading Scale and the Peritron manometer. Physiotherapy 2011; 97: 132-138
- 23 Frawley H, Galea M, Phillips B, Sherburn M, Bø K. Reliability of pelvic floor muscle strength assessment using different test positions and tools. Neurourol Urodyn 2006; 25: 236-242
- 24 Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP. ACSM . Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43: 1334-1359
- 25 Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. Br J Obstet Gynaecol 2003; 110: 247-254
- 26 Harriss DJ, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 update. Int J Sports Med 2017; 38: 1126-1131
- 27 Haylen BT, De Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN. 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
- 28 Hilde G, Stær-Jensen J, Siafarikas F, Engh ME, Brækken IH, Bø K. Impact of childbirth and mode of delivery on vaginal resting pressure and on pelvic floor muscle strength and endurance. Am J Obstet Gynecol 2013; 208: e1-e7
- 29 Irwin DE, Kopp ZS, Agatep B, Milsom AP. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int 2011; 108: 1132-1139
- 30 Middlekauff ML, Egger MJ, Nygaard IE, Shaw JM. The impact of acute and chronic strenuous exercise on pelvic floor muscle strength and support in nulliparous healthy women. Am J Obstet Gynecol 2016; 215: 316.e311-e317
- 31 Mittal RK, Sheean G, Padda BS, Rajasekaran MR. Length tension function of puborectalis muscle: Implications for the treatment of fecal incontinence and pelvic floor disorders. J. Neurogastroenterol Motil 2014; 20: 539-546
- 32 Morin M, Bourbonnais D, Gravel D, Dumoulin C, Lemieux M-C. Pelvic floor muscle function in continent and stress urinary incontinent women using dynamometric measurements. Neurourol Urodyn 2004; 23: 668-674
- 33 Neumann P, Gill V. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J 2002; 13: 125-132
- 34 Nygaard IE, Shaw JM. Physical activity and the pelvic floor. Am J Obstet Gynecol 2016; 214: 164-171
- 35 Nygaard IE, Shaw JM, Bardsley T, Egger MJ. Lifetime physical activity and female stress urinary incontinence. Am J Obstet Gynecol 2015; 213: 1-10
- 36 Peng Q, Jones R, Shishido K, Omata S, Constantinou CE. Spatial distribution of vaginal closure pressures of continent and stress urinary incontinent women. Physiol Meas 2007; 28: 1429-1450
- 37 Quartly E, Hallam T, Kilbreath S, Refshauge K. Strength and endurance of the pelvic floor muscles in continent women: An observational study. Physiotherapy 2010; 96: 311-316
- 38 Rahmani N, Mohseni-Bandpei MA. Application of perineometer in the assessment of pelvic floor muscle strength and endurance: A reliability study. J Bodyw Mov Ther 2011; 15: 209-214
- 39 Ree ML, Nygaard I, Bø K. Muscular fatigue in the pelvic floor muscles after strenuous physical activity. Acta Obstet Gynecol Scand 2007; 86: 870-876
- 40 Shafik A, Doss S, Asaad S. Etiology of the resting myoelectric activity of the levator ani muscle: Physioanatomic study with a new theory. World J Surg 2003; 27: 309-314
- 41 Shaw JM, Hamad NM, Coleman TJ, Egger MJ, Hsu Y, Hitchcock R, Nygaard IE. Intra-abdominal pressures during activity in women using an intra-vaginal pressure transducer. J Sports Sci 2014; 32: 1176-1185
- 42 Shishido K, Peng Q, Jones R, Omata S, Constantinou CE. Influence of pelvic floor muscle contraction on the profile of vaginal closure pressure in continent and stress urinary incontinent women. J Urol 2008; 179: 1917-1922
- 43 Tamanini JT, Dambros M, D'Ancona CA, Palma PC, Netto NR. Validation of the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) for Portuguese. Rev Saude Publica 2004; 38: 438-444