Pattern of activation of pelvic floor muscles in men differs with verbal instructions

Stafford, Ryan E., Ashton-Miller, James A., Constantinou, Constantinou, Coughlin, Geoff, Lutton, Nicholas J. and Hodges, Paul W. (2016) Pattern of activation of pelvic floor muscles in men differs with verbal instructions. Neurourology and Urodynamics, 35 4: 457-463. doi:10.1002/nau.22745

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Author Stafford, Ryan E.
Ashton-Miller, James A.
Constantinou, Constantinou
Coughlin, Geoff
Lutton, Nicholas J.
Hodges, Paul W.
Title Pattern of activation of pelvic floor muscles in men differs with verbal instructions
Journal name Neurourology and Urodynamics   Check publisher's open access policy
ISSN 1520-6777
0733-2467
Publication date 2016-04-01
Year available 2015
Sub-type Article (original research)
DOI 10.1002/nau.22745
Open Access Status File (Author Post-print)
Volume 35
Issue 4
Start page 457
End page 463
Total pages 7
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Formatted abstract
Aims
To investigate the effect of instruction on activation of pelvic floor muscles (PFM) in men as quantified by transperineal ultrasound imaging (US) and to validate these measures with invasive EMG recordings.

Methods
Displacement of pelvic floor landmarks on transperineal US, intra-abdominal pressure (IAP) recorded with a nasogastric transducer, and surface EMG of the abdominal muscles and anal sphincter were recorded in 15 healthy men during sub-maximal PFM contractions in response to different verbal instructions: “tighten around the anus,” “elevate the bladder,” “shorten the penis,” and “stop the flow of urine.” In three men, fine-wire EMG recordings were made from puborectalis and bulbocavernosus, and trans-urethral EMG recordings from the striated urethral sphincter (SUS). Displacement data were validated by analysis of relationship with invasive EMG. Displacement, IAP, and abdominal/anal EMG were compared between instructions.

Results
Displacement of pelvic landmarks correlated with the EMG of the muscles predicted anatomically to affect their locations. Greatest dorsal displacement of the mid-urethra and SUS activity was achieved with the instruction “shorten the penis.” Instruction to “elevate the bladder” induced the greatest increase in abdominal EMG and IAP. “Tighten around the anus” induced greatest anal sphincter activity.

Conclusions
The pattern of urethral movement measured from transperineal US is influenced by the instructions used to teach activation of the pelvic floor muscles in men. Efficacy of PFM training may depend on the instructions used to train activation. Instructions that optimize activation of muscles with a potential to increase urethral pressure without increasing abdominal EMG/IAP are likely ideal.
Keyword Electromyography
Male
Pelvic floor exercise
Prostatectomy
Ultrasound imaging
Urinary incontinence
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Health and Rehabilitation Sciences Publications
 
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