Investigation of effective standing posture for increasing activity of pelvic floor muscles: a cross-sectional study

Abstract

Pelvic floor muscle (PFM) exercises have been shown to strengthen PFM function and improve urinary incontinence (UI) symptoms. Several studies have focused on voluntary PFM activity changes among various supine postures. However, few studies have investigated standing postures that promote PFM contraction. Since patients often complain of UI symptoms in the standing position, knowing which posture during voluntary PFM contraction in the standing position promotes contraction would be useful from the viewpoint of issuing exercise instructions and improving prevention. This study aimed to investigate adequate standing postures for PFM contraction and included nine healthy women. All participants performed maximum voluntary contraction (MVC) of PFM in six standing postures: neutral, abduction, adduction, neutral-external rotation, abduction-external rotation, and adduction-external rotation. The MVC of PFM, adductor magnus muscle, and internal oblique muscles were measured in each posture, and muscle activities were recorded using surface electromyography. We compared muscle activity, with and without hip joint external rotation, in the neutral, abduction, and adduction positions, and looked for increased muscle activity of PFM in standing postures with hip joint external rotation compared to standing positions without hip joint external rotation (p < 0.01). Since PFM contracts in conjunction with hip adductors and external rotators, the activity of PFM may have been higher in the standing posture with hip external rotation. Selecting the effective posture is important to increase PFM activity.

Keywords

• electromyography
• urinary incontinence
• rehabilitation
• standing posture
• pelvic floor muscle exercise