Hypopressive abdominal technique or transversus abdominis muscle contraction?: differences in activation of pelvic floor muscles and abdominal pressure

Abstract

Hypothesis / aims of study The hypothesis of this project is that Transversus Abdominis (TrA) muscle contraction increases pelvic floor muscle (PFM) electric activity more than Hypopressive Abdominal Exercises (HAE) and HAE decrease abdominal pressure (AP) both compared with a basal state. The aim of this study is to assess TrA muscle contraction and HAE on pelvic floor muscle electric activity and AP compared with a basal state. Study design, materials and methods Twenty-two urinary-continent women participated in this study. Sample size and power have been calculated with GRANMO software (Version 7.12 April 2012). Alpha and Beta risks were set as 0.01 and 0.10 respectively. Standard deviations were taken from a pilot study and minimum expected differences were taken from different RCTs(1,2). Only patients who were able to perform correct HAE were included in the study. Participants were placed in the orthostatic position of HAE. They performed randomized repeated HAE and contractions of TrA. PFM and TrA electromyography (EMG) signals and associated AP data were recorded simultaneously. AP data were recorded from a rectal pressure balloon. The ANOVAs repeated measures with LSD Post-Hoc test were used for statistical analysis. Results Results are shown in Table 1. TrA contraction increases the activity of PFM more than a HAE or basal state (p<0,001). However, HAE increases the activity of PFM more than basal state (p=0.048). A HAE decreases AP on both the basal state and TrA contraction (p=0.002 and p=0.047 respectively). With regard to TrA muscles, they have more EMG activity during a voluntary contraction of themselves (p<0.001), although they increase EMG activity during a HAE but not significantly (p=0.057 in right TrA and p=0.089 in left TrA).

Hypothesis / aims of study The hypothesis of this project is that Transversus Abdominis (TrA) muscle contraction increases pelvic floor muscle (PFM) electric activity more than Hypopressive Abdominal Exercises (HAE) and HAE decrease abdominal pressure (AP) both compared with a basal state. The aim of this study is to assess TrA muscle contraction and HAE on pelvic floor muscle electric activity and AP compared with a basal state. Study design, materials and methods Twenty-two urinary-continent women participated in this study. Sample size and power have been calculated with GRANMO software (Version 7.12 April 2012). Alpha and Beta risks were set as 0.01 and 0.10 respectively. Standard deviations were taken from a pilot study and minimum expected differences were taken from different RCTs(1,2). Only patients who were able to perform correct HAE were included in the study. Participants were placed in the orthostatic position of HAE. They performed randomized repeated HAE and contractions of TrA. PFM and TrA electromyography (EMG) signals and associated AP data were recorded simultaneously. AP data were recorded from a rectal pressure balloon. The ANOVAs repeated measures with LSD Post-Hoc test were used for statistical analysis. Results Results are shown in Table 1. TrA contraction increases the activity of PFM more than a HAE or basal state (p<0,001). However, HAE increases the activity of PFM more than basal state (p=0.048). A HAE decreases AP on both the basal state and TrA contraction (p=0.002 and p=0.047 respectively). With regard to TrA muscles, they have more EMG activity during a voluntary contraction of themselves (p<0.001), although they increase EMG activity during a HAE but not significantly (p=0.057 in right TrA and p=0.089 in left TrA).