Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis

Authors

  • Giovana Vesentini Universidade Estadual Paulista, Faculdade de Medicina de Botucatu https://orcid.org/0000-0002-7116-1667
  • Regina El Dib Universidade Estadual Paulista, Instituto de Ciencia e Tecnologia
  • Leonardo Augusto Rachele Righesso Mainz University Medical Center https://orcid.org/0000-0002-8130-596X
  • Fernanda Piculo Universidade Estadual Paulista, Faculdade de Medicina de Botucatu
  • Gabriela Marini Universidade Estadual Paulista, Faculdade de Medicina de Botucatu
  • Guilherme Augusto Rago Ferraz Universidade Estadual Paulista, Faculdade de Medicina de Botucatu
  • Iracema de Mattos Paranhos Calderon Universidade Estadual Paulista, Faculdade de Medicina de Botucatu
  • Angélica Mércia Pascon Barbosa Universidade Estadual Paulista, Departamento de Fisioterapia e Terapia Ocupacional
  • Marilza Vieira Cunha Rudge Universidade Estadual Paulista, Faculdade de Medicina de Botucatu

DOI:

https://doi.org/10.6061/clinics/2019/e1319

Keywords:

Pelvic Floor Disorders, Abdominopelvic Muscles, Pelvic Floor Function, Synergism

Abstract

There is an ongoing discussion regarding abdominal muscle (AbM) and pelvic floor muscle (PFM) synergism. Therefore, this study aimed to investigate the cocontraction between AbMs and PFMs in women with or without pelvic floor dysfunction (PFD). The following databases were searched up to December 21, 2018: MEDLINE, EMBASE, LILACS, PEDro and CENTRAL. We included any study that assessed the cocontraction between PFMs and AbMs in women with and without PFD. Two reviewers independently screened eligible articles and extracted data. The outcomes were extracted and analyzed as continuous variables with random effect models. Twenty studies were included. A meta-analysis did not show differences in women with and without PFD. However, a sensitivity analysis suggested cocontraction of the transversus abdominis (TrA) during PFM contraction in healthy women (standardized mean difference (SMD) 1.02 [95% confidence interval (CI) 1.90 to 0.14], P=0.02; I2 = not applicable; very low quality of evidence). Women with PFD during contraction of PFMs showed cocontraction of the obliquus internus (OI) (SMD 1.10 [95% CI 0.27 to 1.94], P=0.01; I2 = not applicable; very low quality of evidence), and obliquus externus (OE) (SMD 2.08 [95% CI 1.10 to 3.06], Po0.0001; I 2 = not applicable; very low quality of evidence). Increased cocontraction of the TrA may be associated with maximal contraction of PFMs in women without PFD. On the other hand, there is likely an increased cocontraction with the OI and OE in women with PFD.

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Published

2019-11-27

Issue

Section

Review Articles

How to Cite

Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis. (2019). Clinics, 74, e1319. https://doi.org/10.6061/clinics/2019/e1319