Contraction of the pelvic floor muscles during abdominal maneuvers.

OBJECTIVE

To determine whether voluntary abdominal muscle contraction is associated with pelvic floor muscle activity.

DESIGN

Pelvic floor muscle activity was recorded during contractions of the abdominal muscles at 3 different intensities in supine and standing positions.

SETTING

Research laboratory.

PARTICIPANTS

Six women and 1 man with no histories of lower back pain.

INTERVENTION: Not applicable.

MAIN OUTCOME MEASURES: Electromyographic activity of the pelvic floor muscles was recorded with surface electrodes inserted into the anus and vagina. These recordings were corroborated by measurements of anal and vaginal pressures. Gastric pressure was recorded in 2 subjects.

RESULTS

Pelvic floor muscle electromyography increased with contraction of the abdominal muscles. With strong abdominal contraction, pelvic floor muscle activity did not differ from that recorded during a maximal pelvic floor muscle effort. The pressure recordings confirmed these data. The increase in pressure recorded in the anus and vagina preceded the pressure in the abdomen.

CONCLUSIONS

In healthy subjects, voluntary activity in the abdominal muscles results in increased pelvic floor muscle activity. The increase in pelvic floor pressure before the increase in the abdomen pressure indicates that this response is preprogrammed. Dysfunction of the pelvic floor muscles can result in urinary and fecal incontinence. Abdominal muscle training to rehabilitate those muscles may be useful in treating these conditions.