title: Can the Paula method facilitate co-contraction of the pelvic floor muscles? A 4D ultrasound study.
abstract: OBJECTIVE
  The aim was to compare constriction of the levator hiatus (LH) and reduction of pelvic floor muscle (PFM) length during instruction of the Paula method (contraction of ring musculature of the mouth) and contraction of the PFM.
  
  
  METHODS
  Seventeen pregnant or postpartum women, mean age 28.6 (range 20-35) participated. A Voluson E8 ultrasound machine with 4-8 MHz curved array 3D/4D transducer (RAB 4-7l/obstetric) was used. Measurements were performed in the axial plane of minimal hiatal dimensions. Muscle length was calculated as circumference of the LH minus the suprapubic arch. Differences between groups were analyzed using Wilcoxon signed rank test. Significance level was set to 0.05.
  
  
  RESULTS
  There was a significant reduction of the LH area (p<0.001) and muscle length (p<0.001) during PFM contraction, but not during contraction according to the Paula method, p=0.51 and p=0.31, respectively.
  
  
  CONCLUSIONS
  The Paula method did not facilitate PFM contraction.
authors.affiliation: Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806, Oslo, Norway. kari.bo@nih.no
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
authors.forename: Gunvor
authors.initials: G
authors.lastname: Hilde
authors.forename: Jette
authors.initials: J
authors.lastname: Stær-Jensen
authors.forename: Ingeborg Hoff
authors.initials: IH
authors.lastname: Brækken
mesh_terms: D000328:Adult; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005152:Facial Muscles / Q000502:physiology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D009055:Mouth / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology*; D017773:Pelvic Floor / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000502:physiology*; D018709:Statistics, Nonparametric; D014463:Ultrasonography; D055815:Young Adult