title: Pelvic floor muscle displacement during voluntary and involuntary activation in continent and incontinent women: a systematic review.
abstract: BACKGROUND
  Investigations of the dynamic function of female pelvic floor muscles (PFM) help us to understand the pathophysiology of stress urinary incontinence (SUI). Displacement measurements of PFM give insight into muscle activation and thus help to improve rehabilitation strategies. This systematic review (PROSPERO 2013: CRD42013006409) was performed to summarise the current evidence for PFM displacement during voluntary and involuntary activation in continent and incontinent women.
  
  
  METHODS
  MEDLINE, EMBASE, Cochrane and SPORTDiscus databases were searched using selected terminology reflecting the PICO approach. Screening of Google Scholar and congress abstracts added to further information. Original articles investigating PFM displacement were included if they reported on at least one of the aims of the review, e.g., method, test position, test activity, direction and quantification of displacement, as well as the comparison between continent and incontinent women. Titles and abstracts were screened by two reviewers. The papers included were reviewed by two individuals to ascertain whether they fulfilled the inclusion criteria and data were extracted on outcome parameters.
  
  
  RESULTS
  Forty-two predominantly observational studies fulfilled the inclusion criteria. A variety of measurement methods and calculations of displacement was presented. The sample was heterogeneous concerning age, parity and continence status. Test positions and test activities varied among the studies.
  
  
  CONCLUSIONS
  The findings summarise the present knowledge of PFM displacement, but still lack deeper comprehension of the SUI pathomechanism of involuntary, reflexive activation during functional activities. We therefore propose that future investigations focus on PFM dynamics during fast and stressful impact tasks.
authors.affiliation: Health Division/Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland. monika.leitner@bfh.ch.|Graduate School for Health Sciences, University of Bern, Bern, Switzerland. monika.leitner@bfh.ch.
authors.forename: Monika
authors.initials: M
authors.lastname: Leitner
authors.affiliation: Health Division/Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.
authors.forename: Helene
authors.initials: H
authors.lastname: Moser
authors.affiliation: Health Division/Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.|Faculty of Sport and Rehabilitation Sciences, Vrije Universiteit Brussel, Brussels, Belgium.|Faculty of Health Sciences, Antwerp University, Antwerp, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Taeymans
authors.affiliation: Gynaecology, Bern University Hospital, Bern, Switzerland.
authors.forename: Annette
authors.initials: A
authors.lastname: Kuhn
authors.affiliation: Health Division/Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Radlinger
mesh_terms: D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology*
keywords: Activities of daily living; Diagnostics; Stress urinary incontinence