title: Can Abdominal Hypopressive Technique Change Levator Hiatus Area?: A 3-Dimensional Ultrasound Study.
abstract: This study aimed to evaluate the levator hiatus area (LHA) at rest and during the performance of maximal pelvic floor muscle (PFM) contractions, during the abdominal hypopressive technique (AHT), and during the combination of PFM contractions (PFMCs) and the AHT. The study included 17 healthy nulliparous women who had no history of pelvic floor disorders. The LHA was evaluated with the patients in the lithotomy position. After a physiotherapist instructed the patients on the proper performance of the PFM and AHT exercises, 1 gynecologist performed the 3-dimensional translabial ultrasound examinations. The LHA was measured with the patients at rest. The PFMC alone, the AHT alone or the AHT in combination with a PFMC with 30 seconds of rest between the evaluations were performed. Each measurement was performed 2 times, and the mean value was used for statistical analysis. The Wilcoxon test was used to test the differences between the 2 maneuvers. Similar values were observed when comparing the LHA of the PFM at rest (12.2 ± 2.4) cm and during the AHT (11.7 ± 2.6) cm (P = 0.227). The AHT+ PFMC (10.2 ± 1.9) cm demonstrated lower values compared with AHT alone (11.7 ± 2.6) cm (P = 0.002). When comparing the PFMC (10.4 ± 2.1) cm with the AHT + PFMC (10.2 ± 1.9) cm, no significant difference (P = 0.551) was observed. During PFMC, the constriction was 1.8 cm; during the AHT, the constriction was 0.5 cm; and during the AHT + PFMC, it was 2 cm. The LHA assessed by 3-dimensional ultrasound did not significantly change with AHT. These results support the theory that AHT does not strengthen PFM.
authors.affiliation: *Faculty of Physical Education and Physiotherapy, Federal University of Uberlândia (UFU), Uberlândia, MG; †Department of Gynecology, and ‡Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo-SP, Brazil.
authors.forename: Ana Paula Magalhães
authors.initials: AP
authors.lastname: Resende
authors.forename: Luiza
authors.initials: L
authors.lastname: Torelli
authors.forename: Miriam Raquel Diniz
authors.initials: MR
authors.lastname: Zanetti
authors.forename: Carla Dellabarba
authors.initials: CD
authors.lastname: Petricelli
authors.forename: Zsuzsanna IIona Katalin
authors.initials: ZI
authors.lastname: Jármy-Di Bella
authors.forename: Mary Uchiyama
authors.initials: MU
authors.lastname: Nakamura
authors.forename: E
authors.initials: E
authors.lastname: Araujo Júnior
authors.forename: Antonio Fernandes
authors.initials: AF
authors.lastname: Moron
authors.forename: Manoel João Batista Castello
authors.initials: MJ
authors.lastname: Girão
authors.forename: Marair Gracio Ferreira
authors.initials: MG
authors.lastname: Sartori
mesh_terms: D000009:Abdominal Muscles / Q000502:physiology*; D000328:Adult; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D009119:Muscle Contraction / Q000502:physiology*; D017773:Pelvic Floor / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000502:physiology*; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult