title: Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study.
abstract: OBJECTIVE
  Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman's ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI.
  
  
  METHODS
  This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity.
  
  
  RESULTS
  Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups.
  
  
  CONCLUSIONS
  In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the mechanism of continence.
authors.affiliation: Department of Obstetrics, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Kuba
authors.initials: K
authors.lastname: Ptaszkowski
authors.affiliation: Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Paprocka-Borowicz
authors.affiliation: Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Lucyna
authors.initials: L
authors.lastname: Słupska
authors.affiliation: Department of Obstetrics, Wroclaw Medical University, Wroclaw, Poland ; Department of Obstetrics and Gynecology, Health Center Bitterfeld/Wolfen gGmbH, Bitterfeld-Wolfen, Germany.
authors.forename: Janusz
authors.initials: J
authors.lastname: Bartnicki
authors.affiliation: Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Dymarek
authors.affiliation: Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Rosińczuk
authors.affiliation: Department of Gynaecology and Obstetrics, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Heimrath
authors.affiliation: Department and Clinic of Urology, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Dembowski
authors.affiliation: Department and Clinic of Urology, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Romuald
authors.initials: R
authors.lastname: Zdrojowy
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D004576:Electromyography; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D017773:Pelvic Floor / Q000502:physiology*; D011044:Poland; D017698:Postmenopause; D011187:Posture / Q000502:physiology; D011446:Prospective Studies; D012146:Rest / Q000502:physiology; D014550:Urinary Incontinence, Stress / Q000503:physiopathology*
keywords: pelvic floor muscles; postmenopausal period; stress urinary incontinence; surface electromyography; synergistic muscle