Novel insight into the coordination between pelvic floor muscles and the glottis through ultrasound imaging: a pilot stu
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ORIGINAL ARTICLE
Novel insight into the coordination between pelvic floor muscles and the glottis through ultrasound imaging: a pilot study Aliza Rudavsky 1
&
Tricia Turner 2
Received: 31 March 2020 / Accepted: 20 July 2020 # The International Urogynecological Association 2020
Abstract Introduction Pelvic floor physical therapists have long utilized breathing cues with exercises and are beginning to incorporate vocalization tasks. To date, there have been no publications describing pelvic floor displacement during vocalization tasks. This study is a preliminary investigation into the changes in bladder shape distortion as a proxy for pelvic floor muscle displacement during respiratory and phonatory tasks. Methods Bladders were imaged using two-dimensional ultrasound in standing position. Measurement consisted of a diagonal line from the most anterior–superior aspect of the bladder to the most inferior–posterior aspect of the bladder. Length was measured at baseline and maximum distortion for each task. The first two tasks cued pelvic floor muscles to contract and then strain. Subsequent tasks only cued glottis function. A linear regression tested correlation between bladder distortion response to glottis tasks and cued pelvic floor tasks. The hypothesis was that diagonal would shorten with contraction, lengthen with strain, and follow a similar pattern seen in respiration for phonation tasks. Results Ten asymptomatic participants (5 men, 5 women) showed bladder diagonal shortening when cuing pelvic floor contraction for all participants and lengthening for 7 of the 10 participants when cued to strain the pelvic floor. The response of bladder length change was variable for glottis tasks, trending toward lengthening and significantly different in response to contraction. Conclusions When cuing pelvic floor to contract, healthy individuals showed shortening of bladder length and most lengthened during strain. When cuing phonation and respiration tasks, there was a tendency toward bladder lengthening. Keywords Glottis . Pelvic floor muscles . Ultrasonography . Phonation
Introduction The trunk can be divided into two cavities: the thoracic cavity on top and the abdominal cavity below. The two halves are functionally divided by the thoracic diaphragm [1]. At the top of the thoracic cavity are the vocal folds where the space between the folds is known as the glottis. The bottom of the abdominal cavity is a multi-layered muscular sling known as the pelvic floor. The glottis and pelvic floor have a relationship to each other in fascial connections throughout the trunk, neural control, and regulation of intra-abdominal and intra* Aliza Rudavsky [email protected] 1
Department of Kinesiology, The Pennsylvania State University, State College, USA
2
Southhills School¡ of Business and Technology, Diagnostic Medical Sonography, State College, USA
thoracic pressures [2, 3]. The pelvic floor muscles can close/ open orifices for sexual function and elimination or continence of bowel and bladder [4]. They can also lift and low
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