The effect of modified Pilates-based positions on pelvic floor electromyographic (EMG) activity; a pilot study
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ORIGINAL ARTICLE
The effect of modified Pilates-based positions on pelvic floor electromyographic (EMG) activity; a pilot study Gemma Nightingale 1
&
Kandiah Chandrakumaran 1 & Christian Phillips 1,2
Received: 16 July 2020 / Accepted: 1 September 2020 # The International Urogynecological Association 2020
Abstract Introduction The evidence regarding the effect of exercise, specifically Modified Pilates (MP), on pelvic floor muscles (PFMs) is limited. We report our pilot study using the MAPLe® device to assess the effect of MP type exercises on PFM electomyographic (EMG) activity and whether PFM contraction could be performed during specific MP exercises. Methods The MAPLe® device was used to measure EMG activity of PFMs in healthy volunteers in different MP positions. Positions were divided into ‘neutral’, ‘core’ and ‘plank’ and EMG readings were taken at rest, during Valsalva and during active contraction. Results Twenty volunteers were recruited. The median age was 35 (IQR 27–39.5) years. Higher EMG readings were seen in ‘core’ and ‘plank’ positions at rest. No position inhibited a conscious contraction and positions which engaged core muscles provoked an augmented contraction. Conclusion This is the first study to show that when MP positions are held for short periods of time, in asymptomatic women, the changes in PFM EMG are higher. This suggests that a stronger muscle contraction can be achieved when the core is cocontracted. Higher EMG readings were seen during ‘core’ and ‘plank’ positions; despite this, further activation with a conscious PFM contraction was still achievable. Keywords Electromyography . Exercise . Modified Pilates . Multiple Array Probe Leiden (MAPLe®) . Pelvic floor contraction . Valsalva
Introduction Pelvic floor dysfunction is common among women of all ages and can lead to problems with prolapse and incontinence. The prevalence of pelvic floor disorders is predicted to increase substantially given the changing demographics of our population [1], and it is therefore imperative to identify activities that could exacerbate pelvic floor dysfunction and, conversely, confirm which activities can benefit pelvic floor strength. Physical activity has many health benefits, but some hypothesise there may be a threshold for the pelvic floor where physical activity is more deleterious than beneficial [2]. There is
* Gemma Nightingale [email protected] 1
Basingstoke and North Hampshire Hospital, Basingstoke, UK
2
University of Winchester, Winchester, UK
little evidence on which sporting activities are beneficial for the pelvic floor, but it is postulated that high-impact sports and activities that are associated with a high intra-abdominal pressure (IAP) may have a negative effect. The evidence to date is contradictory. One study found ‘recommended’ versions of different exercises, including those involving core muscles, did not have significantly different IAPs than the ‘discouraged’ versions of the same exercise [3]. However, another study found that IAP was not significantly incre
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