The Effect of Ankle Position on Pelvic Floor Muscle Contraction Activity in Women (accepted article)

Purpose
Stress urinary incontinence is extremely common in women. Conservative management includes pelvic floor muscle exercises to increase strength and muscular contraction forces to improve incontinence. We examined the effects of passive and active ankle flexion on pelvic floor muscle activity during exercises.

Materials and Methods
A total of 31 married women performed random pelvic floor muscle contractions while standing, and in 8 passive and active positions while pelvic floor muscle activity was simultaneously measured by electromyography.

Results
All ankle positions resulted in greater pelvic floor muscle activity than the horizontal foot position. Significantly greater muscle activity was seen with ankles in the plantar position with raised arms (p = 0.0051).

Conclusions
Pelvic floor muscle exercises performed with active ankle positions may increase the effectiveness of these exercises. Further studies are required to elucidate mechanisms for this finding.

Key Words: urinary incontinence; stress; muscle; skeletal; ankle joint; pelvic floor; electromyography

Abbreviations: DF, dorsiflexion; DFAU, DF and arms up; EMG, electromyography; HS, horizontal standing; MVC, maximal voluntary contraction; PF, plantar flexion; PFAU, PF and arms up; PFM, pelvic floor muscle; SUI, stress urinary incontinence