The Perception of Pelvic Floor Muscle Function amongst Exercising Women Who Are Repeatedly Instructed to Contract Their Pelvic Floor Muscles

In this study, the self-perception of pelvic floor muscle (PFM) contractions amongst women receiving repeated verbal instructions during exercise classes was examined. The prevalence and severity of urinary stress incontinence were also assessed. This cross-sectional observational study included 46 women (mean age 48 (±8.6)), who regularly participated in Pilates classes where repeated instruction was given to contract PFM (“instruction group”; N = 22) or not (controls, N = 24). PFM function was evaluated using transabdominal ultrasound. Simultaneously, the participant described her personal evaluation of her PFM contraction ability. The International Consultation on Incontinence Questionnaire–Short Form was also utilized. Most women (80%) correctly contract PFM; however, 95% did not perform a voluntary contraction during leg movement, without differences observed between groups. A higher perception of PFM contraction was found in the “instruction group” when performing knee flexion towards the chest without specific verbal instruction. Women who were instructed to contract their PFM suffered less incontinence and had a lower degree of severity than the controls. Most women performing Pilates exercises correctly contracted their PFM. However, there was no PFM voluntary contraction during leg movement. Exposure to repeated verbal instructions to contract PFM, over time, might lead to an improvement in women’s perception of their ability to contract PFM. Verbal instructions for PFM contraction were found to be effective in reducing urinary incontinence

Effect of a full pilates group exercise program on transversus abdominis thickness, daily function and pain in women with chronic low back pain

The Pilates method is often used in the treatment of nonspecific low back pain (NSCLBP). The effect of Pilates group exercising (mat and apparatus combined) on women with NSCLBP is unknown. Studies on the Pilates method often use ultrasound (US) to measure transversus abdominis (TrA) thickness in one anatomical location. We recruited 40 women, 22 with NSCLBP and 18 healthy women (active control group), to join five weeks of biweekly Pilates group exercising (apparatus and mat). Measurements included TrA thickness (left and right) at rest, during active draw-in maneuver (ADIM), and its TrA% change in three anatomical areas; Roland-Morris disability questionnaire (RMDQ); and pain level (VAS). Before the study, no asymmetry in TrA thickness was noted as well as no between-group differences in TrA-thickness in three anatomic areas (in rest and ADIM). Following the intervention, TrA thickness increased during rest in the healthy group in two areas. No differences were noted between the two groups in ADIM in the anatomical locations. No between-group differences were found before the intervention in the TrA% change. Following the intervention, an increase in the TrA-% change was noticed in the NSCLBP group. A decrease in the healthy group was observed in area C. No effects were noted on the RMDQ and VAS. Five weeks of Pilates group exercising increased TrA thickness in healthy women and its percentage changed in women with NSCLBP. Measuring TrA thickness with US should be performed in three different anatomical locations on both sides. This measuring procedure has good inter- and intra-rater reliability and the potential to reveal physiological effects

The Effect of Load Carrying on Gait Kinetic and Kinematic Variables in Soldiers with Patellofemoral Pain Syndrome

Individuals suffering from patello-femoral pain syndrome (PFPS) exhibit altered gait parameters compared with healthy individuals. As soldiers carry heavy equipment, the extra load might further alter gait pattern. The aim of this study was to investigate the effect of load carrying on kinetic and kinematic variables in soldiers with PFPS compared with controls. The sample comprised 23 active-duty infantry soldiers (10 with bilateral/13 without bilateral PFPS, mean age: 20.4 (±0.5) years, height 179 (±5.8) cm, weight 76 (±6.9) kg). The participants walked barefoot on a 10 m walkway with and without loading equipment. The equipment added 50% to each participant’s body mass. Gait kinematic and kinetic variables were assessed by the VICON three-dimensional motion analysis system and two force plates. Weight carrying increased joint maximal angles, mean peak moments and double support and decreased single support and walk speed in both groups, without differences between groups (p > 0.05). The only difference between groups was in the hip adduction angle without a load (p < 0.05); no difference was observed while carrying the load. Kinematic and kinetic differences in gait were detected between weight and non-weight conditions, yet there was no effect of PFPS. Further studies with subjects performing different tasks are essential to examining the effect of PFPS and load among soldiers

Forward step down test - clinical rating is correlated with joint angles of the pelvis and hip: an observational study

Abstract Background Clinical methods for assessing quality of movement and functional tests are important to clinicians. Typical deviations from normal kinematics during the clinical test of Forward Step Down Test (FSDT) are pelvic tilt and hip adduction which are associated with the risk of knee pain. Objectives (1) to examine the correlation between clinical assessment of the FSDT and joint angle measurements of pelvis, hip, knee and ankle joints in males and females; (2) to examine the differences in joint angles between individuals rated as good, fair or poor in a FSDT performance test. Methods Ninety-two healthy individuals performing FSDT were video-taped with two-dimensional digital video cameras. The clinical assessment of the FSDT was rated by two experienced physical therapists as good, fair, or poor based on a Crossley et al. (2011) validated scale. Measurements of pelvic drop, hip adduction and knee valgus were taken using Image J software. Results Out of 177 lower limbs, 74 (37 in each limb) were clinically rated as “good/fair” (41.80%) while 103 (52 in the dominant leg and 51 in the non-dominant leg) were rated as “poor” (58.19%). No significant differences were observed between dominant and non-dominant legs or between males and females in clinical rating of the FSDT. Pelvic drop angle was significantly higher and hip adduction angle was significantly lower for “poor” clinical rating compared to “good/fair” in both dominant and non-dominant legs (p < 0.001) in males and females. Females demonstrated higher pelvic drop, lower hip adduction and higher knee valgus angles compared with males (p < 0.05). Conclusions This study showed that the clinical rating of FSDT is correlated with joint angle measurements suggesting that this assessment can be utilized in clinical practice. Individuals with poor quality performance of FSDT showed higher pelvic drop and hip adduction movement. Further studies examining different populations with diverse disorders or pathologies are essential