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Pelvic floor muscle activation in stress urinary incontinent women: Impact of a distraction task
Author(s) -
Dewaele Pauline,
Deffieux Xavier,
Villot Anne,
Amarenco Gérard,
Billecocq Sylvie,
Thubert Thibault
Publication year - 2019
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23936
Subject(s) - medicine , electromyography , urinary incontinence , pelvic floor , reflex , pelvic floor muscle , contraction (grammar) , urinary system , muscle contraction , urology , physical medicine and rehabilitation , audiology , anesthesia , surgery
Aims Our purpose was to explore the involvement of cognition in voluntary and involuntary pelvic floor muscle (PFM) contraction in stress urinary incontinent women. Methods PFM contraction monitored by surface electromyography (EMG) was measured without a mental distraction task (DT), and with a DT called “paced auditory serial additional test” (PASAT). Forty stress incontinent women performed voluntary contractions of the external anal sphincter (EAS), and reflex EAS contractions induced by means of coughing were studied using the external intercostal muscle (EIC) EMG pattern. Results A DT altered PFM pre‐activation when coughing: the reaction time between EIC muscle contraction and EAS contraction (called RT3) was respectively −54.94 ms (IQR −87.12; 3.12) without the PASAT and −3.99 ms (IQR: −47.92; 18.69) with a DT ( P = 0.02, Wilcoxon's test). Concerning voluntary contraction, women activated their PFM sooner without than with a DT. Conclusion The PASAT altered voluntary and reflex contractions of the PFM in stress urinary incontinent women. Our study suggests that cognition plays a role in urinary pathophysiology. Future studies should investigate rehabilitation programs that consider the role of cognition in stress urinary incontinent women.