The effect of Pilates on pelvic floor muscle strength in women with urinary incontinence
Clinically Relevant Anatomy[edit | edit source]
Urinary incontinence during the rise of abdominal pressure is largely prevented by sphincteric and musculofascial systems[1].
The bladder, uterus, rectum and the urethral- and anal sphincters are surrounded by a dome-shaped striated muscular sheet. This dome-shaped structure plays an important role in storing and elimination of urine and stool[2].
This dome-shaped muscular structure mainly consists of the levator ani and coccygeus muscles[3].
The levator, coccygeus and urogenital diaphragm are innervated by S2, S3, and S4 nerve fibres; while the external anal sphincter is innervated by the pudendal nerve [4].
(insert pic of bony structures; muscles, sphincters AND nerves)
Mechanism of pelvic floor Injury[edit | edit source]
Pregnancy and childbirth may lead to pelvic floor injury due to compression, stretching or tearing of nerve, muscle, and connective tissue.
The following pelvic floor-complications may occur due to pregnancy and childbirth;
- Neural injury (due to compression during labour and vaginal delivery)
- Levator ani and coccygeus muscles injury
- Fascial injury
- Impaired connective tissue remodelling (increased synthesis of collagen and elastin causes an alteration in soft tissue biomechanics during pregnancy)
Clinical Presentation[edit | edit source]
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Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
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Management / Interventions[edit | edit source]
PILATES specific
Differential Diagnosis[edit | edit source]
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Resources[edit | edit source]
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References[edit | edit source]
- ↑ Ashton-Miller J, DeLANCEY JO. Functional anatomy of the female pelvic floor. Bø K, Berghmans B, Mørkved S, van Kampen M, Evidence based physical therapy for the pelvic floor—Bridging science and clinical practice. 2007:19-33.
- ↑ Bharucha AE. Pelvic floor: anatomy and function. Neurogastroenterology & Motility. 2006 Jul;18(7):507-19.
- ↑ Handa VL. Urinary incontinence and pelvic organ prolapse associated with pregnancy and childbirth. UpToDate2014. 2015.
- ↑ Percy JP, Swash M, Neill ME, Parks AG. Electrophysiological study of motor nerve supply of pelvic floor. The Lancet. 1981 Jan 3;317(8210):16-7.
