Friday, July 13, 2007
This presentation is part of : Models for Sub-Acute Care
Influence of passive or active holding ankle position on pelvic floor muscle strength in women
Hsiao-Lien Chen, MS, Nursing Department, Cathay General Hospital, Taipei, Taiwan, Ping-Ling Chen, Graduate Institute of Nursing, Taipei Medical University, Taipei, Taiwan, and Yin-Chou Lin, Department of Rehabilitation and Physical Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Learning Objective #1: understand the relationship of maximal strength of PFM and different ankle positions
Learning Objective #2: understand the application of active ankle positons in PFM training will enhance the effect of training

Background: Stress incontinence is the most common type of urinary incontinence in women. Pelvic floor muscle exercise (PFM) has been shown to be an effective, highly tolerable and cost-effective treatment for stress incontinence.  The increase of PFM strength and maximal strength, have associated with improvement of stress urinary incontinence.  However, the association of PFM strength and postural changes has limited evidence. 
Objective: To examine the influence of passive or active holding ankle position on PFM strength in women
Method: Twenty healthy women were recruited in this study. They participated in testing of PFM strength changes in different ankle positions. PFM strength was measured by an intravaginal probe with surface electromyographic (EMG) electrodes. Each subject was asked to perform the PFM contractions while assuming a series of nine positions during which EMG recordings of the PFM were made: Horizontal standing, dorsiflexion with 2.5cm toe height, dorsiflexion with 4.5cm toe height, dorsiflexion, dorsiflexion and hands up, plantar flexion with 2.5cm heel height , plantar flexion with 4.5cm heel height, plantar flexion, plantar flexion and hands up.
Results: Greater PFM activity occurred in active holding ankle positions than passive holding ankle positions. Plantar flexion hands up position had the strongest PFM strength, significant difference with other positions (p<0.05).
Conclusions: An upright standing posture that includes active holding ankle positions effectively facilitates PFM strength through muscles co-activation and synergy. Thus, we can apply active ankle positions in PFM training to enhance the effect of exercise in future.