Dynamic Balance Indices in women with and without Pelvic Organ Prolapse

Document Type : Original Article

Authors

1 M.Sc. of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Associate Professor, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Assistante Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

4 Professor, Department of Biostatistics, Proteomics Research Center, School of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Pelvic Organ Prolapse (POP) is one of the dysfunctions of the Pelvic Floor Muscles (PFM), with descending of pelvic viscera, vaginal wall, uterus, bladder and rectum. Regarding the role of PFM as part of the core muscles in body balance, it has been suggested that women with PFM dysfunctions may have a lower level of balance. Therefore, this study was performed with aim to compare the level of dynamic balance in non-postmenopausal women with and without POP in two positions of full and empty bladder.
Methods: This cross-sectional comparative study was performed in 2018 on 30 non-pregnant married women in the Rehabilitation School of Shahid Beheshti University of Medical Sciences. The subjects were divided in to three groups (n=10 in each group): with symptomatic POP, asymptomatic POP and without POP. After collecting demographic information, the pelvic inclination angle, and the dynamic balance in Antero-Posterior, Medio-Lateral planes as well as total balance index were assessed. Data were analyzed using SPSS statistical software (version 22) and Kolmogorov-Smirnov, one-way ANCOVA and Fisher's exact test. P<0.05 was considered statistically significant.
Results: No significant differences were not found among three groups in terms of dynamic balance index with both full and empty bladder (p<0.05). Moreover, there were no significant differences among three groups regarding the pelvic inclination angle (p<0.05).
Conclusion: The association of POP as one of the dysfunctions of pelvic floor muscle is not confirmed by postural stability. Further studies using the motion analysis system and simultaneous recording of electrical muscle activity are recommended.

Keywords

References

  1. Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). International urogynecology journal 2016; 27(2):165-94.
  2. Bureau M, Carlson KV. Pelvic organ prolapse: A primer for urologists. Canadian Urological Association Journal 2017; 11(6Suppl2):S125.
  3. Masenga GG, Shayo BC, Rasch V. Prevalence and risk factors for pelvic organ prolapse in Kilimanjaro, Tanzania: A population based study in Tanzanian rural community. PloS one 2018; 13(4):e0195910.
  4. Chow D, Rodríguez LV. Epidemiology and prevalence of pelvic organ prolapse. Current opinion in urology 2013; 23(4):293-8.
  5. Word RA, Pathi S, Schaffer JI. Pathophysiology of pelvic organ prolapse. Obstetrics and Gynecology Clinics 2009; 36(3):521-39.
  6. Dsingh A, Kaur A. Role of postural control exercises and pelvic floor strengthening exercises on chronic low back pain of women with sitting jobs. InInternational Conference on Applied Human Factors and Ergonomics 2019:775-782.
  7. Sapsford RR, Hodges PW, Richardson CA, Cooper DH, Markwell SJ, Jull GA. Co‐activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourology and Urodynamics: Official Journal of the International Continence Society 2001; 20(1):31-42.
  8. Thompson JA, O’Sullivan PB, Briffa NK, Neumann P. Assessment of voluntary pelvic floor muscle contraction in continent and incontinent women using transperineal ultrasound, manual muscle testing and vaginal squeeze pressure measurements. International Urogynecology Journal 2006; 17(6):624-30.
  9. Smith MD, Coppieters MW, Hodges PW. Is balance different in women with and without stress urinary incontinence?. Neurourology and Urodynamics: Official Journal of the International Continence Society 2008; 27(1):71-8.
  10. Hodges PW, Sapsford R, Pengel LH. Postural and respiratory functions of the pelvic floor muscles. Neurourology and urodynamics 2007; 26(3):362-71.
  11. Pool-Goudzwaard A, van Dijke GH, van Gurp M, Mulder P, Snijders C, Stoeckart R. Contribution of pelvic floor muscles to stiffness of the pelvic ring. Clinical Biomechanics 2004; 19(6):564-71.
  12. Sedighimehr N, Manshadi FD, Shokouhi N, Baghban AA. Pelvic musculoskeletal dysfunctions in women with and without chronic pelvic pain. Journal of bodywork and movement therapies 2018; 22(1):92-6.
  13. Manshadi FD, Ghanbari Z, Miri ES, Azimi H. Postural and musculoskeletal disorders in women with urinary incontinence: A research report. Journal of Clinical Physiotherapy Research 2016; 1(1):27-31.
  14. Mattox TF, Lucente V, McIntyre P, Miklos JR, Tomezsko J. Abnormal spinal curvature and its relationship to pelvic organ prolapse. American journal of obstetrics and gynecology 2000; 183(6):1381-4.
  15. Ahangar MH, Manshadi FD, Barat S, Bagheban AA. Comparison of the alignment of spine and pelvis and pelvic floor muscles’ function between women with and without pelvic organ prolapse. J Rehab Med 2016; 4(4):89-97.
  16. Chen CH, Huang MH, Chen TW, Weng MC, Lee CL, Wang GJ. Relationship between ankle position and pelvic floor muscle activity in female stress urinary incontinence. Urology 2005; 66(2):288-92.
  17. Capson AC, Nashed J, Mclean L. The role of lumbopelvic posture in pelvic floor muscle activation in continent women. Journal of Electromyography and Kinesiology 2011; 21(1):166-77.
  18. Lee K. Activation of pelvic floor muscle during ankle posture change on the basis of a three-dimensional motion analysis system. Medical science monitor: international medical journal of experimental and clinical research 2018; 24:7223.
  19. Halski T, Ptaszkowski K, Słupska L, Dymarek R, Paprocka-Borowicz M. Relationship between lower limb position and pelvic floor muscle surface electromyography activity in menopausal women: a prospective observational study. Clinical interventions in aging 2017; 12:75.
  20. Sarrafzadeh J, Ghanbari Z, Nejad AK, Azghani M, Parnianpour M. Standing Pelvic Postures and Continence Ultrasonic Parameters in Women with and without Stress Urinary Incontinence. Journal of Research in Rehabilitation Sciences 2014; 9(7):1254-66.
  21. Pollock AS, Durward BR, Rowe PJ, Paul JP. What is balance?. Clinical rehabilitation 2000; 14(4):402-6.
  22. Holbein-Jenny MA, McDermott K, Shaw C, Demchak J. Validity of functional stability limits as a measure of balance in adults aged 23–73 years. Ergonomics 2007; 50(5):631-46.
  23. Jácomo RH, Alves AT, Garcia PA, Amatuzzi F, de Campos-Lobato LF, Carvalho GA, et al. Old Women Body Balance: Does the Pelvic Organ Prolapse Matter?. Topics in Geriatric Rehabilitation 2016; 32(4):E10-5.
  24. Belayneh T, Gebeyehu A, Adefris M, Rortveit G, Genet T. Validation of the Amharic version of the pelvic organ prolapse symptom score (POP-SS). International urogynecology journal 2019; 30(1):149-56.
  25. Pourmomeny AA, Rezaeian ZS, Soltanmohamadi M. Translation and linguistic validation of the Persian version of the Bristol Female Lower Urinary Tract Symptoms instrument. International urogynecology journal 2017; 28(9):1329-33.
  26. Cachupe WJ, Shifflett B, Kahanov L, Wughalter EH. Reliability of biodex balance system measures. Measurement in physical education and exercise
  27. Hosseini AE, Khalkhali M. The design and implementation of two instruments for pure hip flexion and pelvic inclination. Scientific journal of Shahed University 1994; 4:48-51.
  28. Rondini SK. Is postural stability compromised in women with urinary incontinence?. Graduate Theses, Dissertations, and Problem Reports; 2013. https://researchrepository.wvu.edu/etd/3617.
  29. de Arruda GT, Porolnik S, Weschenfelder ÁJ, Barbieri SO, Braz MM, Pivetta HM. Static postural control and risk of falls in older women with and without urinary incontinence. Fisioterapia e Pesquisa 2019; 26(3):285-90.
  30. Chmielewska D, Stania M, Słomka K, Błaszczak E, Taradaj J, Dolibog P, et al. Static postural stability in women with stress urinary incontinence: Effects of vision and bladder filling. Neurourology and urodynamics 2017; 36(8):2019-27.
  31. Vesentini G, El Dib R, Righesso LA, Piculo F, Marini G, Ferraz GA, et al. Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis. Clinics 2019; 74.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 24, Issue 4
June 2021
Pages 47-55

Files

Share

How to cite

Statistics