Please use this identifier to cite or link to this item:
http://hdl.handle.net/10397/76752
| Title: | Ankle positions potentially facilitating greater maximal contraction of pelvic floor muscles : a systematic review and meta-analysis | Authors: | Kannan, P Winser, S Goonetilleke, R Cheing, G |
Issue Date: | 2019 | Source: | Disability and rehabilitation, 2019, v. 41, no. 21, p. 2483-2491 | Abstract: | Objectives: To evaluate the effect of ankle positions on pelvic floor muscles in women. Methods: Multiple databases were searched from inception-July 2017. Study quality was rated using the grading of recommendations, assessment, development, and evaluation system and the “threats to validity tool”. Results: Four studies were eligible for inclusion. Meta-analysis revealed significantly greater resting activity of pelvic floor muscles in neutral ankle position (−1.36 (95% CI −2.30, −0.42) p = 0.004) and induced 15° dorsiflexion (−1.65 (95% CI −2.49, −0.81) p = 0.0001) compared to induced 15° plantar flexion. Significantly greater maximal voluntary contraction of pelvic floor was found in dorsiflexion compared to plantar flexion (−2.28 (95% CI −3.96, −0.60) p = 0.008). Meta-analyses revealed no significant differences between the neutral ankle position and 15° dorsiflexion for either resting activity (0.30 (95% CI −0.75, 1.35) p = 0.57) or maximal voluntary contraction (0.97 (95% CI −0.77, 2.72) p = 0.27). Conclusion: Pelvic floor muscle-training for women with urinary incontinence could be performed in standing with ankles in a neutral position or dorsiflexion to facilitate greater maximal pelvic floor muscle contraction. As urethral support requires resting contraction of pelvic floor muscles, decreased resting activity in plantar flexion identified in the meta-analysis indicates that high-heel wearers with urinary incontinence might potentially experience more leakage during exertion in a standing position. •Implications for rehabilitation •Pooled analyses revealed that maximal voluntary contraction of pelvic floor muscle is greater in induced ankle dorsiflexion than induced plantar flexion. •As pelvic floor muscle strengthening involves achieving a greater maximal voluntary contraction, pelvic floor muscle training for women with stress urinary incontinence could be performed in standing either with ankles in a neutral position or dorsiflexion. •Decreased resting activity in plantar flexion identified in the meta-analysis indicates that high-heel wearers with stress urinary incontinence might potentially experience more leakage during exertion in a standing position. •Women with stress urinary incontinence should be advised to wear flat shoes instead of high-heels and should be cautioned about body posture and ankle positions assumed during exercise and daily activities. |
Keywords: | Ankle positions Pelvic floor muscles Stress urinary incontinence Systematic review |
Publisher: | Taylor & Francis Group | Journal: | Disability and rehabilitation | ISSN: | 0963-8288 | EISSN: | 1464-5165 | DOI: | 10.1080/09638288.2018.1468934 | Rights: | © 2018 Informa UK Limited, trading as Taylor & Francis Group This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 07 May 2018 (Published online), available online: http://www.tandfonline.com/10.1080/09638288.2018.1468934. |
| Appears in Collections: | Journal/Magazine Article |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| a0771-n07_1552.pdf | Pre-Published version | 1.14 MB | Adobe PDF | View/Open |
Access
View full-text via PolyU eLinks 
Page views
163
Last Week
0
0
Last month
Citations as of Jun 4, 2023
Downloads
137
Citations as of Jun 4, 2023
SCOPUSTM
Citations
12
Citations as of Jun 8, 2023
WEB OF SCIENCETM
Citations
7
Last Week
0
0
Last month
Citations as of Jun 8, 2023
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.