Training through gametherapy promotes coactivation of the pelvic floor and abdominal muscles in young women, nulliparous and continents

Vol. 42 (4): 779-786, July – August, 2016

doi: 10.1590/S1677-5538.IBJU.2014.0580


Valeria Regina Silva 1, Natalia Miguel Martinho 1, Joseane Marques 1, Cássio Riccetto 1, Leonardo Cesar Carvalho 2, Simone Botelho 1,2

1 Departamento de Cirurgia da Faculdade de Ciências Médicas – Universidade Estadual de Campinas (UNICAMP), SP, Brasil; 2 Curso de Fisioterapia, Escola de Enfermagem, Universidade Federal de Alfenas (UNIFAL-MG), MG, Brasil


Introduction and objectives: several studies have been investigated co-activation can enhance the effectveness of PFM training protocols allowing preventive and therapeutic goals in pelvic floor dysfunctions. The objective of the present study was to investigate if an abdominal-pelvic protocol of training (APT) using gametherapy would allow co-activation of PFM and transversus abdominis/oblique internal (TrA/OI) muscles.
Patients and methods: Twenty-five nulliparous, continent, young females, with median age 24.76 (±3.76) years were evaluated using digital palpation (DP) of PFM and surface electromyography of PFM and TrA/OI simultaneously, during maximal voluntary contraction (MVC), alternating PFM and TrA/OI contraction requests. All women participated on a supervised program of APT using gametherapy, that included exercises of pelvic mobilization associated to contraction of TrA/OI muscles oriented by virtual games, for 30 minutes, three times a week, in a total of 10 sessions. Electromyographic data were processed and analyzed by ANOVA – analysis of variance.
Results: When MVC of TrA/OI was solicited, it was observed simultaneous increase of electromyographic activity of PFM (p=0.001) following ATP. However, EMG activity did not change significantly during MVC of PFM.
Conclusion: Training using gametherapy allowed better co-activation of pelvic floor muscles in response to contraction of TrA, in young nulliparous and continent women.

Keywords: Pelvic Floor; Abdominal Muscles; Electromyography

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