Title: Acute Effects of Single Session Pelvic Floor Muscle Training on Somatosensory and Corticospinal Excitability
Thesis Supervisors: Dr. Tania Lam & Dr. John (Kip) Kramer
Committee member: Dr. Jean-Sébastien Blouin
Defence Chair: Dr. Karim Khan
Abstract:
Background: The pelvic floor muscles play a critical role in maintaining urogenital function. Pelvic floor muscle training is a commonly prescribed, non-invasive, exercise intervention to manage urinary incontinence. It involves the practice of voluntary contractions of the muscles to different intensities and durations, as well as in combination with different functional tasks. As a non-invasive intervention with few to no side effects, PFMT is an attractive intervention for the management of urinary incontinence in different clinical populations. Despite its known clinical benefits, we still do not have a full understanding of the underlying neurophysiological effects of the intervention.
Objective: The objective of this study was to investigate the acute neurophysiological changes in sensorimotor pathways following a single session of PFMT, compared to a control intervention (biceps brachii contractions).
Methods: We randomly assigned participants to either the experimental (PFMT) or control (biceps training) group. Participants completed a training program consisting of 55 contractions to different intensities and durations in either their PFM or biceps brachii. To examine changes in somatosensory excitability associated with the PFM, we used electroencephalography to record somatosensory evoked potentials in response to pudendal nerve stimulation. To examine changes in corticospinal excitability, we used surface electromyography to record motor evoked potentials from the PFM elicited by transcranial magnetic stimulation over the primary motor cortex. All measures were recorded before and after a single session of training and compared between groups.
Results: Our data show no significant modulation in P40 amplitude of pudendal somatosensory evoked potential and PFM motor evoked potential amplitude. However, exploratory analysis suggests a possible relationship between intervention responder type (whether there was improvement in PFM contraction) and participant age, as well as corticospinal excitability.
Conclusion: We found no acute modulation of somatosensory and corticospinal excitability of the PFM following a single session of PFMT. However, further exploration of the data revealed possible effect of age on the response to PFMT, as well as between responder type and changes in corticospinal excitability, which needs to be investigated further.