Evaluation of pelvic floor kinematics in continent and incontinent women during running: An exploratory study.

Impact activity like running is associated with an increase in intra-abdominal pressure which needs to be sufficiently countered by pelvic floor muscle (PFM) activity to secure continence. The aim of this study was to investigate and compare PFM kinematics in continent and incontinent women during running.

Three-dimensional position and orientation was measured with the electromagnetic tracking device trakSTAR™. One sensor was attached to the vaginal probe and a second one was secured to the subjects’ skin at the height of the second sacral vertebrae. Cranial-caudal and forward-backward displacement of the vaginal probe was measured during 10 sec running on a treadmill at the speeds 7, 11, and 15 km/h. Displacement data from 100 ms before to 300 ms after heel-strike were analyzed.  Nineteen incontinent and twenty-seven continent women were included in this study. Before the foot touched the ground caudal translation and forward rotation of the vaginal probe was detected, whereas after heel-strike a cranial translation and backward rotation was measured. Cranial-caudal translation as well as backward-forward-rotation did not differ significantly between continent and incontinent subjects for the three speeds. Analysis of maximum displacements showed significantly increasing displacement with increasing speeds.

Kinematic measurements during impact activity of running demonstrated caudal translation before and cranial translation after heel-strike. The hypothesis of caudal translation through impact activity was not confirmed. Patterns seem similar between continent and incontinent subjects. Associations between the direction of displacement and muscle action of PFMs remain assumptions.

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