Abstract
Kinesiologic EMG measurements show that the pelvic floor muscles are capable of both continuing activity and brisk reactivity; although some variability in the amount and characteristics of motor unit activity and recruitment could be demonstrated from different sites in the pubococcygeus muscles, the activation or inhibition of firing of motor units in the pelvic floor muscles of healthy females was always found to be concordant bilaterally. In contrast, we have demonstrated significantly shorter maximal voluntary activation times, unilateral pubococcygeus activation disturbances, and even paradoxical unilateral inhibition of motor unit firing in the pelvic floor muscles of urinary incontinent women. As the particular human motor control patterns of the pelvic floor muscles — as they relate to the continence and excretory functions — are philogenetically rather recent, we postulate that they are therefore vulnerable and easily disturbed by even minor denervation injuries (as has been demonstrated in women after vaginal deliveries). We further postulate that such disturbances lead to deficient performance of the pelvic floor muscles, and contribute to the development of incontinence.
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Deindl, F.M., Vodusek, D.B., Schussler, B. et al. Pelvic floor activity patterns in urinary stress incontinent women: Evolutionary, neurophysiological and diagnostic considerations. Int Urogynecol J 6, 175–179 (1995). https://doi.org/10.1007/BF01900583
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DOI: https://doi.org/10.1007/BF01900583