Stability, continence and breathing: The role of fascia following pregnancy and delivery

Journal of Bodywork and Movement Therapies

Volumn 12, Issue 4, 2008, Pages 333-348

  Lee, D G ^a   Lee, L J ^a   McLaughlin, L ^a  

^a Diane Lee and Associates   (Canada)

Author keywords

Breathing; Diastasis rectus abdominis; Hypocapnia; Linea alba; Paravaginal defects; Pelvic floor

Indexed keywords

ABDOMINAL DISEASE; ABDOMINAL PRESSURE; ADULT; ARTICLE; BIOMECHANICS; BODY POSTURE; BREATHING; BREATHING DISORDER; CASE REPORT; DELIVERY; DIASTASIS RECTUS ABDOMINIS; ECHOGRAPHY; ENDOPELVIC FASCIA; FASCIA; FECES INCONTINENCE; FEMALE; HUMAN; HYPOCAPNIA; LINEA ALBA; MOTOR CONTROL; MUSCULOSKELETAL FUNCTION; PELVIC GIRDLE; PELVIC ORGAN PROLAPSE; PELVIS FLOOR; PELVIS PAIN SYNDROME; PREDICTION; PREGNANCY; PREGNANCY RELATED PELVIC GIRDLE PAIN; PUERPERAL DISORDER; PUERPERIUM; RECTUS ABDOMINIS MUSCLE; REMISSION; SKELETAL MUSCLE; URINE INCONTINENCE; WEIGHT BEARING;

ADULT; FASCIA; FEMALE; HUMANS; PAIN; PARTURITION; POSTPARTUM PERIOD; PREGNANCY; PREGNANCY COMPLICATIONS; RECTUS ABDOMINIS; RESPIRATION; URINARY INCONTINENCE;

EID: 51449102527     PISSN: 13608592     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jbmt.2008.05.003     Document Type: Article

References (71)

1. Albert H.B., Godskesen M., and Westergaard J.G. Incidence of four syndromes of pregnancy-related pelvic joint pain. Spine 27 (2002) 2831-2834
2. Ashton-Miller J.A., and DeLancey J.O.L. Functional anatomy of the female pelvic floor. Annals of the New York Academy of Sciences 1101 (2007) 266-296
3. Ashton-Miller J.A., Howard D., and DeLancey J.O. The functional anatomy of the female pelvic floor and stress continence control system. Scandinavian Journal of Urology and Nephrology Supplementum 207 (2001) 1-7
4. Axer H., Graf D., Keyserlingk M.D., and Prescher A. Collagen fibers in linea alba and rectus sheaths. Journal of Surgical Research 96 (2001) 127-134
5. Baessler K., Miska K., Draths R., and Schuessler B. Effects of voluntary pelvic floor contraction on the urethral closure pressure. International Urogynecology Journal 16 (2005) 187-190
6. Barbic M., Kralj B., and Cor A. Compliance of the bladder neck supporting structures: importance of activity pattern of levator ani muscle and content of elastic fibers of endopelvic fascia. Neurourology and Urodynamics 22 (2003) 269
7. Bendova, P., Ruzicka, P., Peterova, V., Fricova, M., Springrova, I., 2007. MRI-based registration of pelvic alignment affected by altered pelvic floor muscle characteristics. Clinical Biomechanics 22(9), 980 Epub.
8. Boissonnault J.S., and Blaschak M.J. Incidence of diastasis recti abdominis during the childbearing year. Physical Therapy 68 (1988) 7
9. Coldron, Y., Stokes, M.J., Newham, D.J., Cook, K., 2007. Postpartum characteristics of rectus abdominis on ultrasound imaging. Manual Therapy. Epub.
10. DeLancey J.O.L. Structural support of the urethra as it relates to stress urinary incontinence: the Hammock hypothesis. American Journal of Obstetrics and Gynecology 170 6 (1994) 1713
11. DeLancey J.O.L. Fascial and muscular abdnormalities in women with urethral hypermobility and anterior vaginal wall prolapse. American Journal of Obstetrics and Gynecology 187 1 (2002) 93-98
12. Delancey J.O.L., Kearney Q., Chou A., et al. The appearance of levator ani muscle abnormalities in magnetic resonance images after vaginal delivery. Obstetrics and Gynecology 101 1 (2003) 46-53
13. Dietz H.P., and Bennett M.J. The effect of childbirth on pelvic organ mobility. Obstetrics and Gynecology 102 2 (2003) 223-228
14. Dietz H.P., and Clarke B. Prevalence of rectocele in young nulliparous women. Australian & New Zealand Journal of Obstetrics & Gynaecology 45 5 (2005) 391-394
15. Dietz H.P., and Lanzarone V. Levator trauma after vaginal delivery. Obstetrics and Gynecology 106 4 (2005) 707-712
16. Dietz H.P., and Schierlitz L. Pelvic floor trauma in childbirth-myth or reality?. Australian & New Zealand Journal of Obstetrics & Gynaecology 45 1 (2005) 3-11
17. Dietz H.P., and Steensma. The role of childbirth in the aetiology of rectocele. BJOG 113 (2006) 264-267
18. Dietz H.P., Eldridge A., Grace M., and Clarke B. Pelvic organ descent in young nulligravid women. American Journal of Obstetrics and Gynecology 191 1 (2004) 95-99
19. Hinz B. Masters and servants of the force: the role of matrix adhesions in myofibroblast force perception and transmission. European Journal of Cell Biology 85 (2006) 175
20. Hodges P.W., and Cholewicki J. Functional control of the spine. In: Vleeming A., Mooney V., and Stoeckart R.. (Eds). Movement, Stability & Lumbopelvic Pain (2007), Elsevier, Edinburgh (Chapter 33)
21. Hodges P., and Richardson C. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Archives of Physical Medicine and Rehabilitation 80 (1999) 1005
22. Hodges, P.W., Sapsford, R.R., Pengel, H.M., 2000. Feedforward activity of the pelvic floor muscles precedes rapid upper limb movements. In: Proceedings of the VIth International Physiotherapy Conference, Sydney, Australia.
23. Hodges P.W., Kaigle Holm A., Holm S., et al. Intervertebral stiffness of the spine is increased by evoked contraction of transversus abdominis and the diaphragm: in vivo porcine studies. Spine 28 23 (2003) 2594
24. Hodges P., Sapsford R., and Pengel L. Postural and respiratory functions of the pelvic floor muscles. Neurology and Urodynamics 26 (2007) 362
25. Hungerford B., Gilleard W., and Lee D. Alteration of pelvic bone motion determined in subjects with posterior pelvic pain using skin markers. Clinical Biomechanics 19 (2004) 456
26. Hungerford B., Gilleard W., Moran M., and Emmerson C. Evaluation of the reliability of therapists to palpate intra-pelvic motion using the stork test on the support side. Journal of Physiotherapy 87 (2007) 7879
27. Jensen D., Webb K.A., and O'Donnell D.E. Chemical and mechanical adaptations of the respiratory system at rest and during exercise in human pregnancy. Applied Physiology of Nutrition and Metabolism 32 6 (2007) 1239-1250
28. Jensen D., Duffin J., Lam Y.M., Webb K.A., Simpson J.A., Davies G.A., Wolfe L.A., and O'Donnell D.E. Physiological mechanisms of hyperventilation during human pregnancy. Respiratory Physiology and Neurobiology 161 1 (2008) 76-86
29. Lee D.G. The Pelvic Girdle. third ed. (2004), Elsevier, Amsterdam
30. Lee, D.G., 2007. Clinical reasoning and pelvic girdle pain: show me the patient! In: Proceedings of the Sixth World Congress on Low Back and Pelvic Girdle Pain, Barcelona, Spain, p. 27.
31. Lee, D., Lee, L.J., 2004a. An integrated approach to the assessment and treatment of the lumbopelvic-hip region-DVD. 〈www.dianelee.ca〉 or 〈www.discoverphysio.ca〉.
32. Lee, D.G., Lee, L.J., 2004b. Stress urinary incontinence a consequence of failed load transfer through the pelvic girdle? In: Proceedings of the Fifth Interdisciplinary World Congress on Low Back and Pelvic Pain, Melbourne, Australia.
33. Lee, D.G., Lee, L.J., 2007. Bridging the gap: the role of the pelvic floor in musculoskeletal and urogynecological function. In: Proceedings of the World Physical Therapy Conference, Vancouver, Canada.
34. Leffler K.S., Thompson J.R., Cundiff G.W., Buller J.L., Burrows L.J., and Schon M.A. Attachment of the rectovaginal septum to the pelvic sidewall. American Journal of Obstetrics and Gynecology 185 1 (2001) 41-43
35. Levitsky M.G. Pulmonary Physiology. sixth ed. (2003), McGraw-Hill, Toronto, ON
36. Lien K.C., Mooney B., DeLancey J.O., and Aston-Miller J.A. Levator ani muscle stretch induced by simulated vaginal birth. Obstetrics and Gynecology 103 (2004) 31-40
37. Mens J.M.A., Vleeming A., Snijders C.J., Stam H.J., and Ginai A.Z. The active straight leg raising test and mobility of the pelvic joints. European Spine 8 (1999) 468
38. Moseley G.L., and Hodges P.W. Loss of normal variability in postural adjustments is associated with non-resolution of postural control after experimental back pain. Behavioral Neuroscience 120 2 (2004) 474-476
39. Moseley G.L., and Hodges P.W. Does anticipation of back pain predispose to back trouble?. Brain 127 10 (2004) 2339-2347
40. Neumann P., and Gill V. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. International Urogynecology Journal 13 (2002) 125-132
41. Nguyen J.K., Lind L.R., Choe J.Y., McKindsey F., Sinow R., and Bhatia N.N. Lumbosacral spine and pelvic inlet changes associated with pelvic organ prolapse. Obstetrics and Gynecology 95 3 (2000) 332-336
42. Nixon P., and Andrews J. A study of anaerobic threshold in chronic fatigue syndrome (CFS). Biological Psychology 43 3 (1996) 264
43. O'Boyle A.L., O'Boyle J.D., Calhous B., and Davis G.D. Pelvic organ support in pregnancy and postpartum. International Urogynecology Journal and Pelvic Floor Dysfunction 16 1 (2005) 69-72
44. O'Sullivan P. Diagnosis and classification of chronic low back pain disorders, maladaptive movement and motor control impairments as underlying mechanism. Man. Ther. 10 4 (2005) 242-255
45. Ostgaard H.C., and Andersson. Postpartum low back pain. Spine 17 1 (1992) 53-55
46. Ostgaard H.C., Andersson G.B.J., and Karisson K. Prevalence of back pain in pregnancy. Spine 16 (1991) 49-52
47. Peng Q., Jones R., Shishido K., and Constantinou C.E. Ultrasound evaluation of dynamic responses of female pelvic floor muscles. Ultrasound in Medicine and Biology 33 3 (2007) 342-352
48. Peschers U., Schaer G., Anthuber C., DeLancey J.O., and Schuessler B. Changes in vesical neck mobility following vaginal delivery. Obstetrics and Gynecology 88 6 (1996) 1001-1006
49. Peschers U.M., Vodusek D.B., Fanger G., Schaer G.N., DeLancey J.O., and Schuessler B. Pelvic muscle activity in nulliparous volunteers. Neurourology and Urodynamics 20 3 (2001) 269-275
50. Pool-Goudzwaard A., van Dijke G.H., van Gurp M., Mulder P., Snijders C., and Stoeckart R. Contribution of pelvic floor muscles to stiffness of the pelvic ring. Clinical Biomechanics 19 6 (2004) 564-571
51. Pool-Goudzwaard A., Slieker ten Hove M.C., Vierhout M.E., Mulder P.H., Pool J.J., Snijders C.J., et al. Relations between pregnancy-related low back pain, pelvic floor activity and pelvic floor dysfunction. International Urogynecology Journal and Pelvic Floor Dysfunction 16 6 (2005) 468-474
52. Radebold A., Cholewicki J., Polzhofer B., and Greene H. Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine 26 7 (2001) 724-730
53. Rath A.M., Attali P., Dumas J.L., et al. The abdominal linea alba: an anatomo-radiologic and biomechanical study. Surgical Radiologic Anatomy 18 (1996) 281-288
54. Richardson A.C., Edmonds P.B., and Williams N.L. Treatment of stress urinary incontinence due to paravaginal fascial defect. Obstetrics and Gynecology 57 3 (1981) 357-362
55. Richardson C.A., Snijders C.J., Hides J.A., Damen L., Pas M.S., and Storm J. The relationship between the transversely oriented abdominal muscles, sacroiliac joint mechanics and low back pain. Spine 27 4 (2002) 399
56. Sapsford R. Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Manual Therapy 9 1 (2004) 3-12
57. Sapsford R., and Hodges P.W. Contraction of the pelvic floor muscles during abdominal maneuvers. Archives of Physical Medicine and Rehabilitation 82 8 (2001) 1081-1088
58. Schleip, R., 2006 Active fascial contractility. Implications for musculoskeletal mechanics. Dissertation for Doctor of Human Biology, Ulm University, Germany.
59. Smith M.D., Russell A., and Hodges P.W. Disorders of breathing and continence have a stronger association with back pain than obesity and physical activity. Australian Journal of Physiotherapy 52 (2006) 11
60. Smith M.D., Coppieters M.W., and Hodges P.W. Postural activity of the pelvic floor muscles is delayed during rapid arm movements in women with stress urinary incontinence. International Urogynecology Journal 18 8 (2006) 901-911 (2007 August)
61. Smith, M.D., Russell, A., Hodges, P.W., 2007a. Is there a relationship between parity, pregnancy, back pain and incontinence? International Urogynecology Journal and Pelvic Floor Dysfunction [Epub ahead of print] July 31.
62. Smith M.D., Coppieters M.W., and Hodges P.W. Postural response of the pelvic floor and abdominal muscles in women with and without incontinence. Neurourology and Urodynamics 26 3 (2007) 377-385
63. Spitznagle T.M., Leong F.C., and van Dillen L.R. Prevalence of diastasis recti abdominis in a urogynecological patient population. International Urogynecology Journal 18 (2007) 3
64. Thomson W.S.T., Adams J.F., and Cowan R.A. Clinical Acid-base Balance (1997), Oxford University Press, New York, NY
65. Thompson J.A., O'Sullivan P.B., Briffa N.K., and Neumann P. Altered muscle activation patterns in symptomatic women during pelvic floor muscle contraction and valsalva manouevre. Neurourology and Urodynamics 25 (2006) 268-276
66. Toranto I.R. Resolution of back pain with the wide abdominal rectus plication abdominoplasty. Plastic and Reconstruction Surgery 81 5 (1988) 777-779
67. Tunn R., Paris S., Fischer W., Hamm B., and Kuchinke J. Static magnetic resonance imaging of the pelvic floor muscle morphology in women with stress urinary incontinence and pelvic prolapse. Neurourology and Urodynamics 17 6 (1998) 579-589
68. Tunn R., DeLancey J.O., Howard D., Thorp J.M., Ashton-Miller J.A., and Quint L.E. MR imaging of levator ani muscle recovery following vaginal delivery. International Urogynecology Journal 10 5 (1999) 300-307
69. Watson P.J., Booker Ck., and Main C.H. Evidence for the role of psychological factors in abnormal paraspinal activity in patients with chronic low back pain. Journal of Musculoskeletal Pain 5 (1997) 41-56
70. Wilson P.D., Herbison P., Glazener C., McGee M., and MacArthur C. Obstetric practice and urinary incontinence 5-7 years after delivery. ICS Proceedings Neurourology and Urodynamics 21 4 (2002) 284-300
71. Wu W.H., Meijer O.G., Uegaki K., Mens J.M., Van Dieen J.H., Wuisman P.I., et al. Pregnancy-related pelvic girdle pain (PPP), I: terminology, clinical presentation, and prevalence. European Spine Journal 13 7 (2004) 575-589