Surface electromyography (sEMG) is a valuable tool for assessing pelvic floor muscle function and guiding interventions for stress urinary incontinence (SUI) and pelvic organ prolapse. A study comparing the effects of Pilates exercises with pelvic floor muscle training (PFMT) plus sEMG biofeedback on the bioelectrical activity of pelvic floor muscles in women with SUI was conducted. In this study, 18 women participated in the sEMG biofeedback group, receiving PFMT with sEMG biofeedback, while 13 women were assigned to the Pilates group, engaging in basic level Pilates workouts. Both interventions were carried out for eight weeks. The electromyographic characteristics of pelvic floor muscles, quality of life, and voiding diary, were assessed at baseline, after eight weeks, and at a six-month follow-up. The sEMG was measured in two positions during five trials. The study found no significant improvement in the bioelectrical activity of pelvic floor muscles during contraction following either sEMG biofeedback training or Pilates exercises. However, the resting bioelectrical activity of pelvic floor muscles and during relaxation in the supine-lying position decreased after eight weeks of sEMG biofeedback training. Regarding incontinence episodes, both groups showed reductions post-intervention and after six-months. However, the differences between the two groups did not reach statistical significance. In terms of quality of life, the Pilates group demonstrated significantly better effects compared to the biofeedback group. The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) showed similar effects between Pilates exercises and sEMG biofeedback training. Both groups showed similar effects on incontinence episodes, micturition frequency, and nocturia frequency. While both groups experienced alleviation of urinary incontinence symptoms, the Pilates group showed more pronounced improvements in quality of life. In conclusion, the study did not find evidence to support the superiority of either method in terms of the bioelectrical activity of pelvic floor muscles. However, Pilates exercises demonstrated better effects on quality of life compared to sEMG biofeedback training.

David Lucena Atón

References:

1. Chmielewska D, Stania M, Kucab-Klich K, Błaszczak E, Kwaśna K, Smykla A, Hudziak D, Dolibog P. Electromyographic characteristics of pelvic floor muscles in women with stress urinary incontinence following sEMG-assisted biofeedback training and Pilates exercises. PLoS One. 2019 Dec 2;14(12):e0225647. doi: 10.1371/journal.pone.0225647. PMID: 31790463; PMCID: PMC6886793.
2. Resende AP, Petricelli CD, Bernardes BT, Alexandre SM, Nakamura MU, Zanetti MR. Electromyographic evaluation of pelvic floor muscles in pregnant and nonpregnant women. Int Urogynecol J. 2012 Aug;23(8):1041-5. doi: 10.1007/s00192-012-1702-6. Epub 2012 Mar 14. PMID: 22415702.
3. Zhang Q, Wang L, Zheng W. Surface electromyography of pelvic floor muscles in stress urinary incontinence. Int J Gynaecol Obstet. 2006 Nov;95(2):177-8. doi: 10.1016/j.ijgo.2006.07.006. Epub 2006 Aug 22. PMID: 16920119.
4. Culligan PJ, Scherer J, Dyer K, Priestley JL, Guingon-White G, Delvecchio D, Vangeli M. A randomized clinical trial comparing pelvic floor muscle training to a Pilates exercise program for improving pelvic muscle strength. Int Urogynecol J. 2010 Apr;21(4):401-8. doi: 10.1007/s00192-009-1046-z. Epub 2010 Jan 22. PMID: 20094704.