Respuesta muscular durante un ejercicio hipopresivo tras tratamiento de fisioterapia pelviperinealvaloración con ecografía transabdominal

Resumen

Objective To use transabdominal ultrasound imaging to assess pelvic floor and abdominal muscle function during a hypopressive exercise. Material and methods A cross-sectional study was conducted on 30 women who had previously finished a two-month individual physiotherapy treatment based on hypopressive exercises. The women were instructed to perform a hypopressive repetition that involved holding the breath after an exhalation of up to expiratory reserve volume. Breathing was held for 10s during which participants tried to expand their ribcage and to bring the abdominal wall to a posterior and superior position. Transabdominal ultrasound assessment was performed in supine position, with pelvic floor muscle action being recorded above the pubis bone in mid-transversal and mid-sagittal planes by using a curved lineal array probe at a frequency of 3.5MHz. In order to measure the increase of the cross-sectional area of abdominal muscles, a straight lineal array ultrasound transducer was used, being placed transversely on the right side of the abdominal wall. Results The whole sample achieved an elevation of the pelvic floor muscles during the hypopressive exercise with a median (interquartile range) of 6.8 (3.7) mm in transversal plane and 4.6 (4.7) mm in sagittal plane. The transverse abdominis muscle, internal oblique muscle, and external oblique muscle increased their thickness by 1.8 (1.2) mm, 1.5 (1.9) mm, and 0.5 (1.4) mm, respectively (P<.05). Rectus abdominis muscle showed a tendency to decrease its thickness, although there were no statistically significant differences (P=.48). Conclusions Hypopressive exercises achieved elevation of pelvic floor muscles without a direct contraction command. Deep abdominal muscles also contracted during a hypopressive exercise.