NEW YORK (Reuters Health) - Using certain ankle positions to influence inclination when standing is effective in facilitating pelvic floor muscle (PFM) activity through enhanced pelvic tilt in women with stress urinary incontinence. The technique may be a useful adjunct to PFM training in helping manage such incontinence.

In the August issue of Urology, Dr. Gwo-Jaw Wang and colleagues from Kaohsiung Medical University School of Medicine, Taiwan, note that they examined the impact of ankle positions on PFM activity in women with stress urinary incontinence.

A total of 39 women (mean age 58.8 years) with clinically diagnosed stress urinary incontinence engaged in testing of PFM activity changes during various pelvic tilt angles created by horizontal, dorsiflexed, and plantar flexed ankle positions.

The angles were created with an adjustable angle platform that set the ankles in each of the three positions. The researchers used an intravaginal probe with surface electromyographic electrodes to measure PFM activity.

Significant differences were observed in resting PFM activity during horizontal ankle standing compared to standing with the ankle in plantar flexion. Significant differences were also found between the dorsiflexion ankle position and the ankle plantar flexed position. The team found no significant differences between the horizontal standing and ankle dorsiflexion postures.

Overall, the researchers observe that "an upright standing position with the ankles dorsiflexed could facilitate anterior pelvic tilt, which in turn increased effective PFM activity to its greatest point."

In conclusion they point out that "there is a connecting relationship among PFM activity, abdominal muscle strength, and pelvic tilt tendency, which is worthy of additional investigation."

Urology 2005;66:288-292

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