Relationship between ankle position and pelvic floor muscle activity in female stress urinary incontinence

To assess the influence of ankle position on pelvic floor muscle (PFM) activity in women with stress urinary incontinence.

A total of 39 women, ranging in age from 38 to 72 years and clinically diagnosed with stress urinary incontinence, participated in testing of PFM activity changes during various pelvic tilt angles created by horizontal, dorsiflexed, and plantar flexed ankle positions. PFM activity was measured by an intravaginal probe with surface electromyographic electrodes. An adjustable angle platform was used to set the ankle in each of the positions to create the various pelvic tilt postures.

Significant differences were found in resting PFM activity between horizontal standing with the ankle in the neutral position and standing with the ankle in plantar flexion (P = 0.01). Patients with ankle dorsiflexion also had greater resting PFM activity than with ankle plantar flexion (P < 0.01). Subjects showed significant changes in mean maximal PFM activity when standing with the ankle dorsiflexed and horizontal or in plantar flexion.

A standing posture that includes various ankle positions effectively facilitates PFM activity through enhanced pelvic tilt. We recommend these ankle positions as an adjunctive option combined with PFM training for stress urinary incontinence.