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The Role of Phonation in Pelvic Floor Muscle Activation: Implications for Rehabilitation
Humeyra Kiloatar1, Aylin Aydogdu Delibay2, Cimen Olcay Demir1
1Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Kutahya Health Sciences University, Campus of Germiyan, 43100, Kutahya, Türkiye.
Introduction And Hypothesis:
In recent years, phonation has been popular as a complementary method in pelvic floor rehabilitation during pelvic floor muscle training. The aim of this study is to evaluate the electromyographic (EMG) activity of the pelvic floor muscles (PFM) during the production of the sounds /i/, /y/ (Turkish /ü/), and /z/.
Methods:
This cross-sectional study included 39 healthy female volunteers aged 18-30 years. The EMG activity of the PFM was assessed using surface electrodes and a portable biofeedback device called NeuroTrac® MyoPlus 4 Pro. Measurements were taken while the participants were in a modified butterfly position, with 10-s rest and 10-s maximum contraction cycles. Participants were asked to produce the sounds /i/, /y/ (Turkish /ü/), and /z/ for 10 s each at their natural speaking pitch and intensity. Each sound was repeated three times, and average values were recorded.
Results:
Thirty-nine women participated in the study, with an average age of 21.21 ± 2.22 years. PFM activity increased significantly during the /i/, /y/ (Turkish /ü/), and /z/ sounds compared with the resting position (p < 0.001). Effect sizes were high (r = 0.58-0.87). In comparisons between sounds, a difference was found only in work average parameter; /z/ sound caused higher activation than /y/ and /i/ sounds (p < 0.01). No significant differences were found between sounds in MVC and onset time parameters (p > 0.05).
Conclusions:
Phonation can reflexively increase PFM activity in healthy women. These findings suggest that phonation could be further investigated as a potential supportive strategy in PFM training programs.
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