RecruitingACTRN12614000795695

The effect of chiropractic care on synchronised pelvic floor muscle contraction

The effects of chiropractic care compared to passive movement on pelvic floor muscle function in women with non-synchronised pelvic floor muscle contractions

Sponsor

New Zealand College of Chiropractic

Enrollment

15 participants

Start Date

Aug 28, 2014

Study Type

Interventional

Conditions

Non-synchronised pelvic floor muscle contractions

Summary

This project will investigate whether adjusting lumbopelvic vertebral subluxations alters pelvic floor muscle function using a novel multiarray surface electrode vaginal probe. Pelvic floor muscles are fundamental in the birth process, mainly during the pushing stage of labour. They normally contract in a synchronised coordinated fashion. However, nonsynchronised pelvic floor muscle contractions are often detected and this is thought to be the cause of pelvic floor dysfunction such as urinary incontinence. If spinal adjustments are able to improve pelvic floor muscle function then this could have important benefits for both delivery and pelvic floor health. Spinal adjustments are known to improve the timing and ability to contract the deep abdominal muscles. Since the pelvic floor muscles work together with the abdominal muscles, it is possible that adjustments will also be able to improve the timing and the synchronization of the pelvic floor muscles.

Eligibility

Sex: FemalesMin Age: 18 YearssMax Age: 55 Yearss

Plain Language Summary

Simplified for easier understanding

This study investigates whether chiropractic spinal adjustments can improve pelvic floor muscle function in women who have non-synchronized (uncoordinated) pelvic floor contractions. Pelvic floor muscles are important for bladder control and during childbirth. You may be eligible if: - You are a woman between 18 and 55 years old - You have been found to have non-synchronized pelvic floor muscle contractions by ultrasound or EMG testing - Your body mass index (BMI) is less than 25 - You have normal sensation in the perineal area You may NOT be eligible if: - You have a history of pelvic floor dysfunction, stress incontinence, pelvic organ prolapse, or avulsions - You have a current vaginal, urethral, or bladder infection - You have had significant back pain in the last 3 months - You have a known neurological disease - You take antidepressants, painkillers, or sedative medication - You have had a recent injury or have conditions that contraindicate chiropractic adjustments - You have previously had a bad reaction to spinal adjustments Talk to your doctor about whether this trial might be right for you.

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Interventions

Individuals who are identified as having non-synchronous pelvic floor muscle contraction during the baseline/control session will be assessed a second time within one month of the initial assessment.

Individuals who are identified as having non-synchronous pelvic floor muscle contraction during the baseline/control session will be assessed a second time within one month of the initial assessment. At the second assessment all measures will be recorded before and after lumbopelvic chiropractic adjustments. The order of the various measures will be pseudo-randomised (e.g. order of assessment of maximal voluntary contractions, submaximal contractions and voluntary coughs). No control setup will be performed during the second assessment as control data will be available from the first assessment. All of the spinal adjustments to be carried out in this study will be high-velocity, low-amplitude thrusts to the spine. This is a standard adjustment technique used by manipulative physicians, physiotherapists, and chiropractors. The mechanical properties of this type of CNS perturbation have been investigated; and although the actual force applied to the subject's spine depends on the therapist, the patient, and the spinal location of the adjustment, the general shape of the force-time history of spinal adjustments is very consistent (Hessell, Herzog, Conway, & McEwen, 1990) and the duration of the thrust is always less than 200 milliseconds (for review see Herzog, 1996).The high-velocity type of adjustment was chosen specifically because previous research (Herzog, Conway, Zhang, Gail, & Guimaraes, 1995) has shown that reflex EMG activation observed after adjustments only occurred after high-velocity, low-amplitude adjustments (as compared with lower-velocity mobilizations). This adjustment technique has also been previously used in studies that have investigated neurophysiological effects of spinal adjustments (for review see Haavik & Murphy, 2012). After each individual segmental adjustment the spine will be re-checked in order to determine if the subsequent levels identified as subluxated still require an adjustment. The levels of the spine adjusted for each subject will be recorded in an experimental log book. The adjustment intervention will take approximately 5 minutes and will be administered once.

Locations(1)

Auckland, New Zealand

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ACTRN12614000795695