Browsing by Author "Celiker Tosun O."
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Item Exercise Position to Improve Synergy Between the Diaphragm and Pelvic Floor Muscles in Women With Pelvic Floor Dysfunction: A Cross Sectional Study(Elsevier Inc., 2023) Korkmaz Dayican D.; Keser I.; Celiker Tosun O.; Yavuz O.; Tosun G.; Kurt S.; Baser Secer M.Objective: This study aimed to investigate the synergy between the diaphragm and pelvic floor muscles (PFM) according to different exercise positions in women with pelvic floor dysfunction. Our secondary aim was to determine the short-term effects of single-week pelvic floor muscle training (PFMT) program on diaphragmatic function. Methods: The cross-sectional study included 64 women with pelvic floor dysfunction. The participants' diaphragm and abdominal muscle functions during voluntary PFM contraction and relaxation were assessed by surface electromyography and ultrasonography. The surface electromyography assessments were performed in supine (P1), crawling (P2) and sitting (P3) positions. A single week-PFMT was conducted on women who agreed to determine the short-term responses of the diaphragm function. The muscle functions according to exercise positions were compared with Friedman Analysis of Variance, and the short-term effects of single-week PFMT on diaphragm function was analyzed with Wilcoxon Signed-Ranks Test. Results: The diaphragm activity during voluntary PFM contraction was highest in P2 before and after single-week PFMT (P < .001). Positive significant correlations were found between the activities diaphragm and abdominal muscles in different exercise positions (P < .05). After single-week PFMT, diaphragm thickness increased (P = .030) in P1, but diaphragm activity did not change in all 3 exercise positions (P > .05). Conclusion: The synergy between the diaphragm and PFM was greater in the crawling position in women with pelvic floor dysfunction. The abdominal muscles seemed to contribute to maintaining this synergy. Therefore, PFMT combined with diaphragmatic breathing exercises in the crawling position should be considered. In addition, single-week PFMT may positively affect diaphragm function in the short-term. © 2024Item Does pelvic floor and abdominal muscle function and the synergy between these muscles change in young and older women with urinary incontinence?(Elsevier Ireland Ltd, 2025) Başer Seçer M.; Korkmaz Dayican D.; Celiker Tosun O.; Yavuz O.; Kurt S.Aim: The aim of this study was to examine the synergistic relationship between the pelvic floor muscles (PFM) and abdominal muscles in older women with urinary incontinence (UI). Our secondary aim is to compare PFM and abdominal muscle functions and synergistic relationship according to incontinence type in younger and older women. Material and methods: This cross-sectional study was conducted with 46 older and 31 younger women. Urogenital Distress Inventory (UDI-6) and Over Active Bladder-Validated 8 (OAB-V8) were used to evaluate the severity of participants’ urinary symptoms, and the Incontinence Impact Questionnaire (IIQ-7) was used to evaluate the quality of life related to the symptoms. PFM function was evaluated by superficial electromyography (EMG) and digital palpation; abdominal muscle function was evaluated by EMG. Results: The average ages of the participants in the younger and old female groups were 49.74 ± 7.25 years and 74.87 ± 5.41 years, respectively. PFM endurance (p = 0.005), number of fast repetitions (p = 0.073) and work average value of the participants in the older women group were found to be lower than those in the younger women group (p = 0.002). In the group of older women with mixed incontinence (MUI), PFM endurance (p = 0.022), PFM (p = 0.002), Transversus abdominis (TrA) (p = 0.007), rectus abdominis (RA) (p = 0.015), internal oblique (IO)(p = 0.002) and external oblique (EO) abdominal muscles (p = 0.001) work average values were significantly lower. In the younger women group with urge incontinence (UUI), the PFM work average value was higher than in the older women group (p = 0.021). During PFM contraction, a moderate positive correlation was found between PFM and RA (r = 0.498, p = 0.001), IO (r = 0.405, p = 0.006) and EO (r = 0.442, p = 0.002) in the older women group. Conclusion: This study showed that older women with UI demonstrated reduced PFM endurance, fewer fast PFM contractions, and lower PFM and abdominal muscle activity compared to younger women with UI. A positive association was observed between the PFM and the RA, IO, and EO muscles specifically in older women with UI. Importantly, our findings indicate that both PFM and abdominal muscle function decline with age in women, irrespective of UI status, leading to a worsening of related symptoms. Consequently, we recommend the implementation of preventive physiotherapy and rehabilitation programs beginning at a young age to preserve and optimize PFM and abdominal muscle function in women. © 2025 Elsevier B.V.