Browsing by Author "Tosun, OC"

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    Relationship Between Abdominal Muscle and Pelvic Floor Muscle Activation in Elderly Individuals with Urinary Incontinence
    Dönbak, BS; Seçer, MB; Aktas, M; Tosun, OC; Kara, B; Tosun, G
    Introduction and HypothesisThe aim of our study is to examine the relationship between abdominal muscles and pelvic floor muscles (PFM) activation in elderly individuals with urinary incontinence (UI).MethodsThis cross-sectional study was conducted with 43 elderly individuals (27 women, 16 men) with UI in a nursing home. Superficial electromyography (EMG) was used to assess the contraction and relaxation activities of the PFM and abdominal muscles (rectus abdominis, transversus abdominis, internal obliques, external obliques). The Overactive Bladder Awareness Questionnaire (OAB-V8) and the Urogenital Distress Inventory Short Form (UDI-6) were used to assess incontinence symptoms and severity. The Geriatric Self-Efficacy Index for Urinary Incontinence (GSE-UI) was used to evaluate the level of self-efficacy. Quality of life was assessed using the Incontinence Impact Questionnaire Short Form (IIQ-7) and the Incontinence Quality of Life Scale (I-QOL). Chi-square test, Mann-Whitney U test, Kruskal-Wallis test, and Spearman correlation analysis were used for statistical analysis.ResultsA moderate positive correlation was found between PFM work MVC and RA work MVC (r 0.540, p 0.001), IO work MVC (r 0.485, p 0.002), and RA rest MVC (r 0.441, p 0.006). When analyzed by gender, significant differences were found in the average activity of RA contraction, average activity of EO contraction, and normalized MVC values (p 0.035, p 0.048, p 0.001). When analyzed by incontinence type, significant differences were found in the TA relaxation MVC and average activity of IO contraction (p 0.006, p 0.011).ConclusionsThere is a relationship between the functions of PFM and abdominal muscles in individuals with UI. Additionally, EMG data during both abdominal and PFM contractions are higher in men at this age. Incontinence type may affect abdominal muscle function.
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    Exercise Position to Improve Synergy Between the Diaphragm and Pelvic Floor Muscles in Women With Pelvic Floor Dysfunction: A Cross Sectional Study
    Dayican, DK; Keser, I; Tosun, OC; Yavuz, O; Tosun, G; Kurt, S; Secer, MB
    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.
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    Does combining two evidence-based exercise programs in elderly people with incontinence have a triple effect on incontinence symptoms, balance and functional status?
    Seçer, MB; Tosun, OC; Akbayrak, T; Ilçin, N; Tosun, G
    BackgroundImproving pelvic floor muscle training (PFMT), balance and functional activity is recommended in the treatment of urinary incontinence (UI) in the elderly people. The aim of this study is to examine whether PFMT combined with Otago exercises is effective on symptoms, balance and functional status in elderly people with UI compared to PFMT alone.MethodsThis study is an assessor-blinded, randomized controlled trial. Participants with UI aged 65 and over living in a nursing home were randomly assigned to the intervention (IG) and control groups (CG). The intervention group attended an exercise program that included Otago exercises combined with PFMT. The control group was included in the PFMT program with different positions. The duration of exercise for both groups was 45-60 min per session three times a week for 12 weeks. UI symptoms and severity (Pelvic Floor Distress Inventory-20, bladder diary), PFM muscle function (superficial electromyography), balance (Berg Balance Scale), functional status (Senior Fitness Test) and fear of falling (Falls Efficacy Scale) were measured at baseline and after the intervention.ResultsThe median age of the IG (n: 22) and CG (n: 21) was 73.5 and 77 years, respectively. At baseline and after the intervention within the group, a significant improvement was observed in the PTDE-20 score (IG and CG, p: 0.00) and the 2-min step test in the IG (p: 0.02) and CG (p: 0.01). A significant decrease was found in the 2.45 m get up-and-go test, PFM work average onset, and PFM rest MVC EMG values (p: 0.01, p: 0.01, p: 0.00) in the IG. The PFM rest average value decreased (p: 0.04) in the CG.ConclusionThe findings of this study show that combining PFMT with Otago exercises, two evidence-based interventions, is beneficial for effectively treating incontinence symptoms, balance and functional status in elderly people. Thus, a triple effect can be achieved with a single exercise training in the same treatment session and for the same duration.Clinical trial numberClinical trial number: NCT06331039.
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    Is the function of the core muscles affected during pregnancy?
    Cicek, S; Tosun, OC; Parlas, M; Bilgic, D; Yavuz, O; Kurt, S; Secer, MB; Tosun, G
    Introduction and hypothesisThe aim of our study is to examine the changes in core muscle functions during pregnancy.MethodsOur study was carried out in 67 primigravida pregnant women. Superficial electromyography (EMG) and non-invasive 2D/3D ultrasonography (USG) were used to evaluate core muscle (diaphragm, transversus abdominus [TA], internal oblique [IO]-external oblique [EO] muscles, pelvic floor muscles, multifidus) function during pregnancy. Pelvic floor muscle strength was also measured by a digital palpation method (PERFECT system). USG was used to measure expected fetal weight and the diastasis recti (DR) distance. Mann-Whitney U test was used to show changes in trimesters in the core muscles, and Spearman correlation analysis was used to determine the relationship.ResultsIn the third trimester, an nonsignificant increase in EMG parameters was observed in all of the core muscles. Although a statistically significant decrease was observed in muscle thickness values measured by EO and IO USG in the third trimester, DR was found to increase at all levels (p < 0.005). When we evaluated both trimesters and all pregnant women together, no relationship was found between all core muscles and pelvic floor muscles in the data evaluated by EMG and USG. We found a negative correlation in USG values between fetal weight and IO and the upper part of the rectus abdominus muscle, and a positive correlation between the EMG data of the EO and rectus abdominus muscles.ConclusionsIn women, the coactivation relationship between the core muscles may disappear during pregnancy. As the trimesters progress during pregnancy, a decrease in thickness and an increase in muscle activity can be observed in the core muscles. Pregnant women can be given exercise training for core muscles for protection in both the prenatal and postnatal periods. But more research needs to be done.
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    Does pelvic floor and abdominal muscle function and the synergy between these muscles change in young and older women with urinary incontinence?
    Seçer, MB; Dayican, DK; Tosun, OC; 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.