Influence of adequate pelvic floor muscle contraction on the movement of the coccyx during pelvic floor muscle training.
Akiko Fujisaki, Miwa Shigeta, Misa Shimoinaba and 1 others
PMID 29706703WHAT IT FOUND
In 63 women, adequate pelvic floor contraction was associated with more upward movement of the coccyx tip than inadequate contraction.
The coccyx tip may be a self-check cue, but training effectiveness was not tested.
Key findings
01Among 63 females, inadequate muscle substitution patterns were observed in 33 participants (52.4%).
02Inadequate substitution was observed in 1 participant (7.1%) with good pelvic floor strength and 32 patients (65.3%) without good pelvic floor strength (p<0.01).
03The 13 participants with adequate contraction had median coccyx tip movement toward the head of +1.9 mm, versus +0.5 mm in the 50 participants without adequate contraction (p<0.01).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was cross-sectional, so it cannot show that a coccyx movement cue improves pelvic floor muscle training or stress urinary incontinence. It included only 63 females, with 57 patients with stress urinary incontinence and 6 healthy volunteers, so it is not a general population survey. Only sagittal MRI images and one reference line were used, so movement of the whole sacrum, including nutation and counternutation, could not be fully assessed. Interobserver error for Modified Oxford grading and inadequate substitution patterns was not assessed. Participants had not been taught correct pelvic floor muscle contraction at the time of evaluation, so the findings describe untrained attempts rather than trained technique.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not conclude that palpating or cueing the coccyx tip makes pelvic floor muscle training more effective or reduces leakage. The study measured coccyx movement associated with adequate contraction on MRI, not treatment outcomes.