Cough-Induced Contraction Response Time and Strength of the Pelvic Floor Muscles Between Women with and Without Stress Urinary Incontinence

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Abstract
Anatomic and functional changes in the pelvic floor muscles (PFMs) have been associated with stress urinary incontinence (SUI). The aim of this study is to compare cough-induced contraction response time and PFM strength in women with and without SUI. This cross-sectional study evaluated 40 women (20 with and 20 without SUI) aged 20 to 60 years. PFM strength was measured using a vaginal dynamometer. The cough signal was captured using an accelerometer, and activity of the right external oblique muscle was measured using surface electromyography. All signals were synchronized and recorded using the same signal acquisition module. Analysis of covariance (ANCOVA) with the Bonferroni post hoc test was used to compare the dynamometric data between groups (control and SUI). No significant differences were found between groups regarding variables related to PFM strength, but significant differences were found for activation time of the PFMs (F = 59.42, p < 0.0001, ηp2 = 0.76), activation time of the external oblique muscle (F = 6.55, p = 0.004, ηp2 = 0.26), and cough pulse time (F = 3.32, p = 0.04, ηp2 = 0.15). Women with stress urinary have a delayed cough-induced contraction response of the pelvic floor muscles, but no difference in the contraction force of these muscles was found in comparison to women without stress urinary incontinence.

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