Pelvic floor muscle activation during singing: a pilot study

The objectives of this study were to examine the effects of voluntary sub-maximal activation of the pelvic floor muscles (PFMs) during singing on PFM strength and compliance with the exercise regime. The participants in this pilot interventional study were a convenience sample of 11 asymptomatic (eight at follow-up) and seven symptomatic (five at follow-up) individuals. The primary outcome measures were: PFM strength assessment by vaginal examination; biofeedback evaluation of electromyographic (EMG) amplitude (in micro-volts, V); the number of fast contractions (maximum=10); and the length of the slow hold (maximum=10 s). The secondary outcome measure was compliance with the exercise regime. The mean preand post-test results for the asymptomatic group were, respectively: (PFM manual muscle testing, MMT) 3+ and 4; (EMG amplitude) 27 and 33 V; (number of fast contractions) 7 and 10; and (length of the slow hold) 8 and 10 s. Compliance in the asymptomatic group was 13 min per day, 6 days a week for 3 weeks. The mean preand post-test results for the symptomatic group were, respectively: (PFM MMT) 2 and 2+; (EMG amplitude) 7.6 and 11.4 V; (number of fast contractions) 4 and 6; and (length of the slow hold) 6.0 and 9.2 s. Compliance in the symptomatic group was 15 min per day, 6 days a week for 3 weeks. Activation of the PFMs during singing improved PFM strength, EMG amplitude, the number of fast contractions and the length of the slow hold with 3–4 weeks of practice. Compliance with the exercise regime was good. Further research using larger samples and a control group is required to investigate whether this method consistently improves PFM strength and whether compliance is maintained.