Evaluation
girdle, pelvic floor muscle contractions, pelvic floor muscle function
PAD, URINE LEAKAGE
Anthropometric, urination diary, pulmonary capacity, muscle activation, pelvic floor muscle function, and 1-h pad test were conducted before and after the exercise training program. Anthropometric parameters were measured, including body height, weight and body circumferences, body composition, urination diary and pulmonary capacity. Dual-energy X-ray absorptiometry (DXA, Hologic QDR4500W, Inc) was used to measure lean body mass and body fat composition after emptying the stomach, intestines and bladder with minimal radiationFor the urination diary, the participants were required to record the time of urination, urine volume, and frequency of urine leakage for three consecutive days. A benchmarked measuring cup (Pyrex, USA) was provided to record the accurate amount of the urineFor pulmonary capacity, the participants were instructed to stand in a natural and anatomical position, hold the handle of the spirometer (NL-100 spirometer, NaiLi, China), tilt their head slightly back, and breathe in as deep as they could. Then, the participant was asked to breathe out slowly at the mouthpiece until they could not breathe out further. The same procedure was repeated three times, and the largest value was selected for further analyses.For the muscle activation measurement, Ag/AgCI electrodes with a diameter of 25 mm and inter-electrode distance of 15 mm were placed over the left and right gluteus maximus, rectus abdominis, and gracilis to measure the surface electromyography (EMG) during the lumbo-pelvic coordination exercise. The rectus abdominis electrodes were positioned on the lower part of the muscle, superior to the umbilicus. The gluteus maximus electrodes were placed over the midway between the sacrum and greater trochanter. The gracilis electrodes were positioned on the medial part of the thigh, between the posterior edge of the gracilis, medial muscle of the thigh, and medial edge of the posterior muscles of the lower limb girdle at approximately one-third proximal point. The monopolar reference electrode was positioned on the anterior superior iliac spine for a stable baseline potential. Five consecutive trials were collected for subsequent analyses.Additionally, pelvic floor muscle function was evaluated using a neuromuscular electrical stimulation device (Phenix USB4, Phenix, France) with eight channels. Vaginal electrodes were applied to assess the pelvic floor muscle functional level. Participants were asked to perform five trials of 3-s maximum pelvic floor muscle contractions in the supine position. The data were bandpass filtered (50 to 1000 Hz), rectified and smoothedFor the standard 1-h pad test, the participants were asked to wear pre-weighed pads and drink 500 ml of sodium-free liquid in < 15 min