What is the most effective verbal instruction for correctly contracting the pelvic floor muscles?

Noa Ben Ami, Gali Dar

Research output: Contribution to journalArticlepeer-review


Aims: The purpose of the present study was to compare the effectiveness of four different verbal instructions in correctly contracting pelvic floor muscles (PFMs), examined as a displacement of the pelvic floor by transabdominal ultrasound. Methods: Fifty-six female undergraduate physiotherapy students, mean age 24.2 ± 2.5 years, participated in the study. A 6 MHz 35-mm curved linear array ultrasound transducer (Mindray M5) was placed in the transverse plane, suprapubically over the lower abdomen and angled at 15-30° from the vertical depending. The participants were randomly divided into two groups: posterior and anterior. Each group received four different verbal instructions as to how to correctly contract the PFMs. Only one verbal instruction differed between the groups: “squeeze the anus” (posterior group) compared with “stop the flow of urine” (anterior group). Results: In the posterior group, 27 participants (90%) performed a correct contraction compared with 17 participants (65%) in the anterior group, thus demonstrating a statistically significant difference in favor of the “anus” instruction (P = 0.025). Forty-seven participants (84%) exhibited a downward movement during the verbal instruction combining transversus abdominis contractions with breathing, that is, “take a moderate breath in, let the breath out then draw in and lift your pelvic floor.”. Conclusions: Our findings suggest that the most effective verbal instruction for correctly contracting the PFMs among 56 physiotherapy students was the posterior instruction of “squeezing the anus.” The majority (90%) of participants succeeded in correctly contracting the PFMs.

Original languageEnglish
Pages (from-to)2904-2910
Number of pages7
JournalNeurourology and Urodynamics
Issue number8
StatePublished - Nov 2018

Bibliographical note

Publisher Copyright:
© 2018 Wiley Periodicals, Inc.


  • incontinence
  • pelvic diaphragm
  • ultrasound
  • verbal instruction

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology


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