{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T20:43:38Z","timestamp":1784580218439,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,3,1]],"date-time":"2015-03-01T00:00:00Z","timestamp":1425168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"publisher","award":["LP100100400"],"award-info":[{"award-number":["LP100100400"]}],"id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1002190"],"award-info":[{"award-number":["APP1002190"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the effect of instruction on activation of pelvic floor muscles (PFM) in men as quantified by transperineal ultrasound imaging (US) and to validate these measures with invasive EMG recordings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Displacement of pelvic floor landmarks on transperineal US, intra\u2010abdominal pressure (IAP) recorded with a nasogastric transducer, and surface EMG of the abdominal muscles and anal sphincter were recorded in 15 healthy men during sub\u2010maximal PFM contractions in response to different verbal instructions: \u201ctighten around the anus,\u201d \u201celevate the bladder,\u201d \u201cshorten the penis,\u201d and \u201cstop the flow of urine.\u201d In three men, fine\u2010wire EMG recordings were made from puborectalis and bulbocavernosus, and trans\u2010urethral EMG recordings from the striated urethral sphincter (SUS). Displacement data were validated by analysis of relationship with invasive EMG. Displacement, IAP, and abdominal\/anal EMG were compared between instructions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Displacement of pelvic landmarks correlated with the EMG of the muscles predicted anatomically to affect their locations. Greatest dorsal displacement of the mid\u2010urethra and SUS activity was achieved with the instruction \u201cshorten the penis.\u201d Instruction to \u201celevate the bladder\u201d induced the greatest increase in abdominal EMG and IAP. \u201cTighten around the anus\u201d induced greatest anal sphincter activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The pattern of urethral movement measured from transperineal US is influenced by the instructions used to teach activation of the pelvic floor muscles in men. Efficacy of PFM training may depend on the instructions used to train activation. Instructions that optimize activation of muscles with a potential to increase urethral pressure without increasing abdominal EMG\/IAP are likely ideal. <jats:italic>Neurourol. Urodynam. 35:457\u2013463, 2016<\/jats:italic>. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.22745","type":"journal-article","created":{"date-parts":[[2015,3,1]],"date-time":"2015-03-01T22:15:35Z","timestamp":1425248135000},"page":"457-463","source":"Crossref","is-referenced-by-count":48,"title":["Pattern of activation of pelvic floor muscles in men differs with verbal instructions"],"prefix":"10.1002","volume":"35","author":[{"given":"Ryan E.","family":"Stafford","sequence":"first","affiliation":[{"name":"The University of Queensland, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health School of Health and Rehabilitation Sciences Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Ashton\u2010Miller","sequence":"additional","affiliation":[{"name":"Departments of Mechanical and Biomedical Engineering, Institute of Gerontology The University of Michigan Ann Arbor 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