Linda Mclean

Linda Mclean
University of Ottawa · School of Rehabilitation Sciences

PhD

About

149
Publications
45,671
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2,929
Citations
Additional affiliations
July 2002 - June 2014
Queen's University
Position
  • Professor (Full)

Publications

Publications (149)
Article
Objective The purpose of this study was to determine the acute effect of an abdominal hypopressive exercise (AHE) on linea alba morphology among women who are primiparous and to compare this effect to that of other common abdominal exercise modalities. Methods A cross-sectional study of 46 women 3 months after first delivery was conducted. B-mode...
Poster
Full-text available
Introduction: “The knack” is described as a pre-contraction of the pelvic floor muscles (PFMs) during tasks that increase intra-abdominal pressure (IAP), and is taught to women with stress urinary incontinence (SUI) as a means to reduce urine leakage1. It is not known whether women who are taught the knack adopt it into their everyday activities....
Article
Background While cumulative loading of the pelvic floor during exercise appears to increase the risk of developing pelvic floor disorders, the pathophysiologic role of pelvic floor loading is poorly understood. The aim of this exploratory study was to present a method for evaluating vibrational frequency damping of the female pelvic floor and to in...
Article
Full-text available
Introduction and hypothesis There is a high prevalence of urinary incontinence among endometrial cancer survivors. They are also known to present with pelvic floor muscle alterations. Evidence on the effects of conservative interventions for the management of UI is scarce. This study aims at verifying the effects of an in-home rehabilitation progra...
Article
Introduction and hypothesisThe objectives were to determine whether levator ani muscle (LAM) motor function is associated with female stress urinary incontinence (SUI) severity, and whether changes in LAM motor function induced through pelvic floor muscle training (PFMT) are associated with improvements in SUI signs and symptoms.Methods Pelvic morp...
Article
We aimed to investigate the impact of time on fine-wire (fw) electromyography (EMG) signal amplitude, and to determine whether any attenuation is confounded by task type. Twenty healthy participants were instrumented with fw and surface (s) EMG electrodes at the biceps brachii bilaterally. Participants held a weight statically with one arm and with...
Conference Paper
Background: The role of levator ani muscle (LAM) dysfunction in female stress urinary incontinence (SUI) is not known. Purpose: To determine whether LAM function is associated with SUI severity, and whether changes in LAM function induced through pelvic floor muscle training (PFMT) are associated with improvements in SUI in females. Methods: Female...
Article
Full-text available
https://doi.org/10.1007/s00192-020-04622-9 The article “The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis”, written by Kobra Falah-Hassani, Joanna Reeves, Rahman Shiri, Duane Hickling, and Linda McLean, was originally published Online First without Open Access. After publication in volume 32, issue 3, page 5...
Conference Paper
Full-text available
Background: Corticomotor excitability can be assessed through motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS). While TMS has been used extensively to probe the distal extremity musculature, very little effort has been made to explore the more proximal motor representations, notably those of the pelvic floor muscle...
Presentation
Full-text available
ABSTRACT Background: As we have observed unfortunately during the recent COVID-19 pandemic, all healthcare professionals are at a high risk of both acquiring and spreading infections. This includes physiotherapists working in pelvic health. If proper guidelines for infection control measures are lacking, there may be an increased risk of infection...
Article
Aims To investigate the intra‐ and inter‐rater reliability of two‐dimensional (2D) transperineal ultrasound imaging (USI) measures of bladder wall thickness (BWT), urethral length (UL), and parameters related to levator plate length (LP) and transient changes in LP during pelvic floor muscle (PFM) contraction, and on Valsalva in women who received...
Article
Introduction and hypothesis: This single-blind, randomised controlled trial was aimed at determining whether peri-operative physiotherapist-supervised pelvic floor muscle (PFM) training was superior to standard care (handout) in terms of improvements in stress urinary incontinence (SUI) symptoms, cure rate, and/or post-operative filling or voiding...
Article
Full-text available
Introduction and hypothesisTo evaluate the evidence for pathologies underlying stress urinary incontinence (SUI) in women.Methods For the data sources, a structured search of the peer-reviewed literature (English language; 1960–April 2020) was conducted using predefined key terms in PubMed and Embase. Google Scholar was also searched. Peer-reviewed...
Article
Aims (1) To present the design of a novel intravaginal dynamometer (IVD) capable of measuring vaginal closure force on both the anterior and posterior arms, (2) to use bench testing to validate the force, speed of arm opening, and positional accuracy of load measurement along the IVD arms, and (3) to present in vivo force measurements made with thi...
Article
Full-text available
Introduction and hypothesis The aim of this study was to prospectively identify aspects of baseline demographic, clinical, and pelvic morphology of women with stress urinary incontinence (SUI) that are predictive of cure with physiotherapist-supervised pelvic floor muscle training (PFMT). Methods Women ≥18 years old with SUI were recruited from ur...
Conference Paper
Objective: To determine whether the amplitude of pelvic floor muscle (PFM) electromyographic responses (EMGrs) recorded from the pubovisceralis(PV), external anal sphincter(EAS) or bulbocavernosus(BC) muscles differ based on the intensity (low vs moderate) or site [vaginal fourchette (VF) vs the posterior thigh (PT)] of applied pressure. Study des...
Conference Paper
Full-text available
Introduction: Provoked vestibulodynia (PVD) is a chronic pain condition characterized by severe sharp and/or burning pain at the vulvar vestibule when pressure is applied to this area. Although it affects roughly one in five women, and has a negative impact on quality of life for approximately half of them, PVD remains poorly understood. The litera...
Chapter
In addition to self‐report measures of pain, objective measures have been used to assess and quantify pain and pelvic floor muscle (PFM) function in women with provoked vestibulodynia (PVD). This chapter focuses on objective measures used to test the sensation of the vestibule and the involvement of the pelvic floor musculature. The cotton‐swab tes...
Article
Introduction The assessment of pelvic floor muscle (PFM) overactivity is part of a comprehensive evaluation including a detailed history (medical, gynecological history/antecedent), appraisal of the psychosocial contexts of the patient, as well as a musculoskeletal and a neurological examination. Objectives The aims of this article are to review (...
Article
Aims Reliability and validity of force measurement and task detection by the Elvie Trainer were evaluated against an intravaginal dynamometer (IVD) and ultrasound (US) imaging. Methods Women were recruited from local physiotherapy clinics. At the first visit, pelvic floor muscle (PFM) strength and tone were assessed manually. Women performed two s...
Article
Full-text available
Hypopressive exercises have emerged as a conservative treatment option for pelvic floor dysfunction (PFD). The aim of this study was to compare the effects of an eight-week hypopressive exercise program to those of an individualized pelvic floor muscle (PFM) training (PFMT) program, and to a combination of both immediately after treatment and at fo...
Article
The displacement of tumor bed walls during oncoplastic breast surgery (OBS) decreases the accuracy of using surgical clips as the sole surrogate for tumor bed location. This highlights the need for better communication of OBS techniques to radiation oncologists. To facilitate OBS practice and investigate clip placement reliability, a realistic sili...
Article
Introduction Overactive pelvic floor (OPF) muscles are defined as muscles that do not relax, or may even contract, when relaxation is needed, for example, during micturition or defecation. Conditions associated with OPF are multifactorial and include multiple possible etiologies and symptom complexes. The complex interplay between biological and ps...
Article
Responsive patient-reported outcome measures (PROMs) are able to detect change induced by a treatment. It is unknown whether PROMs on urinary incontinence (UI) are responsive in a conservative management setting. To systematically review the responsiveness of recommended PROMs (grade A) for the assessment of health-related quality of life in women...
Article
Full-text available
Aim: To measure the neuromuscular activation of the pelvic floor and abdominal muscles concurrently with vaginal closure forces induced during a hypopressive exercise (HE) and to identify the contribution of the HEs sequences (posture and maneuver) in the muscle's activation. Methods: A cross-sectional study design was employed. Sixty-six women...
Article
Full-text available
Context: Pelvic floor muscle training (PFMT) is strongly recommended for the management of mild to moderate urinary incontinence (UI) in women, yet the specific elements of PFMT that lead to improvement have not been identified. This gap in knowledge may be related, at least in part, to the lack of detail provided on intervention parameters report...
Article
Study Objective This preliminary investigation aimed to evaluate the feasibility of using ultrasound elastography (UE) to evaluate the myometrial and uterine leiomyoma stiffness. Our objectives were to (1) assess the reliability of UE stiffness measures of non-neoplastic myometrium, and (2) compare UE stiffness measures of non-neoplastic myometrium...
Article
Full-text available
Purpose: To explore the feasibility of two physiotherapy interventions for the management of diastasis recti abdominis (DrA): abdominal binding and targeting trunk exercises. Methods: A pilot randomized controlled trial (RCT) design was used to compare the effectiveness of exercise therapy and/or abdominal binding to no intervention on thirty-two p...
Conference Paper
Objective: Using three different intervention reporting instruments : the Consensus on Exercise Reporting Template (CERT), the template for intervention description and replication (TIDieR), and the CONTENT scale for therapeutic validity of therapeutic exercise programs, the purpose of this study was to assess the completeness of exercise reporting...
Article
Introduction and hypothesis The objective was to appraise the current use of mobile technologies for the conservative self-management of urinary incontinence (UI). Moreover, we aimed to explore whether they integrate recommended features for the use of mobile technologies in healthcare and recognized parameters for optimal conservative UI treatment...
Article
Full-text available
Study design: Cross-sectional, observational cohort. Background: The biomechanical implications of diastasis recti abdominis (DRA) are unknown. Objectives: (1) To investigate the impact of DRA, measurement site and task on inter-rectus disstance (IRD), linea alba (LA) stiffness and LA distortion measured at rest, and during head lift and semi-...
Article
Aims The aim of this study was to investigate the impact of task familiarization on (1) the magnitude and (2) the repeatability of active and passive properties of the female pelvic floor muscles (PFMs) measured using automated intra‐vaginal dynamometry. Methods Women attended three laboratory sessions at one‐week intervals. After receiving initia...
Article
Background: A separation of the abdominal muscles at the linea alba, known as diastasis recti abdominis (DRA), can occur after childbirth. However, the impact of DRA on abdominal muscle function is not clear. Objective: The objective was to determine if differences exist in trunk muscle function and self-reported pain and low back dysfunction be...
Article
Aims (1) To determine the reliability of an automated dynamometer designed to assess pelvic floor muscle (PFM) strength and resistance to passive elongation. (2) To evaluate the impact of PFM length and rate of tissue elongation on dynamometric outcomes. Methods At each of two sessions, twenty nulliparous women performed three maximum voluntary co...
Article
Background: Digital intravaginal palpation remains the favored method for clinical assessment of pelvic floor muscle (PFM) function in women; however, there is growing interest in using transperineal ultrasound imaging (TPUSI). TPUSI does not involve vaginal penetration, making it particularly relevant for PFM assessment in women with genito-pelvi...
Article
Full-text available
Transperineal ultrasound (TPUS) allows for objective quantification of mid-sagittal urogenital mechanics, yet current practice omits dynamic motion information in favor of analyzing only a rest and a peak motion frame. This work details the development of UROKIN, a semi-automated software which calculates kinematic curves of urogenital landmark mot...
Article
Background: Diastasis recti abdominis (DrA) is associated with negative body image, musculoskeletal pain and dysfunction, and perhaps urogynecological complaints. The severity of DrA has traditionally been determined by measuring the inter-rectus distance (IRD); however, the relationship between IRD and symptoms in women with DrA is unclear. Obje...
Article
Aims: The purpose of this study was to investigate the relationship between pelvic floor muscle (PFM) electromyographic (EMG) activation and urogenital landmark motion measured using 2D transperineal ultrasound (US) imaging. Methods: Eight healthy, nulliparous women performed maximum voluntary PFM contractions while EMG and transperineal US imag...
Article
Aims: The purposes of this study were: (i) to evaluate the reliability of vaginal palpation, vaginal manometry, vaginal dynamometry; and surface (transperineal) electromyography (sEMG), when evaluating pelvic floor muscle (PFM) strength and/or activation; and (ii) to determine the associations among PFM strength measured using these assessments....
Article
Full-text available
Purpose: An increased inter-rectus distance (IRD) can persist after a pregnancy and may be associated with lumbopelvic dysfunction. Ultrasound imaging (USI) is currently the gold standard for measuring IRD; however, no study has explored the need to standardize the transducer angle during these evaluations. The purpose of this study was to determi...
Article
Introduction: Emergent evidence suggests that pelvic floor muscle (PFM) dysfunction contributes to dyspareunia, the experience of pain on vaginal penetration. Electromyography (EMG) is a valuable tool for the assessment of neuromuscular control and could be very useful in enhancing our understanding of PFM involvement in sexual function and in con...
Article
Objective: To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis. Methods: A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs fo...
Article
Objective: To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. Methods: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exerci...
Article
Full-text available
Objectives: To identify effective aerobic exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning traditional land-based exercises for knee osteoarthritis. Methods: A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for...
Article
Full-text available
Purpose: To investigate the interrater reliability of inter-rectus distance (IRD) measured from ultrasound images acquired at rest and during a head-lift task in parous women and to establish the standard error of measurement (SEM) and minimal detectable change (MDC) between two raters. Methods: Two physiotherapists independently acquired ultrasou...
Article
Objective: Pelvic morphology has been suggested to reflect increased tone and reduced strength of the pelvic floor muscles (PFMs) in women with provoked vestibulodynia (PVD) compared to healthy controls. We aimed to determine whether there are differences in pelvic morphology in the resting state, on maximum voluntary contraction (MVC), or on maxi...
Article
Purpose: The aim of this study was to evaluate the effect of intravaginal neuromuscular electrical stimulation (NMES) and transcutaneous tibial nerve stimulation (TTNS) on lower urinary tract symptoms (LUTS) and health-related quality of life in women undergoing pelvic floor muscle (PFM) training (PFMT) with multiple sclerosis (MS) and to compare...
Article
Full-text available
Background: Targeted activation of the transversus abdominis (TrA) muscle through the abdominal drawing-in maneuver (ADIM) is a frequently prescribed exercise for the prevention and rehabilitation of low back pain. However, there is still debate over the role the ADIM plays in maintaining a stable spine during movement. Thus, a single cohort pre/p...
Article
Purpose: We aimed to determine if state of bladder fullness affects pelvic floor muscle activation in healthy women without urogenital symptoms. Materials and methods: Twenty-three nulliparous, continent female participants were recruited to participate. Women were randomized to begin the protocol with either an empty (EF) or a full (FE) bladder...
Article
Full-text available
Non-medical and non-surgical treatments for provoked vestibulodynia target psychological, sexual, and pelvic floor muscle factors that maintain the condition.
Article
Introduction: Pelvic floor muscle (PFM) involvement is suspected in the pathophysiology of provoked vestibulodynia (PVD); however, the underlying mechanisms are unclear. PFM morphology can be inferred from the biometry of the levator hiatus determined through dynamic ultrasound imaging. Aims: The aim of this study was to determine the nature of...
Chapter
This textbook provides a comprehensive, state-of-the art review of the Overactive Pelvic Floor (OPF) that provides clinical tools for medical and mental health practitioners alike. Written by experts in the field, this text offers tools for recognition, assessment, treatment and interdisciplinary referral for patients with OPF and OPF related condi...
Article
Full-text available
Objectives: The primary objective is to identify effective land-based therapeutic exercise interventions and provide evidence-based recommendations for managing hip osteoarthritis. A secondary objective is to develop an Ottawa Panel evidence-based clinical practice guideline for hip osteoarthritis. Methods: The search strategy and modified selec...
Article
Full-text available
Study design: Reliability and validity study. Objectives: To investigate the criterion-related validity and reliability of inter-rectus distance (IRD) measurement using extended field-of-view (FOV) techniques during ultrasound imaging (USI) in parous women. Background: Ultrasound imaging is the gold standard for noninvasive IRD measurement in...
Article
Full-text available
Study design: Clinimetrics. Objectives: To investigate the intrarater between-session reliability of inter-rectus distance (IRD) measurement using ultrasound imaging in postpartum women with diastasis recti. Background: Diastasis recti, a separation of the rectus abdominis muscles at the linea alba, occurs as a result of pregnancy and is chara...
Article
The purpose of this study was to assess the concurrent validity and sensitivity to change of three knee osteoarthritis (OA) grading scales. The Kellgren-Lawrence (KL) and the Osteoarthritis Research Society International (OARSI) joint space narrowing (JSN) grading scales are well-established. The third scale, the compartmental grading scale for OA...
Article
To survey commercially available intravaginal probes designed to record electromyography (EMG) from the pelvic floor muscles (PFMs), and to discuss the strengths and limitations of current technology. The MEDLINE EMBASE, CINAHL, PEDRO, and Cochrane databases were searched for articles in which intravaginal probes were described as having been used...
Article
Full-text available
The objective of this cross-sectional study was to assess the intra-rater, inter-rater and test-retest reliability and concurrent validity of lower-extremity alignment estimated from a photograph [photographic alignment (PA) angle]. A convenience sample of participants was recruited from the community. Radiopaque stickers were placed over participa...
Article
To evaluate inter-examiner reliability in the ultrasound (US) assessment of levator hiatal dimensions when different physiotherapists perform independent data acquisition and analysis. In this cross-sectional observational study, 14 asymptomatic nulliparous women were imaged at rest, during pelvic floor muscle contraction, and during Valsalva manoe...