The human pelvic floor is an anatomically, functionally, and morphologically complex region that is associated with many disorders such as chronic prostatitis/pelvic pain syndrome (CPPS), chronic low back pain, and urinary incontinence. The purpose of this dissertation was to explore the cortical mechanisms that underlie human pelvic floor muscle synergies. Our first original experiment involved the study of 20 healthy male controls who were instructed to perform a variety of muscle tasks presumed to be associated with pelvic floor muscle synergies. Surface electromyography (EMG) method was used to detect timing onsets, as well as activation patterns of the pelvic floor, gluteus maximus, and first dorsal interosseous muscles. Functional magnetic resonance imaging (fMRI) was used to measure blood oxygenation density levels (BOLD) in the brain while subjects performed various prime mover tasks. Our second original experiment involved another set of 10 healthy male subjects who were trained to perform a complex synergy breaking/decoupling task that was confirmed with EMG. They repeated the coupling motor task (gluteal activation) as well as the more complex motor decoupling task while being scanned with fMRI, so that BOLD signals could be compared. The first experiment revealed evidence of cortically facilitated synergy of the pelvic floor muscles and the second experiment revealed that complex motor tasks such as the breaking of a cortically facilitated muscle synergy involves BOLD signals in the brain known to be involved with interoception.

LLU Discipline

Rehabilitation Sciences


Rehabilitation Sciences


School of Allied Health Professions

First Advisor

Berk, Lee S.

Second Advisor

Daher, Noha S.

Third Advisor

Kutch, Jason J.

Fourth Advisor

Lohman, Everett B.

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Pelvic Floor

Subject - Local

Pelvic Floor Muscles; Pelvic Pain Syndrome; Muscle Synergies; Blood Oxygen Density Levels; Functional Magnetic Resonance Imaging; Cortically Facilitated Synergy



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives