Measurement and Interpretation of Intra-Abdominal Pressure During Physical Activity: A Scoping Review

INTRODUCTION AND HYPOTHESIS: Intra-abdominal pressure (IAP) is frequently discussed as a main contributor to pelvic floor loading during physical activities; however, the measurement of IAP in this context is complex. The aim of this scoping review was to synthesize how IAP has been measured, inferred, and interpreted during physical activities, summarizing sensor types, placement, activity contexts, reported values, measurement properties, and methodological limitations. METHODS: Structured searches were conducted in Medline, Embase, and Web of Science for peer-reviewed studies reporting IAP during physical activities or exercise (final search: 30 January 2025). RESULTS: Of the 4026 articles retrieved, 52 met the inclusion criteria. IAP was measured using microtip catheters, ingestible capsules, piezoelectric sensors, and air- or fluid-filled balloons placed in the stomach, esophagus, rectum, vagina, and bladder. Sensor measurement properties were rarely described and all sensors lacked validation for use during dynamic activities. Most studies included small samples (28 studies with < 20 participants) and only females (n = 25) or only males (n = 16), limiting generalizability. Reported pressure outcomes were highly variable, and, although consistently referred to as IAP, reflect the context-specific combination of forces (e.g., IAP, organ weight, and acceleration) acting on the sensor in a given activity. CONCLUSION: During physical activities, pressures recorded via body cavity sensors depend on sensor type, placement, and gravitational and acceleration loads as well as IAP. During physical activity, some sensors are prone to recording artifacts. Measurement validation and greater precision in reporting are essential to advance our understanding of pelvic floor loading during physical activities.