Inter‐ and intrarater reliability of unidigital and bidigital vaginal palpation to evaluation of maximal voluntary contraction of pelvic floor muscles considering risk factors and dysfunctions

2020 ◽  
Author(s):  
Jordana B. Silva ◽  
Tatiana Oliveira Sato ◽  
Ana P. R. Rocha ◽  
Patricia Driusso
Keyword(s):  
Risk Factors ◽  
Pelvic Floor ◽  
Maximal Voluntary Contraction ◽  
Voluntary Contraction ◽  
Pelvic Floor Muscles ◽  
Intrarater Reliability

scholarly journals Assessment of pelvic floor and abdominal muscles three months postpartum: A reliability study

2020 ◽  
Author(s):  
Sabine Vesting ◽  
Monika Fagevik Olsén ◽  
Annelie Gutke ◽  
Gun Rembeck ◽  
Maria EH Larsson
Keyword(s):  
Pelvic Floor ◽  
Maximal Voluntary Contraction ◽  
Pelvic Floor Muscle ◽  
Random Order ◽  
Assessment Method ◽  
Voluntary Contraction ◽  
Muscle Endurance ◽  
Minimal Detectable Change ◽  
Abdominal Muscles ◽  
Diastasis Recti

Abstract Background Pregnancy and childbirth often result in alterations of core muscles, and women may require postpartum assessment of pelvic floor muscle function and abdominal wall changes, e.g. diastasis recti abdominis (DRA). However, there is currently no gold standard for postpartum assessment of these muscles´ function. Here we aimed to evaluate the reliability of clinically applicable methods for assessing pelvic floor muscles and DRA after pregnancy. Methods We recruited 222 postpartum women from Swedish antenatal and childbirth centers, and via social media. Pelvic floor and DRA assessment were performed via observation and palpation at three rehabilitation centers in Sweden. At each center, two independent physiotherapists performed the assessments in random order. Results Assessment of the maximal voluntary contraction and pelvic floor muscle endurance revealed kappa values ranging from 0.49–0.69. Assessments of voluntary contraction by observation, involuntary contraction, and voluntary relaxation yielded inconsistent results, with slight-to-moderate weighted kappa values ranging from 0.10–0.51. DRA assessment by caliper yielded ICC values of 0.73–0.83 after physiotherapists underwent 2 months of training in applying this assessment method. The standard error of measurements for this method was about 4 mm, and the minimal detectable change was 12 mm. Assessments of DRA depth and bulging showed moderate kappa values of 0.43–0.51, with reservation for some inconsistency between the centers. Conclusions Palpation of maximal voluntary contraction and pelvic floor muscle endurance are reliable postpartum assessment methods. With some experience and training, a caliper is a reliable instrument for assessing the postpartum DRA width. Additional research is needed to identify a reliable assessment method for pelvic floor muscle functions other than voluntary contraction, and for DRA depth and bulging.

scholarly journals Distensibility and Strength of the Pelvic Floor Muscles of Women in the Third Trimester of Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Carla Dellabarba Petricelli ◽  
Ana Paula Magalhães Resende ◽  
Julio Elito Júnior ◽  
Edward Araujo Júnior ◽  
Sandra Maria Alexandre ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Electrical Activity ◽  
Maternal Age ◽  
Surface Emg ◽  
Voluntary Contraction ◽  
Pelvic Floor Muscles ◽  
Third Trimester ◽  
The Third ◽  
Nulliparous Women ◽  
Multiparous Women

Objective.The objective of this study was to compare the role of the pelvic floor muscles between nulliparous and multiparous women in the third trimester of pregnancy, by analyzing the relationship between electrical activity (surface electromyography—EMG), vaginal palpation (modified Oxford scale), and perineal distensibility (Epi-no).Methods.This was an observational cross-sectional study on a sample of 60 healthy pregnant women with no cervical dilation, single fetus, gestational age between 35 and 40 weeks, and maternal age ranging from 15 to 40 years. The methods used were bidigital palpation (modified Oxford scale, graded 0–5), surface EMG (electrical activity during maximal voluntary contraction), and perineal distensibility (Epi-no device). The Pearson correlation coefficient (r) was used to analyze the Epi-no values and the surface EMG findings. The Kruskal-Wallis test was used to compare the median values from surface EMG and Epi-no, using the modified Oxford scale scores.Results.Among the 60 patients included in this study, 30 were nulliparous and 30 multiparous. The average maternal age and gestational age were 26.06 (±5.58) and 36.56 (±1.23), respectively. It was observed that nulliparous women had both higher perineal muscle strength (2.53 ± 0.57versus2.06 ± 0.64;P = 0.005) and higher electrical activity (45.35 ± 12.24 μV versus35.79 ± 11.66 μV;P = 0.003), while among the multiparous women, distensibility was higher (19.39 ± 1.92versus18.05 ± 2.14;P = 0.013). We observed that there was no correlation between perineal distensibility and electrical activity during maximal voluntary contraction (r = -0.193;P = 0.140). However, we found a positive relationship between vaginal palpation and surface electromyography (P = 0.008), but none between Epi-no values (P = 0.785).Conclusion.The electrical activity and muscle strength of the pelvic floor muscles of the multiparous women were damaged, in relation to the nulliparous women, while the perineal distensibility was lower in the latter group. There was a positive relationship between surface EMG and the modified Oxford scale.

scholarly journals Influence of a protocol of Pilates exercises on the contractility of the pelvic floor muscles of non-institutionalized elderly persons

2017 ◽  
Vol 20 (4) ◽  
pp. 484-492 ◽  
Author(s):  
Ligia Muniz de Souza ◽  
Ana Beatriz Gomes de Souza Pegorare ◽  
Gustavo Christofoletti ◽  
Suzi Rosa Miziara Barbosa
Keyword(s):  
Pelvic Floor ◽  
Elderly Women ◽  
Paired Comparison ◽  
Pelvic Floor Dysfunction ◽  
Voluntary Contraction ◽  
Pelvic Floor Muscles ◽  
Elderly Persons ◽  
Mato Grosso ◽  
Significant Difference ◽  
Pilates Method

Abstract Objective: To investigate the influence of a protocol of Pilates exercises on the functionality and contractility of the pelvic floor muscles (PFM) of older women living in the city of Campo Grande, Mato Grosso, Brazil. Method: Ten women (median age of 63.4±4.5 years) with little or no pelvic floor dysfunction were subjected to 24 sessions of Pilates exercises lasting one hour each, for 12 weeks. The pressure of the pelvic floor muscles (PFM) was assessed using a perineometer (cmH20) and contractility was assessed with the PERFECT scheme. Data were described as median ± interquartile range and inferential analysis was performed using the Wilcoxon paired test, with a significance level of 5%. Results: In view of the proposed treatment, the degree of voluntary contraction of the PFM of the participants increased from 79.0±83.5 to 90.0±82.0 cmH20, with a statistically significant difference in paired comparison (p=0.012). According to the PERFECT scheme, there was an increase in contraction time (from 5.0±0.1 to 7.0±4.7 seconds) and in the number of fast repetitions (from 7.0±4.5 to 8.0±4.7), with a statistically significant difference for both variables (p=0.017 and p=0.008, respectively). Conclusion: The results indicate that the Pilates method increased the contractility and pressure of the PFM of elderly women with little or no PFM impairment. Further studies are required to determine whether the Pilates method is an effective method for the treatment of women with severe pelvic floor dysfunction.

scholarly journals Reliability of Pelvic Floor Muscle Assessment with Transabdominal Ultrasound in Young Nulliparous Women

2021 ◽  
Vol 10 (15) ◽  
pp. 3449
Author(s):  
Bartosz Zając ◽  
Iwona Sulowska-Daszyk ◽  
Anna Mika ◽  
Artur Stolarczyk ◽  
Ewelina Rosłoniec ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Ultrasound Image ◽  
Posterior Wall ◽  
Voluntary Contraction ◽  
Pelvic Floor Muscles ◽  
Quantitative Detection ◽  
Transabdominal Ultrasound ◽  
Nulliparous Women ◽  
The Right

The aim of this study was to assess the reliability of pelvic floor muscles evaluation via transabdominal ultrasonography in young nulliparous women and to present the methodology for quantitative assessment of the ultrasound image of the pelvic floor muscles visible as displacement of the posterior wall of the bladder, caused by action of the pelvic floor muscles. The study comprised 30 young, Caucasian, nulliparous women (age 22–27; 168.6 ± 5.1 cm; 57.1 ± 11.8 kg) without pelvic floor muscle dysfunctions. The intra-rater, test-retest and inter-rater reliability of pelvic floor muscles evaluation was performed using transabdominal ultrasound at rest and during voluntary contraction. The reliability was assessed at three points of the image (at the middle, on the right and left side). The reliability of the three-point measurement of the pelvic floor muscles transabdominal ultrasound is excellent in the case of intra-rater assessments, both at rest (ICC = 0.98–0.99) and during contraction (ICC = 0.97–0.98); moderate at rest (ICC = 0.54–0.62) and poor during contraction (ICC = 0.22–0.50) in the case of test–retest assessment; excellent at rest (ICC = 0.95–0.96), and good during contraction (ICC = 0.81–0.87) in the case of inter-rater assessment. Transabdominal ultrasound is a reliable method of pelvic floor muscle evaluation. The three-points of assessment used in our study allowed for broader and more comprehensive imaging of the pelvic floor muscle, e.g., for quantitative detection contractility imbalances between the left and right side Due to the fact that understanding mechanisms of pelvic floor muscle functioning is crucial in the therapy of pelvic floor dysfunctions, therefore, reliable, valid tests and instruments are important.

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