A Dynamometer-based Wireless Pelvic Floor Muscle Force Monitoring

Technologies for Evaluation of Pelvic Floor Functionality: A Systematic Review

Pelvic floor dysfunction is a common problem in women and has a negative impact on their quality of life. The aim of this review was to provide a general overview of the current state of technology used to assess pelvic floor functionality. It also provides literature research of the physiological and anatomical factors that correlate with pelvic floor health. This systematic review was conducted according to the PRISMA guidelines. The PubMed, ScienceDirect, Cochrane Library, and IEEE databases were searched for publications on sensor technology for the assessment of pelvic floor functionality. Anatomical and physiological parameters were identified through a manual search. In the systematic review, 114 publications were included. Twelve different sensor technologies were identified. Information on the obtained parameters, sensor position, test activities, and subject characteristics was prepared in tabular form from each publication. A total of 16 anatomical and physiological parameters influencing pelvic floor health were identified in 17 published studies and ranked for their statistical significance. Taken together, this review could serve as a basis for the development of novel sensors which could allow for quantifiable prevention and diagnosis, as well as particularized documentation of rehabilitation processes related to pelvic floor dysfunctions.

The state of pelvic floor muscle dynamometry: A scoping review

AIMS

To discuss the advantages and limitation of the different pelvic floor muscle (PFM) dynamometers available, both in research and industry, and to present the extent of variation between them in terms of structure, functioning, psychometric properties, and assessment procedures.

METHODS

We identified relevant studies from four databases (MEDLINE, Compendex, Web of Science, and Derwent Innovations Index) up to December 2020 using terms related to dynamometry and PFM. In addition, we conducted a hand search of the bibliographies of all relevant reports. Peer-reviewed papers, conference proceedings, patents and user's manuals for commercial dynamometers were included and assessed by two independent reviewers.

RESULTS

One hundred and one records were included and 23 PFM dynamometers from 15 research groups were identified. From these, 20 were considered as clinical dynamometers (meant for research settings) and three as personal dynamometers (developed by the industry). Overall, significant heterogeneity was found in their structure and functioning, which limits development of normative data for PFM force in women. Further research is needed to assess the psychometric properties of PFM dynamometers and to standardize assessment procedures.

CONCLUSION

This review points up to the heterogeneity of existing dynamometers and methods of assessing PFM function. It highlights the need to better document their design and assessment protocol methods. Additionally, this review recommends standards for new dynamometers to allow the establishment of normalized data.

Portable Dynamometer-Based Measurement of Pelvic Floor Muscle Force

OBJECTIVE

In attempts to improve the quality of life of women, continuous projects are sought between rehabilitation intervention and engineering. Using the knowledge of the pelvic floor muscle (PFM) physiology, assessment and training methods are developed to reduce lower urinary tract symptoms such as urinary incontinence. Therefore, this paper covers the design and implementation of a portable vaginal dynamometer.

METHODS

A PFM probe is designed, 3D printed, assembled, and tested in ten women to assess its acceptability and usability. The feedback from the usability study is used to optimize the PFM probe design. A vaginal dynamometer is developed based on the designed PFM probe, then tested for linearity, repeatability, hysteresis, noise and heat effect, and power consumption. The variability between the different produced PFM probe prototypes is evaluated.

RESULTS

Force measurements are made using a load cell. Wireless communication is performed through a Bluetooth low energy transceiver v5.0, with a corresponding interface on both computer and smartphone. The device operates at a 3.3V supply and achieves a power consumption of 49.5 mW in operating mode. Two PFM probe sizes are designed to accommodate different vaginal hiatus sizes, based on usability study feedback. The proposed system allows the physiotherapist to wirelessly monitor variation in pelvic floor muscle force during assessment and/or training.

DISCUSSION/CONCLUSION

The testing results showed that the newly designed system has the potential to measure the PFM function in functional conditions such as the standing position.

An Exergame Solution for Personalized Multicomponent Training in Older Adults

In addition to contributing to increased training motivation, exergames are a promising approach to counteract age-related impairments. Mobility limitations, cognitive impairment, and urinary incontinence are very common in older adults. To optimally address these conditions, exergames should include interventions for strength, balance, cognition, and pelvic floor muscle training. In this study, we develop a personalized multicomponent exergame solution for the geriatric rehabilitation of age-related impairments. The exergame can provide interventions for balance, strength, cognition, and urinary incontinence in one single session, accommodating the needs of older adults with multiple disabilities. For its development, we involved a multidisciplinary team that helped us to specify the structure and contents of the exergame considering training requirements, game design principles, and end-user characteristics. In addition to allowing the customization of the training components, the exergame includes automatic adaptation of difficulty/load, in line with player progress over time. The game mechanics ensures the fulfilment of training needs as defined by the therapist. The exergame is cross-platform compatible (web-based) and includes novel means of interaction with wearable sensors.