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Wang C, Che Y, Zhang Y, Guan T, Wang J, Du X. Analysis of pelvic floor muscle electromyography parameters in women with or without sexual dysfunction. Sex Health 2024; 21:SH24026. [PMID: 38743840 DOI: 10.1071/sh24026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/18/2024] [Indexed: 05/16/2024]
Abstract
Background To investigate the differences in pelvic floor muscle (PFM) electromyography (EMG) parameters between women with or without sexual dysfunction (FSD) and their correlations. Methods Women who voluntarily participated in a questionnaire-based survey on sexual function and underwent PFM EMG in Weifang People's Hospital during the period from March 2021 to December 2021 were retrospectively enrolled. The female sexual (dys)function was measured using the Female Sexual Function Index. Glazer PFM EMG was performed using a Melander instrument (MLD A2 Deluxe). The differences in PFM EMG parameters between women with or without FSD were compared, and the relationships between PFM EMG parameters and FSD were analysed using multiple linear regression models. Results A total of 305 women were enrolled, with 163 in the FSD group and 142 in the non-FSD group. Comparisons of PFM EMG parameters between these two groups revealed that the FSD group had significantly higher peak EMG amplitude during the phasic (flick) contractions and shorter recovery latency during the tonic contractions than the non-FSD group (both P P Conclusions The results of the pelvic floor EMG in this study suggest that the pelvic floor muscles of women with FSD may be more susceptible to fatigue, and may have poorer coordination of their pelvic floor muscles.
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Affiliation(s)
- Chunyan Wang
- People's Hospital of Weifang City, Weifang, Shandong Province, China
| | - Yan Che
- People's Hospital of Weifang City, Weifang, Shandong Province, China; and NHC Key Lab of Reproduction Regulation, Shanghai Engineering Research Center of Reproductive Health Drug and Devices, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, China
| | - Yumei Zhang
- People's Hospital of Weifang City, Weifang, Shandong Province, China
| | - Tingfeng Guan
- People's Hospital of Weifang City, Weifang, Shandong Province, China
| | - Jie Wang
- People's Hospital of Weifang City, Weifang, Shandong Province, China
| | - Xinying Du
- People's Hospital of Weifang City, Weifang, Shandong Province, China
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Faucher S, Déry-Rouleau G, Bardin M, Morin M. Investigating the role of the pelvic floor muscles in sexual function and sexual response: a systematic review and meta-analysis. J Sex Med 2024; 21:217-239. [PMID: 38303662 DOI: 10.1093/jsxmed/qdad175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 11/19/2023] [Accepted: 12/09/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION The pelvic floor muscles (PFMs) have been suggested to play a key role in sexual function and response in women. However, syntheses of the evidence thus far have been limited to interventional studies in women with pelvic pain or pelvic floor disorders, and these studies have failed to fully capture the involvement of the PFMs in a broader population. AIM We sought to appraise the evidence regarding the role of the PFMs in sexual function/response in women without pelvic pain or pelvic floor disorders. More specifically, we examined the following: (1) effects of treatment modalities targeting the PFMs on sexual function/response, (2) associations between PFM function and sexual function/response, and (3) differences in PFM function between women with and those without sexual dysfunction. METHODS We searched for all available studies in eight electronic databases. We included interventional studies evaluating the effects of PFM modalities on sexual outcomes, as well as observational studies investigating the association between PFM function and sexual outcomes or the differences in PFM function in women with and those without sexual dysfunction. The quality of each study was assessed using the Mixed Methods Appraisal Tool. Estimates were pooled using random-effects meta-analyses whenever possible, or a narrative synthesis of the results was provided. MAIN OUTCOMES The main outcomes were sexual function (based on a questionnaire)/sexual response (based on physiological test), and PFM function (assessment of the PFM parameters such as strength and tone based on various methods). RESULTS A total of 33 studies were selected, including 14 interventional and 19 observational studies, most of which (31/33) were deemed of moderate or high quality. Ten out of 14 interventional studies in women with and without sexual dysfunctions showed that PFM modalities had a significant effect on sexual function. Regarding the observational studies, a meta-analysis revealed a significant moderate association between PFM strength and sexual function (r = 0.41; 95% CI, 0.08-066). Of the 7 observational studies performed to assess sexual response, all showed that the PFMs were involved in arousal or orgasm. Conflicting results were found in the 3 studies that evaluated differences in PFM function in women with and those without sexual dysfunction. CLINICAL IMPLICATIONS Our results highlight the contribution of the PFMs in sexual function/response. STRENGTHS AND LIMITATIONS One strength of this review is the inclusion of a broad range of study designs and outcomes, allowing a thorough synthesis of evidence. However, interpretations of these data should consider risk of bias in the studies, small sample sizes, and the absence of control/comparison groups. CONCLUSION The findings of this review support the involvement of the PFMs in sexual function/response in women without pelvic pain or pelvic dysfunction. Well-designed studies should be performed to further investigate PFM modalities as part of the management of sexual dysfunction.
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Affiliation(s)
- Stéphanie Faucher
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Québec, Canada, J1H 5N4
| | - Gabrielle Déry-Rouleau
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Québec, Canada, J1H 5N4
| | - Marcela Bardin
- Department of Gynecology and Obstetrics, Campinas University (UNICAMP), Faculty of Medicine and Health Sciences São Paulo, 13083-887, Brazil
| | - Mélanie Morin
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, University of Sherbrooke, Sherbrooke, Québec, Canada, J1H 5N4
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Huang L, Zhang ZY, Liu H, Gao M, Wang XQ, Duan XQ, Liu ZL. Most of the pelvic floor muscle functions in women differ in different body positions, yet others remain similar: systematic review with meta-analysis. Front Med (Lausanne) 2023; 10:1252779. [PMID: 38020153 PMCID: PMC10662015 DOI: 10.3389/fmed.2023.1252779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This systematic literature review and meta-analysis aimed to determine the effect of body position on the measurement of pelvic floor muscle (PFM) contractility and to analyze the influential factors. Data sources Five databases (PubMed, Web of Science, EMBASE, Cochrane Library and Scopus) were searched for relevant studies published up to 12nd October 2023. Study selection or eligibility criteria Included cross-sectional studies had to involve the assessment of pelvic floor muscle function in at least two positions. Study appraisal and synthesis methods We calculated standardized mean difference (SMD) with 95% confidence intervals (CI) to ascertain the potential effect of body position on outcomes. Results In total, we included 11 cross-sectional studies to ascertain the potential effect of body position on outcomes. There was no statistical difference in the results of maximum voluntary contraction (MVC) of the pelvic floor muscles when assessed in between supine and standing positions (SMD -0.22; 95% CI -0.72 to 0.28; p = 0.38). The results of the meta-analysis showed significantly larger values of resting voluntary contractions (RVC) measured in the standing position compared to the supine position (SMD -1.76; 95% CI -2.55 to -0.97; p < 0.001). Moreover, pelvic floor muscle movement during pelvic floor muscle contraction in the standing position was significantly better than that measured in the supine position (SMD -0.47; 95% CI -0.73 to 0.20; P < 0.001). Conclusion The results of this study showed that the RVC and PFM movement varied with the position of the assessment. In contrast, MVC values are independent of the assessment position and can be selected according to clinical needs. Systematic review registration PROSPERO, identifier CRD42022363734, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022363734.
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Affiliation(s)
- Lu Huang
- School of Nursing, Jilin University, Changchun, China
| | | | - Hong Liu
- Department of Rehabilitation, The Second Hospital of Jilin University, Changchun, China
| | - Min Gao
- School of Nursing, Jilin University, Changchun, China
| | - Xiao-Qi Wang
- Department of Rehabilitation, The Second Hospital of Jilin University, Changchun, China
| | - Xiao-Qin Duan
- Department of Rehabilitation, The Second Hospital of Jilin University, Changchun, China
| | - Zhong-Liang Liu
- Department of Rehabilitation, The Second Hospital of Jilin University, Changchun, China
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Barbosa-Silva J, Sato TDO, Homsi Jorge C, Armijo-Olivo S, Driusso P. What are the cut-off points for vaginal manometry to differentiate women with a weak from those with a strong pelvic floor muscle contraction?: Vaginal manometry to classify a pelvic floor muscle contraction. Braz J Phys Ther 2023; 27:100572. [PMID: 38043160 PMCID: PMC10703600 DOI: 10.1016/j.bjpt.2023.100572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Vaginal manometry is regarded as an objective method to assess pelvic floor muscles (PFM) function and can measure several variables during contraction. OBJECTIVE To determine which variables could differentiate women with/without a weak/strong PFM contraction and determine their cut-off points. METHODS This is a diagnostic accuracy study performed on 156 women with a mean age of 40.4 (SD, 15.9) years. The reference test was vaginal palpation and the index test was vaginal manometry (Peritron™ manometer). Variables were pressure at rest, pressure achieved with maximal voluntary contraction (MVC), MVC average, duration, gradient, and area under the curve (AUCm). The Receiver Operating Curve (AUC/ROC) and logistic regression were used to analyze the data and obtain cut-off points. RESULTS Excellent ability to discriminate women with a weak/strong PFM contraction was found for MVC average (cut-off: 28.93 cmH2O), MVC (cut-off: 38.61 cmH2O), and the AUCm (cut-off: 1011.93 cm²*s). The gradient variable had good discrimination ability (AUC/ROC=0.81; cut-off: 28.68 cmH2O/s). The MVC average assessed by manometry, menopausal status, and the presence of stress urinary incontinence (SUI) were associated with a weak/strong PFM contraction in the multivariate analysis; however, the most parsimonious model to discriminate weak/strong PFM contraction included only the MVC average (AUC/ROC = 0.95; sensitivity: 0.87; specificity: 0.91). CONCLUSION These results suggest which manometry variables are appropriate to assess and classify PFM function in females. These could be used to help physical therapists to make clinic decisions about the management of female PFM.
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Affiliation(s)
- Jordana Barbosa-Silva
- Women's Health Research Laboratory, Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil; Faculty of Business and Social Sciences, University of Applied Sciences - Hochschule Osnabrück, Osnabrück, Germany.
| | - Tatiana de Oliveira Sato
- Preventive Physical Therapy and Ergonomics Laboratory, Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Cristine Homsi Jorge
- Pelvic Floor Muscle Function Laboratory, Health Science Departament, Ribeirão Preto Medical School, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Susan Armijo-Olivo
- Faculty of Business and Social Sciences, University of Applied Sciences - Hochschule Osnabrück, Osnabrück, Germany
| | - Patricia Driusso
- Women's Health Research Laboratory, Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.
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Rai A, Sharma N, Jain SK, Lalwani A, Sharma S. Accuracy and Reliability of Different Approaches for the Assessment of Pelvic Floor Muscle Strength: A Systematic Review. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S856-S861. [PMID: 37694079 PMCID: PMC10485409 DOI: 10.4103/jpbs.jpbs_241_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 09/12/2023] Open
Abstract
There had been various methods employed for the evaluation of pelvic floor muscle (PFM) strength. The aim of the study was to do a systemic review of these methods for a better understanding of these techniques and to find the best appropriate method. A systemic review of the literature was done using three databases that included: PubMed, Scopus and Web of Science using the keywords "pelvic floor anatomy" and "functional anatomy of pelvic floor muscles" from 1985 to 2022. All the studies involved were analyzed for the methodologies used by the researcher, advantages, disadvantages, and the conclusion of the study. A total of 1,876 studies were found, out of which only 64 met the criteria of inclusion. In these studies, seven methods were used for the determination of PFM strength. These methods included: clinical palpation, perineometer, electromyography, dynamometer, ultrasonography, magnetic resonance imaging, and vaginal cones. The PFM cannot be calculated accurately using any one measuring technique. There is therefore no "gold standard" approach to PFM assessment. However, combining these methods will result in the best outcomes. According to the literature review, the most often employed procedures were digital palpation, perineometry, and Ultrasonography (USG).
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Affiliation(s)
- Alisha Rai
- Departments of Anatomy, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Nidhi Sharma
- Departments of Anatomy, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Sanjeev Kumar Jain
- Departments of Anatomy, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Astha Lalwani
- Department of Obs and Gynae, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Sonika Sharma
- Departments of Anatomy, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India
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Fang J, Ye J, Huang Q, Lin Y, Weng Y, Wang M, Chen Y, Lu Y, Zhang R. Risk factors of pelvic floor muscle strength in south Chinese women: a retrospective study. BMC Pregnancy Childbirth 2022; 22:624. [PMID: 35933360 PMCID: PMC9356495 DOI: 10.1186/s12884-022-04952-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/26/2022] [Indexed: 12/31/2022] Open
Abstract
Objectives To evaluate pelvic floor muscle strength using surface electromyography and risk factors for pelvic floor muscle strength in the early postpartum period. Methods This retrospective study included 21,302 participants who visited Fujian
Maternity and Child Health Hospital from September 2019 to February 2022. All participants
were assessed by
medical professionals for general information and surface electromyography. Results Univariate analysis indicated that age was inversely related to tonic and endurance contractions. In contrast, all the other variables, including education level, body mass index, neonatal weight, and number of fetuses, had a positive impact on rapid, tonic, and endurance contractions. Likewise, parity was also positively associated with rapid contractions. In addition, compared with vaginal delivery, cesarean section delivery had a protective effect on the amplitude of the three types of contractions. Stepwise regression analysis showed that both age and neonatal weight had a negative linear relationship with the amplitude of rapid, tonic and endurance contractions. In contrast, the amplitude of rapid, tonic and endurance contractions significantly increased as body mass index, parity (≤ 3), education level and gestational weight gain (endurance contractions only) increased. Participants with cesarean section delivery showed positive effects on rapid, tonic, and endurance contractions compared to participants with vaginal delivery. Conclusions We found that age, neonatal weight, vaginal delivery, episiotomy, and forceps delivery were risk factors for pelvic floor muscle strength; in contrast, body mass index, parity (≤ 3) and gestational weight gain had a positive relationship with pelvic floor muscle strength.
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Affiliation(s)
- Jianqi Fang
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Jiajia Ye
- Department of Rehabilitation Assessment, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fujian, 350000, Fuzhou, People's Republic of China
| | - Qing Huang
- College of Environment and Public Health, Xiamen Huaxia University, Xiamen Fujian, People's Republic of China
| | - Yang Lin
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Yilin Weng
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Miao Wang
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Yi Chen
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Yao Lu
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Ronghua Zhang
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China. .,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China.
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Mastwyk S, McClelland J, Cooper MM, Frawley HC. Pelvic floor muscle function in the standing position in women with pelvic floor dysfunction. Int Urogynecol J 2021; 33:2435-2444. [PMID: 34825921 DOI: 10.1007/s00192-021-05003-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Clinical assessment of the pelvic floor muscles (PFMs) in a standing position may provide a more valid representation of PFM function experienced by patients in daily life than assessment in the lying position. The primary aim of this study was to examine PFM function in a standing versus a lying position in parous women with any type of urinary incontinence and/or pelvic organ prolapse. METHODS In this exploratory cross-sectional study, participant symptom status was determined using the Australian Pelvic Floor Questionnaire. Pelvic floor muscle function was assessed in standing and lying positions with a randomised order of testing. The primary outcome measure was vaginal squeeze pressure (VSP) using intra-vaginal manometry. Secondary outcomes included vaginal resting pressure, total PFM work and digital muscle testing. The difference between PFM function in a standing position compared with a lying position was analysed using paired t test or Wilcoxon's signed rank test. RESULTS Vaginal squeeze pressure assessed with manometry was higher in a standing than in a lying position (p = 0.001): standing (mean [SD]) 24.90 [12.67], lying 21.15 [14.65]. In contrast, PFM strength on digital muscle testing was lower in a standing position than in a lying position. CONCLUSIONS This study has demonstrated that PFM function in a standing position is different from that in a lying position in women with pelvic floor dysfunction. Whether the higher VSP observed in a standing position reflects a true difference in strength between positions, or a higher pressure reading due to incorrect PFM contraction technique in a standing position is uncertain. Further research with larger cohorts and a measurement tool that can accurately distinguish a rise in intra-vaginal pressure from PFM contraction rather than increasing intra-abdominal pressure is required to confirm this difference, and the clinical significance of any difference.
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Affiliation(s)
- Sally Mastwyk
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Jodie McClelland
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | | | - Helena C Frawley
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia.,Allied Health Research, The Royal Women's Hospital, Melbourne, Australia.,Allied Health Research, Mercy Hospital for Women, Melbourne, Australia
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Saltiel F, Miranda-Gazzola APG, Vitória RO, Sampaio RF, Figueiredo EM. Linking Pelvic Floor Muscle Function Terminology to the International Classification of Functioning, Disability and Health. Phys Ther 2020; 100:1659-1680. [PMID: 32201881 DOI: 10.1093/ptj/pzaa044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 02/11/2020] [Indexed: 02/09/2023]
Abstract
OBJECTIVE A previous systematic review on pelvic floor muscle function (PFMF) identified a miscellaneity of terms. The lack of consensual terminology might have come from the complexity of neuromusculoskeletal function itself. This study sought to link the previously identified PFMF terms to the International Classification of Functioning, Disability and Health (ICF) terminology. METHODS In this secondary analysis study, 10 linkage rules were applied to link 196 previously identified PFMF terms to the ICF. Two researchers performed the linking process independently. Disagreements were solved by open dialogue with a third researcher. Percentage agreement was computed for main outcome. RESULTS A total of 184 (93.9%) PFMF terms were subsumed into the following 6 ICF terms: tone, involuntary movement reaction, control, coordination, strength, and endurance. The most frequently investigated PFMF was strength (25.5%), followed by involuntary movement reaction (22.9%), endurance (17.2%), control (14.1%), coordination (9.9%), and tone (4.2%). Only 6.2% PFMF could not be linked to ICF terminology. A wide variation of instruments/methods was used to measure PFMF. Vaginal palpation was the only method employed to measure all 6 PFMF. Percentage agreement between raters was 100%. CONCLUSIONS Linking PFMF terminology to the ICF was feasible and valid. It allowed the identification of the most investigated PFMF and their measuring methods. ICF terminology to describe PFMF should be used since it may improve communication, data gathering, and the advance in scientific knowledge. IMPACT Standardized terminology anchored in a theoretical framework is crucial to data gathering, communication, and dissemination of evidence-based practice. PFMF terminology based on ICF can be used to improve data pooling and communication.
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Barakat R. An exercise program throughout pregnancy: Barakat model. Birth Defects Res 2020; 113:218-226. [PMID: 32613735 DOI: 10.1002/bdr2.1747] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 06/05/2020] [Indexed: 01/19/2023]
Abstract
The physiologic processes of pregnancy and childbirth can determine the future well-being of mothers and children due to the great quantity and quality of modifications that these processes require in all areas of the female body and fetus. Recent evidence has confirmed that modern unhealthy lifestyles negatively affect pregnancy outcomes. Engaging in unhealthy habits during pregnancy increases the risk of chronic disease in both the mother and the fetus. Regarding physical exercise during pregnancy, throughout history, many professionals and scientists have reported the best gestational conditions for the mother, fetus, and newborn. The perspectives and advice have changed over time, including periods of strong conservatism. This history has affected the recommendations for the type and amount of exercise that a healthy woman should perform during pregnancy. The aim of this article is to determine the basic aspects that physical exercise programs during pregnancy should define in the near future. Additionally, from the results of this article, we propose an exercise program model that includes many exercises spanning throughout pregnancy (3 blocks = until 20 weeks, until 30 weeks and until the end of the pregnancy). An exercise session model divided into seven parts and recommendations of operative position to exercise during pregnancy are also provided.
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Affiliation(s)
- Ruben Barakat
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
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10
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Saltiel F, Miranda-Gazzola APG, Vitória RO, Figueiredo EM. Terminology of Pelvic Floor Muscle Function in Women With and Without Urinary Incontinence: A Systematic Review. Phys Ther 2018; 98:876-890. [PMID: 30010919 DOI: 10.1093/ptj/pzy084] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 04/08/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND Pelvic floor muscle function (PFMF) is a target of the physical therapist intervention for women with urinary incontinence (UI). However, possible variations in PFMF terminology might hamper communication among researchers and health care professionals in Women's Health. OBJECTIVE The objective of this study was to investigate the terminology of PFMF regarding clear terms, conceptual definitions, and operational definitions. DATA SOURCES Data sources include PUBMED, CINAHL, LILACS, and SCIELO. STUDY SELECTION Observational studies investigating any PFMF in women with or without UI, published in English, Spanish, or Portuguese from 2005 through 2017, were considered. DATA EXTRACTION The risk of bias was assessed by a questionnaire on the quality of observational studies. Data on terminology were extracted as terms, conceptual definitions, and operational definitions of PFMF and were synthesized according to key words, key ideas, and key operationalization, respectively. Consistencies and variations were identified for the most frequently investigated PFMF. DATA SYNTHESIS Sixty-four studies were included, and a low risk of bias was identified. All studies presented terms and operational definitions of PFMF, but only 29.7% presented conceptual definitions of those terms. One hundred ninety-six different terms referred to PFMF. According to similarities in terminology, 161 PFMF terms could be grouped under 26 terms; the other 35 were left ungrouped. Therefore, a total of 61 different PFMF terms were identified in the literature. LIMITATIONS A limitation in the study was that only observational studies were included. CONCLUSIONS A large variation in PFMF terminology was identified, precluding data gathering and meta-analysis. The lack of use of standardized terminology delays the progress of scientific knowledge and evidence-based practice dissemination. Efforts toward creating a collaborative, consensual terminology based on a sound framework are necessary.
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Affiliation(s)
- Fernanda Saltiel
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Women's Health Specialist, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Elyonara M Figueiredo
- Physical Therapy Department, Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Av. Antonio Carolos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901 Brazil
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Laurienzo CE, Magnabosco WJ, Jabur F, Faria EF, Gameiro MO, Sarri AJ, Kawano PR, Yamamoto HA, Reis LO, Amaro JL. Pelvic floor muscle training and electrical stimulation as rehabilitation after radical prostatectomy: a randomized controlled trial. J Phys Ther Sci 2018; 30:825-831. [PMID: 29950773 PMCID: PMC6016310 DOI: 10.1589/jpts.30.825] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 03/15/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the effect of electrical stimulation and pelvic floor muscle
training on muscle strength, urinary incontinence and erectile function in men with
prostate cancer treated by radical prostatectomy. [Subjects and Methods] One hundred
twenty-three males were randomized into 3 groups 1 month after RP: (G1, n=40) control;
(G2, n=41) guideline: patients were instructed to perform three types of home exercises to
strengthen the pelvic floor and (G3, n=42) electrical stimulation: patients in this group
were also instructed to perform exercises as group G2, and also received anal
electro-stimulation therapy, twice a week for 7 weeks. The primary outcome assessment was
based on the measurement of the recovery of pelvic floor muscle strength between groups.
Secondary outcomes were: 1 hour Pad Test, ICIQ-SF, IIEF-5 and IPSS. Data were obtained
preoperatively and at 1, 3 and 6 months after surgery. [Results] There was no significant
difference in the demographic data among groups. Greater urinary leakage and pelvic floor
muscle weakness in the first month compared to pre treatment improved after 3 and 6 months
postoperative, without difference among groups. [Conclusion] The muscle strength recovery
occurs independently of the therapy employed. Pelvic floor exercises or electrical
stimulation also did not have an impact on the recovery of urinary continence and erectile
function in our study.
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Affiliation(s)
- Carla Elaine Laurienzo
- Department of Physiotherapy, Barretos Cancer Hospital: Rua Antenor Duarte Villela, 1331 SP, 14784-400, Brazil
| | | | - Fernanda Jabur
- Department of Physiotherapy, Barretos Cancer Hospital: Rua Antenor Duarte Villela, 1331 SP, 14784-400, Brazil
| | | | | | - Almir Jose Sarri
- Department of Physiotherapy, Barretos Cancer Hospital: Rua Antenor Duarte Villela, 1331 SP, 14784-400, Brazil
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Halski T, Ptaszkowski K, Słupska L, Dymarek R, Paprocka-Borowicz M. Relationship between lower limb position and pelvic floor muscle surface electromyography activity in menopausal women: a prospective observational study. Clin Interv Aging 2017; 12:75-83. [PMID: 28115836 PMCID: PMC5221554 DOI: 10.2147/cia.s121467] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives In physiotherapeutic practice, special attention is being given to the reciprocal anatomical, physiological, and biomechanical relationship of the pelvis and the structures connected to it. However, the scientific literature shows mainly the theoretical information about their mutual connections. The lack of information about these relations from a practical aspect coupled with the paucity of scientific papers on the impact of posture changes on the pelvic floor led the authors to conduct this study. The primary aim of this study was to compare the resting and functional bioelectrical activities of pelvic floor muscles (PFMs) depending on three different positions of the lower limbs (positions A, B, and C) in the supine position. Materials and methods This was a prospective observational study evaluating resting and functional activities of the PFM depending on the position of the lower limbs. The study was carried out at the Department and Clinic of Urology, University Hospital in Wroclaw, Poland and the target group were women in the menopausal period. Bioelectrical activity of PFM was recorded using a surface electromyographic instrument in the supine position. Results of the values obtained in A, B, and C positions were compared using a one-way analysis of variance. Results In position A, the average resting surface electromyography (sEMG) activity of PFM was 6.9±2.6 µV; in position B, the result was 6.9±2.5 µV and in position C, the resting sEMG activity was 5.7±1.8 µV (P=0.0102). The results of the functional bioelectrical activity of PFM were as follows: position A – 20.3±11.8 µV, position B – 19.9±10.6 µV, and position C – 25.3±10.9 µV (P=0.0104). Conclusion The results showed that in the supine position, the PFM achieved the lowest resting activity and the highest functional activity. Therefore, the supine position can be recommended for the diagnosis and therapy of weakened PFM.
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Affiliation(s)
- Tomasz Halski
- Department of Physiotherapy, Opole Medical School, Opole
| | - Kuba Ptaszkowski
- Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders
| | - Lucyna Słupska
- Department of Physiotherapy, Opole Medical School, Opole
| | - Robert Dymarek
- Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
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Ribeiro JDS, Guirro ECDO, Franco MDM, Duarte TB, Pomini JM, Ferreira CHJ. Inter-rater reliability study of the Peritron™ perineometer in pregnant women. Physiother Theory Pract 2016; 32:209-17. [DOI: 10.3109/09593985.2015.1129654] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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