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Mortier P, Vilagut G, García-Mieres H, Alayo I, Ferrer M, Amigo F, Aragonès E, Aragón-Peña A, Asúnsolo Del Barco Á, Campos M, Espuga M, González-Pinto A, Haro JM, López Fresneña N, Martínez de Salázar AD, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Gómez B, Pérez-Zapata A, Pijoan JI, Plana N, Polentinos-Castro E, Portillo-Van Diest A, Puig T, Rius C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J. Health service and psychotropic medication use for mental health conditions among healthcare workers active during the Spain Covid-19 Pandemic - A prospective cohort study using web-based surveys. Psychiatry Res 2024; 334:115800. [PMID: 38387166 DOI: 10.1016/j.psychres.2024.115800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/30/2024] [Accepted: 02/11/2024] [Indexed: 02/24/2024]
Abstract
Little is known about healthcare workers' (HCW) use of healthcare services for mental disorders. This study presents data from a 16-month prospective cohort study of Spanish HCW (n = 4,809), recruited shortly after the COVID-19 pandemic onset, and assessed at four timepoints using web-based surveys. Use of health services among HCW with mental health conditions (i.e., those having a positive screen for mental disorders and/or suicidal thoughts and behaviours [STB]) was initially low (i.e., 18.2 %) but increased to 29.6 % at 16-month follow-up. Service use was positively associated with pre-pandemic mental health treatment (OR=1.99), a positive screen for major depressive disorder (OR=1.50), panic attacks (OR=1.74), suicidal thoughts and behaviours (OR=1.22), and experiencing severe role impairment (OR=1.33), and negatively associated with being female (OR = 0.69) and a higher daily number of work hours (OR=0.95). Around 30 % of HCW with mental health conditions used anxiolytics (benzodiazepines), especially medical doctors. Four out of ten HCW (39.0 %) with mental health conditions indicated a need for (additional) help, with most important barriers for service use being too ashamed, long waiting lists, and professional treatment not being available. Our findings delineate a clear mental health treatment gap among Spanish HCW.
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Affiliation(s)
- Philippe Mortier
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
| | - Gemma Vilagut
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Helena García-Mieres
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Itxaso Alayo
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Biosistemak Institute for Health Systems Research, Barakaldo, Bizkaia, Spain
| | - Montse Ferrer
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Franco Amigo
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Enric Aragonès
- Institut d'Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain; Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain; Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain; Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain; Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, United States
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Meritxell Espuga
- Occupational Health Service. Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ana González-Pinto
- BIOARABA, Hospital Universitario Araba-Santiago, UPV/EHU, Vitoria-Gasteiz, Spain; CIBER Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep M Haro
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | | | | | - Juan D Molina
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain; Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M Ortí-Lucas
- Service of Preventive Medicine and Quality of Attention, University Clinical Hospital of Valencia, Valencia, Spain
| | - Mara Parellada
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José Maria Pelayo-Terán
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Servicio de Psiquiatría y Salud Mental. Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI). Gerencia Regional de Salud de Castilla y Leon (SACYL). Ponferrada, León, Spain; Area de Medicina Preventiva y Salud Pública. Universidad de León, León, Spain
| | - Beatriz Pérez-Gómez
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; National Center of Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | | | - José Ignasio Pijoan
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Clinical Epidemiology Unit-Hospital Universitario Cruces/ OSI EEC, Bilbao, Spain/ Biocruces-Bizkaia Health Research Institute, Spain
| | - Nieves Plana
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - Elena Polentinos-Castro
- Research Unit Primary Care Management, Madrid Health Service, Madrid, Spain; Department of Medical Specialities and Public Health. King Juan Carlos University, Madrid, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud RICAPPS-(RICORS). Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Ana Portillo-Van Diest
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Teresa Puig
- Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Cristina Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Ferran Sanz
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain; Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute, MELIS, Universitat Pompeu Fabra, Barcelona, Spain; Instituto Nacional de Bioinformatica - ELIXIR-ES, Barcelona, Spain
| | - Consol Serra
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain; CiSAL-Centro de Investigación en Salud Laboral, Hospital del Mar Research Institute/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain; Biodonostia Health Research Institute, Clinical Epidemiology, San Sebastián, Spain
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Víctor Pérez-Solá
- CIBER Salud Mental (CIBERSAM), Madrid, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Jordi Alonso
- Hospital del Mar Research Institute, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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Portillo-Van Diest A, Vilagut G, Alayo I, Ferrer M, Amigo F, Amann BL, Aragón-Peña A, Aragonès E, Asúnsolo Del Barco Á, Campos M, Del Cura-González I, Espuga M, González-Pinto A, Haro JM, Larrauri A, López-Fresneña N, Martínez de Salázar A, Molina JD, Ortí-Lucas RM, Parellada M, Pelayo-Terán JM, Pérez-Zapata A, Pijoan JI, Plana N, Puig T, Rius C, Rodríguez-Blázquez C, Sanz F, Serra C, Urreta-Barallobre I, Kessler RC, Bruffaerts R, Vieta E, Pérez-Solá V, Alonso J, Mortier P. Traumatic stress symptoms among Spanish healthcare workers during the COVID-19 pandemic: a prospective study. Epidemiol Psychiatr Sci 2023; 32:e50. [PMID: 37555258 PMCID: PMC10465320 DOI: 10.1017/s2045796023000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/06/2023] [Accepted: 06/24/2023] [Indexed: 08/10/2023] Open
Abstract
AIM To investigate the occurrence of traumatic stress symptoms (TSS) among healthcare workers active during the COVID-19 pandemic and to obtain insight as to which pandemic-related stressful experiences are associated with onset and persistence of traumatic stress. METHODS This is a multicenter prospective cohort study. Spanish healthcare workers (N = 4,809) participated at an initial assessment (i.e., just after the first wave of the Spain COVID-19 pandemic) and at a 4-month follow-up assessment using web-based surveys. Logistic regression investigated associations of 19 pandemic-related stressful experiences across four domains (infection-related, work-related, health-related and financial) with TSS prevalence, incidence and persistence, including simulations of population attributable risk proportions (PARP). RESULTS Thirty-day TSS prevalence at T1 was 22.1%. Four-month incidence and persistence were 11.6% and 54.2%, respectively. Auxiliary nurses had highest rates of TSS prevalence (35.1%) and incidence (16.1%). All 19 pandemic-related stressful experiences under study were associated with TSS prevalence or incidence, especially experiences from the domains of health-related (PARP range 88.4-95.6%) and work-related stressful experiences (PARP range 76.8-86.5%). Nine stressful experiences were also associated with TSS persistence, of which having patient(s) in care who died from COVID-19 had the strongest association. This association remained significant after adjusting for co-occurring depression and anxiety. CONCLUSIONS TSSs among Spanish healthcare workers active during the COVID-19 pandemic are common and associated with various pandemic-related stressful experiences. Future research should investigate if these stressful experiences represent truly traumatic experiences and carry risk for the development of post-traumatic stress disorder.
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Affiliation(s)
- Ana Portillo-Van Diest
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Itxaso Alayo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Asociación instituto de investigación en sistemas de salud Biosistemak, Barakaldo, País Vasco, España
| | - Montse Ferrer
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Franco Amigo
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Benedikt L. Amann
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Centre Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
- Department of Health Services Research Group, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department for Psychiatry and Psychotherapy, Hospital of the Ludwig-Maximilians-University Munich, Germany
| | - Andrés Aragón-Peña
- Epidemiology Unit, Regional Ministry of Health, Community of Madrid, Madrid, Spain
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
| | - Enric Aragonès
- Department of Atenció Primària Camp de Tarragona, Institut d’Investigació en Atenció Primària IDIAP Jordi Gol, Barcelona, Spain
- Atenció Primària Camp de Tarragona, Institut Català de la Salut, Spain
| | - Ángel Asúnsolo Del Barco
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcala, Alcalá de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), Madrid, Spain
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA
| | - Mireia Campos
- Service of Prevention of Labor Risks, Medical Emergencies System, Generalitat de Catalunya, Spain
| | - Isabel Del Cura-González
- Fundación Investigación e Innovación Biosanitaria de AP, Comunidad de Madrid, Madrid, Spain
- Research Unit, Primary Care Management, Madrid Health Service, Madrid, Spain
- Department of Medical Specialities and Public Health, King Juan Carlos University, Madrid, Spain
| | - Meritxell Espuga
- Occupational Health Service, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Ana González-Pinto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- BIOARABA, UPV-EHU, Hospital Universitario Araba-Santiago, Vitoria-Gasteiz, Spain
| | - Josep M. Haro
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- Department Facultat de Medicina y Ciencias de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Amparo Larrauri
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Nieves López-Fresneña
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Juan D. Molina
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Villaverde Mental Health Center, Clinical Management Area of Psychiatry and Mental Health, Psychiatric Service, Hospital Universitario 12 de Octubre, Madrid, Spain
- Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Rafael M. Ortí-Lucas
- Department of Preventive MedicineDepartment, Hospital Clínic Universitari, Valencia, Spain
| | - Mara Parellada
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Medicina Preventiva, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José M. Pelayo-Terán
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Psiquiatría y Salud Mental, Hospital el Bierzo, Gerencia de Asistencia Sanitaria del Bierzo (GASBI), Gerencia Regional de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain
- Area de Medicina Preventiva y Salud Pública, Universidad de León, León, Spain
| | - Aurora Pérez-Zapata
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - José I. Pijoan
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Clinical Epidemiology Unit, Hospital Universitario Cruces/OSI EEC, Bilbao, Spain
| | - Nieves Plana
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department Servicio de Prevención de Riesgos Laborales, Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Teresa Puig
- Department of Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Rius
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Carmen Rodríguez-Blázquez
- National Center of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Madrid, Spain
| | - Ferran Sanz
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Research Progamme on Biomedical Informatics (GRIB), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Instituto Nacional de Bioinformatica – ELIXIR-ES (IMPaCT-Data-ISCIII), Barcelona, Spain
| | - Consol Serra
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
- CiSAL-Centro de Investigación en Salud Laboral, IMIM/UPF, Barcelona, Spain
| | - Iratxe Urreta-Barallobre
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, Donostia University Hospital, Clinical Epidemiology Unit, San Sebastián, Spain
- Clinical Epidemiology, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium
| | - Eduard Vieta
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Víctor Pérez-Solá
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine and Public HealthDepartment, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal, Parc de Salut Mar PSMAR, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Unit, IMIM-Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Navarro Brazález B, Torres Lacomba M, de la Villa P, Sánchez Sánchez B, Prieto Gómez V, Asúnsolo Del Barco Á, McLean L. The evaluation of pelvic floor muscle strength in women with pelvic floor dysfunction: A reliability and correlation study. Neurourol Urodyn 2017; 37:269-277. [PMID: 28455942 DOI: 10.1002/nau.23287] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/12/2017] [Indexed: 11/10/2022]
Abstract
AIMS The purposes of this study were: (i) to evaluate the reliability of vaginal palpation, vaginal manometry, vaginal dynamometry; and surface (transperineal) electromyography (sEMG), when evaluating pelvic floor muscle (PFM) strength and/or activation; and (ii) to determine the associations among PFM strength measured using these assessments. METHODS One hundred and fifty women with pelvic floor disorders participated on one occasion, and 20 women returned for the same investigations by two different raters on 3 different days. At each session, PFM strength was assessed using palpation (both the modified Oxford Grading Scale and the Levator ani testing), manometry, and dynamometry; and PFM activation was assessed using sEMG. RESULTS The interrater reliability of manometry, dynamometry, and sEMG (both root-mean-square [RMS] and integral average) was high (Lin's Concordance Correlation Coefficient [CCC] = 0.95, 0.93, 0.91, 0.86, respectively), whereas the interrater reliability of both palpation grading scales was low (Cohen's Kappa [k] = 0.27-0.38). The intrarater reliability of manometry (CCC = 0.96), and dynamometry (CCC = 0.96) were high, whereas intrarater reliability of both palpation scales (k = 0.78 for both), and of sEMG (CCC = 0.79 vs 0.80 for RMS vs integral average) was moderate. The Bland-Altman plot showed good inter and intrarater agreement, with little random variability for all instruments. The correlations among palpation, manometry, and dynamometry were moderate (coefficient of determination [r2 ] ranged from 0.52 to 0.75), however, transperineal sEMG amplitude was only weakly correlated with all measures of strength (r2 = 0.23-0.30). CONCLUSIONS Manometry and dynamometry are more reliable tools than vaginal palpation for the assessment of PFM strength in women with pelvic floor disorders, especially when different raters are involved. The different PFM strength measures used clinically are moderately correlated; whereas, PFM activation recorded using transperineal sEMG is only weakly correlated with PFM strength. Results from perineal sEMG should not be interpreted in the context of reporting PFM strength.
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Affiliation(s)
- Beatriz Navarro Brazález
- Physical Therapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, Physical Therapy Department, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - María Torres Lacomba
- Physical Therapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, Physical Therapy Department, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Pedro de la Villa
- Physical Therapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, Physical Therapy Department, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Beatriz Sánchez Sánchez
- Physical Therapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, Physical Therapy Department, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Virginia Prieto Gómez
- Physical Therapy in Women's Health Research Group, Faculty of Medicine and Health Sciences, Physical Therapy Department, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Ángel Asúnsolo Del Barco
- Preventive Medicine and Health Science Unit, Faculty of Medicine and Health Sciences, Department of Surgery, Medical and Social Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Linda McLean
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
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