Comparisons of Electromyography and Digital Palpation Measurement of Pelvic Floor Muscle Strength in Postpartum Women with Stress Urinary Incontinence and Asymptomatic Parturients: A Cross-Sectional Study

Abstract

<b><i>Aims:</i></b> Early evaluation of pelvic floor muscle (PFM) in postpartum women is important for the treatment of stress urinary incontinence (SUI). Digital vaginal palpation and electromyography (EMG) evaluation based on Glazer protocol are widely used for the assessment of PFM. However, the correlation among digital palpation, EMG, and morbidity of postpartum SUI is still unclear. This study aims to investigate the relationship between postpartum SUI and PFM examinations. <b><i>Methods:</i></b> This hospital-based cross-sectional study included 1,380 parturients during September 2016 to January 2018. We collected the clinical characteristics, PFM strength, and EMG variables of parturients 6–8 weeks after birth. Then the correlation among the results of EMG, digital palpation, and the occurrence of SUI was analyzed. <b><i>Results:</i></b> There is no significant difference in digital palpation scores of PFM strength between SUI and non-SUI parturients. The EMG values were closely related to SUI: the multivariate logistic regression revealed that the most reliable evaluation indicators of postpartum SUI were pelvic floor contractile amplitude of endurance contraction (B = 0.021, <i>p</i> = 0.019) and pretest resting baseline (B = 0.056, <i>p</i> = 0.019). Correlation analysis demonstrated that the contraction variables of EMG had a significant correlation with the digital palpation PFM strength in postpartum women (<i>r</i> = 0.467–0.545, <i>p</i> < 0.001). <b><i>Conclusion:</i></b> The EMG proved to be reliable in assessing the PFM function in postpartum women. The decreased PFM activity, according to EMG, was correlated with postpartum SUI. Although digital palpation scores were positively correlated with EMG results, no correlation was observed with SUI incidence.

Physiotherapy for Prevention and Treatment of Fecal Incontinence in Women—Systematic Review of Methods

“…The examination includes voluntary (will-dependent) contraction, used during PFM training, and involuntary (will-independent) contraction, occurring during increased intra-abdominal pressure [ 30 , 31 ]. The physiotherapist may also use EMG, perineometer, and palpation to evaluate the PFM function [ 32 , 33 ]. The perineometer is used to assesses vaginal pressure, while the EMG records the electrical activity of muscle fibers [ 32 , 33 , 34 ].…”

“…The physiotherapist may also use EMG, perineometer, and palpation to evaluate the PFM function [ 32 , 33 ]. The perineometer is used to assesses vaginal pressure, while the EMG records the electrical activity of muscle fibers [ 32 , 33 , 34 ]. PFM palpation is a common, fast, and inexpensive examination which should be performed by an experienced therapist.…”

The Prognostic Value of the Surface Electromyographic Assessment of Pelvic Floor Muscles in Women with Stress Urinary Incontinence

“…It should be noted that the results in these earlier articles show higher levels of activity in the PFM than observed in the current study; however, the mean age of the participants in the earlier studies was lower than in the present study. A large number of reports emphasize the fact that PFM activity decreases with age [ 8 , 9 , 15 , 16 ]. Only one paper describes the PFM activity of women with SUI at a similar age (mean 66.1 ± 8.7 years) to those described in our study.…”

A non-randomized chlinical trial The effect of pelvic floor exercises at home and electrical stimulation plus biofeedback in hospital in management of stress urinary incontinence of primiparas in short-term postpartum period

“…Digital vaginal palpation and sEMG evaluation are two common methods to evaluate the strength of PFM. Yang X et al [8] assessed 1,380 parturients at 6-8 postpartum weeks by using both vaginal palpation and sEMG. Results showed that the contraction variables of EMG had a significant correlation between them and sEMG was also correlated with SUI.…”

“…It has been proved that supervised training protocol is more effective than oral instruction alone. Digital palpation and surface Electromyography (sEMG) recordings are often applied to teach PFM contraction and evaluate the effect of PFMT [8][9] . This study investigates the therapeutic effect of at-home PFM training combined with in-hospital electrical stimulation plus biofeedback therapy on Chinese primipara with SUI in the short-term postpartum period.…”