Reliability of pelvic floor muscle electromyography tested on healthy women and women with pelvic floor muscle dysfunction

Koenig, Irène; Luginbuehl, Helena; Radlinger, Lorenz

doi:10.1016/j.rehab.2017.04.002

Cited by 35 publications

(56 citation statements)

References 15 publications

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“…The existing literature shows that sEMG activities in the PFM differ markedly [ 2 , 5 , 8 , 9 , 12 , 13 , 14 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. It is possible that these differences relate to the tests being carried out with different equipment, with different electrodes (shape, size), or with the patient lying in different positions.…”

Section: Discussionmentioning

confidence: 99%

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

Ptaszkowski

Małkiewicz

Zdrojowy

et al. 2020

JCM

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Background: The use of surface electromyography (sEMG) measurements to evaluate the bioelectrical activity of the pelvic floor muscle (PFM) during therapeutic intervention is now well established. This study investigates the diagnostic possibilities of sEMG in women with stress urinary incontinence (SUI). The aim of this study was to carry out objective assessments of the bioelectrical activity of the PFM in women after menopause and determine the prognostic value of sEMG for assessing the PFM in patients with SUI. Methods: This was a prospective, observational study that evaluated the bioelectrical activity of the PFM in postmenopausal women with or without SUI (SUI group, n = 89 vs. non-SUI group, n = 62). The study was carried out between January 2013 and December 2018 at the Clinic of Urology (Wroclaw, Poland). The protocol for all sEMG measurements of PFM activity consisted of following elements: “baseline”, “quick flicks”, “contractions”, “static hold”, and “rest tone”; we then compared these results between groups. To determine the optimal cutoff level for sEMG activation of the PFM to detect the occurrence of SUI, we performed receiver operating characteristic (ROC) curve analysis (with Youden’s index). Results: Significantly lower results were obtained for all PFM measurements in women with SUI. The optimum diagnostic cutoff for “baseline” was 3.7 μV (area under curve (AUC), 0.63), “quick flicks” was 9.15 μV (AUC, 0.84), “contractions” was 11.33 μV (AUC, 0.80), “static hold” was 9.94 μV (AUC, 0.84), and “rest” was 3.89 μV (AUC, 0.63). Conclusions: Measuring sEMG activity in the PFM may be a useful diagnostic tool to confirm the absence of SUI. We can expect that the sEMG activity of subjects with SUI will be lower than that of healthy people. In order to determine appropriate reference values for assessing sEMG activity data in the PFM, it is now necessary to conduct multicenter studies.

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Section: Discussionmentioning

confidence: 99%

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

Ptaszkowski

Małkiewicz

Zdrojowy

et al. 2020

JCM

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“…Showing high test-retest reliability, 13,14 the sEMG measurement is a useful tool for detection of PFM activity. For recording of PFM electrical activity, we used an intravaginal electrode with a large surface to obtain EMG signals of sufficient amplitude with high sensitivity.…”

Section: Pfm Electrical Activity and Semg Measurementsmentioning

confidence: 99%

Electromyographic Evaluation of the Pelvic Muscles Activity After High-Intensity Focused Electromagnetic Procedure and Electrical Stimulation in Women With Pelvic Floor Dysfunction

Elena¹,

Zarkovic

Ramina³

et al. 2020

Sexual Medicine

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Introduction: Impaired coordination, relaxation, and atrophy of pelvic floor muscles (PFMs) may cause various health issues referred to as pelvic floor dysfunction (PFD). In recent years, electromagnetic noninvasive stimulation of the pelvic floor was successfully used to treat PFD symptoms. Aim: This study aims to compare the effectiveness of electrical and magnetic noninvasive stimulation for the treatment of PFD in postpartum women. Methods: 2 intervention groups treated with high-intensity focused electromagnetic ([HIFEM]; G1) procedure and electrical stimulation (G2) were established along with the control group (G3). Patients received 10 therapies delivered at the hospital (G1; 2e3 times per week) or self-administered at home (G2; every other day) after initial training. The protocol was identical for both modalities. Functionality of the PFM was examined by surface electromyography measurements (maximal voluntary contraction [MVC]; mean MVC; muscle activity at rest; endurance of contraction) while patient's subjective perception of pelvic floor functionality was assessed by Pelvic Floor Impact QuestionnaireeShort Form 7 (PFIQ-7) standardized questionnaire. Changes in electromyography values and PFIQ-7 scores were statistically evaluated from baseline to after all treatments. Main Outcome Measure: The main outcome measure was enhancement of PFM activity. Results: In total, 95 patients (G1 ¼ 50; G2 ¼ 25; G3 ¼ 20) participated in the study. The MVC, mean MVC, and endurance were lowered in symptomatic patients. After the treatments, these parameters significantly increased (P < .001) and moved toward the values of healthy population. Electrogenesis at relaxation revealed divergent tendencies in the G1 and G2 groups. PFIQ-7 scores significantly improved in treated patients (P < .001). In general, superior results were documented in the HIFEM group as it reached improvement of electromyography parameters from 48% to 59% (electrical stimulation from 7% to 36%) and similarly the improvement of PFIQ-7 score by 57% (electrical stimulation by 32%). Conclusion: This study documented that the HIFEM procedure was significantly more effective than electrical stimulation in treatment of PFD in postpartum women. Both the objective and subjective evaluation indicates more profound effects of magnetic stimulation. Elena S, Dragana Z, Ramina S, et al. Electromyographic Evaluation of the Pelvic Muscles Activity After High-Intensity Focused Electromagnetic Procedure and Electrical Stimulation in Women With Pelvic Floor Dysfunction. Sex Med 2020;8:282e289.

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“…PFM function is thought to play a significant role in the pathogenesis of POP . PFM kinesiologic function is assessed using relatively reliable measurements, such as digital examination, manometry, and electromyography using a vaginal probe . However, there are some patients, for example, those immediately after transvaginal surgery or vaginal delivery, who feel discomfort and pain.…”

Section: Introductionmentioning

confidence: 99%

“…4 PFM kinesiologic function is assessed using relatively reliable measurements, such as digital examination, manometry, and electromyography using a vaginal probe. [5][6][7] However, there are some patients, for example, those immediately after transvaginal surgery or vaginal delivery, who feel discomfort and pain. We also had patients who declined to take part in studies because of cultural factors in Asian countries.…”

Section: Introductionmentioning

confidence: 99%

Evaluating pelvic floor muscle contractility using two‐dimensional transperineal ultrasonography in patients with pelvic organ prolapse

Ouchi

Kitta

Suzuki³

et al. 2019

Neurourology and Urodynamics

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Aim The hiatal anterior‐posterior distance (APD), as measured by two‐dimensional (2D) transperineal ultrasonography, is an indicator of pelvic floor muscle (PFM) contractility. The function of the pelvic floor is independently related to pelvic organ prolapse (POP) severity. However, little evidence concerning the APD for patients with POP before and after PFM training (PFMT) has been published. Therefore, we analyzed 2D transperineal ultrasonography in women with POP. Methods Twenty‐eight women with POP completed a physiotherapist‐led PFMT regimen that consisted of 4 months of one‐on‐one PFMT and lifestyle advice. The APD was measured using 2D transperineal ultrasonography immediately before and after the PFMT period and used to calculate ΔAPD (APD at rest—APD during contraction). Vaginal squeeze pressure during maximum voluntary contractions was also assessed using a manometer. We then analyzed the reliability and the correlation between ΔAPD as measured using 2D transperineal ultrasonography and vaginal squeeze pressure before and after PFMT. Results The APD at rest and during PFM contractions demonstrated intraclass correlation coefficients (ICCs) of 0.89 and 0.88, respectively. The ICC of maximal vaginal squeeze pressure was 0.97 during PFM contractions. Both ΔAPD (P < 0.01) and PFM strength (P < 0.05) increased significantly after PFMT. PFM strength and ΔAPD were correlated before (R = 0.53) and after (R = 0.68) PFMT (P < 0.01). Conclusions We demonstrated that dynamic 2D transperineal ultrasonography could be used for studying functional changes in patients with POP. The ΔAPD of the levator hiatus has potential as an anatomical surrogate marker for evaluating PFM function in hospitals.

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Reliability of pelvic floor muscle electromyography tested on healthy women and women with pelvic floor muscle dysfunction

Cited by 35 publications

References 15 publications

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

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

Electromyographic Evaluation of the Pelvic Muscles Activity After High-Intensity Focused Electromagnetic Procedure and Electrical Stimulation in Women With Pelvic Floor Dysfunction

Evaluating pelvic floor muscle contractility using two‐dimensional transperineal ultrasonography in patients with pelvic organ prolapse

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