A COMPARISON OF THE PELVIC FLOOR MUSCLE CONTRACTILITY BY MEANS OF DIGITAL PALPATION, DYNAMOMETRY AND ELECTROMYOGRAPHY

 

Andrade MF^I; Miguel MRO^I; Piccini AA^I; Guimarães SS^I; Pereira LC^II; Iunes DH^I; Rocha CBJ^I; Carvalho LC^I; Silva VR^I; Riccetto C^II; Botelho S^I,II

^I Federal University of Alfenas – UNIFAL/MG/Brazil
^II Faculty of Medical Sciences – FCM/UNICAMP/Brazil
e-mail: mariliasmfernandes@gmail.com

 

INTRODUCTION

Pelvic floor muscle (PFM) assessment methods measure the ability as well as the strength of contraction. Digital palpation and dynamometry are used to evaluate pelvic floor muscle strength, while electromyography (EMG) evaluates the electrical activity of these muscles.

Currently, there aren't standard clinical methods for assessing women's pelvic floor muscle function.

This study aimed to check if there is any correlation among the assessment methods: digital palpation, dynamometry and electromyography.

 

METHODS

Thirty nulliparous women, without any urinary complaints, with the mean age of 23.58 (±3.32) years, body mass index of 23.01 (±2.74), and without absence of diastasis of the rectus abdominis muscle participated in this study.

Two investigation methods were performed: Group 1 (G1): twenty one women evaluated with the pelvic floor EMG and digital palpation; Group 2 (G2): nine women evaluated with the dynamometry of PFM with digital palpation.

Digital palpation was performed by means of a functional clinical exam using the Modifi ed Oxford Grading Scale (this is a 6-point scale: 0_no contraction, 1_flicker, 2_weak, 3_moderate, 4_good (with lift), and 5_ strong),¹ putting the subjects in supine position, lower limbs flexed with the feet on the stretcher and asking them to contract the PFM and repeat this contraction while the examiner's index and middle fingers into the vagina.

Dynamometry was done using an intra-vaginal sensor composed of a load cell attached to the EMG equipment (EMG System do Brazil®).

Pelvic floor EMG was performed using a vaginal probe (Physio-Med Services) with the metallic surfaces in contact with the vaginal lateral walls, in microvolts. Three simultaneous contractions were collected. For the statistical analysis an average of three Root Mean Squares (RMS) was calculated. Correlation Coefficient of Pearson and T Student Test were calculated, with significance level for statistical tests was 5%.

 

RESULTS AND DISCUSSION

Another study compared the contractility of the PFM through vaginal EMG and digital palpation and found a signifi cant correlation between the two means of evaluation.² Little is known about pelvic floor dynamometry as a means of investigating muscle strength.³

 

 

 

CONCLUSION

This study identifi ed a strong correlation between EMG and digital palpation, whereas a moderate correlation between dynamometry and digital palpation was found, which could have been influenced by the sample size of this preliminary study.

 

REFERENCES

1. Brink CA, Sampselle CM, Wells TJ, et al. A digital test for pelvic muscle strength in older women with urinary incontinence. Nurs Res. 1989; 38:196–9.

2. Botelho S, Pereira L, Marques J, et al. Assessment of contractility of the pelvic floor – from the clinical practice of scientifi c research - is there a correlation between the methods of functional evaluation and electromyography? 1st Annual Meeting of the International Continence Society, 2011.

3. Dumoulin C, Gravel D, Bourbonnais D, Lemieux MC, Morin M. Reliability of Dynamometric Measurements of the Pelvic Floor Musculature. Neurourol Urodyn. 2004, 23:134-142.

 

ACKNOWLEDGEMENTS

To FAPEMIG, for scientifi c support.

 

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