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Reliability and validity of pelvic floor muscle strength assessment using the MizCure perineometer.

ABSTRACT: BACKGROUND:The purpose of this study was to clarify the reliability and validity of pelvic floor muscle (PFM) strength assessment using the MizCure perineometer in healthy women. METHODS:Twenty healthy women (age 20-45 years) participated in this study. The vaginal pressure measured using the MizCure and validated Peritron perineometers were repeated during PFM contraction in the supine and standing positions. All women were evaluated twice by examiners 1 and 2. Following the measurements in the first session (Test 1), they were repeated after an interval of between 2 and 6 weeks (Test 2). Within- and between-session intra- and inter-rater reliabilities in vaginal pressure were analyzed using intraclass correlation coefficients (ICC) (1, 1) and (2, 1), respectively. Validity was assessed by Pearson's product-moment correlation coefficient and Spearman's rank correlation analysis. RESULTS:Within-session intra-rater reliabilities for both examiners 1 and 2 for all vaginal pressures in Tests 1 and 2 were 0.90-0.96 for both perineometers. Between-session intra-rater reliability for the MizCure was 0.72-0.79 for both positions for examiner 1, and 0.63 in the supine position and 0.80 in the standing position for examiner 2. Inter-rater reliability for Test 1 was 0.91 in the supine position and 0.87 in the standing position for the MizCure. The vaginal pressures using the MizCure and Peritron were significantly associated with the supine position (r?=?0.68, P?

SUBMITTER: Abe-Takahashi Y

PROVIDER: S-EPMC7678071 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Reliability and validity of pelvic floor muscle strength assessment using the MizCure perineometer.

Abe-Takahashi Yui Y Kitta Takeya T Ouchi Mifuka M Okayauchi Minori M Chiba Hiroki H Higuchi Madoka M Togo Mio M Shinohara Nobuo N

BMC women's health 20201119 1

<h4>Background</h4>The purpose of this study was to clarify the reliability and validity of pelvic floor muscle (PFM) strength assessment using the MizCure perineometer in healthy women.<h4>Methods</h4>Twenty healthy women (age 20-45 years) participated in this study. The vaginal pressure measured using the MizCure and validated Peritron perineometers were repeated during PFM contraction in the supine and standing positions. All women were evaluated twice by examiners 1 and 2. Following the meas ...[more]

PMID: 33213429

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Project description:PurposePelvic Floor Disorders (PFDs) affects many women and have a significant impact on their quality of life. Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20) help to assess PFDs; however, both are not culturally translated into the Amharic-language. Hence, we aimed to translate the English versions of short forms of the PFDI-20 and PFIQ-7 into Amharic-language and evaluate their psychometric properties in Amharic-speaking Ethiopian women with symptomatic PFDs.MethodsThe PFDI-20 and PFIQ-7 were translated into Amharic language using standard procedures. The Amharic versions were completed by 197 patients (response rate 92%) with PFDs from University of Gondar specialized and comprehensive Hospital. Internal consistency and test-retest reliability were examined through Cronbach's alpha and Intraclass correlation coefficients (ICC). A relative criterion standard, POP-SS-7 score, was correlated with total PFDI-20 and subscale POPDI-6 scores using spearman's rank order correlation (SCC). Construct validity was evaluated by known group validity using the Mann-Whitney U test.ResultsBoth instruments were successfully translated and adapted with an excellent content validity (> 0.90). The Amharic versions of the PFDI-20 and PFIQ-7 showed excellent internal consistency and test-retest reliability in both summary and subscales (Cronbach's alpha: 0.92 for PFDI-20 and 0.91 for PFIQ-7; and ICC: 0.97 for PFDI-20 and 0.86 for PFIQ-7). Criterion validity was good for POPDI-6 (SCC = 0.71; p < 0.001). Moreover, construct validity was acceptable, showing significant differences among groups of PFDs in the PFDI-20 and PFIQ-7 scores (Mann-Whitney U Test; p < 0.001).ConclusionsThe Amharic versions of the PFDI-20 and PFIQ-7 are comprehensible, reliable, valid, and feasible in Ethiopian Amharic-speaking women with PFDs to evaluate symptoms and its impact during research and clinical practice. However, further studies are needed to evaluate the responsiveness.

Project description:Hand-held dynamometry (HHD) has never previously been used to examine isometric muscle power. Rate of force development (RFD) is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power.30 healthy young adults (age: 23±5 yrs, male: 15) were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2) and a criterion-reference KinCom dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC), Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change.Comparison of RFD methods revealed that a peak 200 ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients ≥ 0.70) for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs ≥ 0.70) for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31-0.79).Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability and validity of these variables in clinical populations.

Project description:The primary aim of the study was to assess intraday and interday reliability of surface electromyography (sEMG) reflex activity of the pelvic floor muscles during synchronous whole-body vibration (S-WBV) of two intensities (30Hz/2mm; 40Hz/4mm) using band-stop filter and high-pass filter signal processing. The secondary aim of the study was to assess intraday and interday (test-retest) reliability of sEMG obtained from maximal voluntary contraction (MVC) test. We evaluated the intraday reliability of sEMG recordings obtained during sessions 1 and 2 performed on the same day. The sessions consisting of maximal voluntary pelvic floor muscle contraction and synchronous vibration sets with 1-hour rest in-between sessions 1 and 2 in healthy nulliparous women. The next intraday reliability was evaluated between the results of sessions 3 and 4 performed on the same day but followed at an interval of 4 weeks. to include the entire menstrual cycle. The interday reliability was determined based on the results of sessions 1 and 3 using the intraclass correlation coefficient (ICC 3,3). The intraday ICCs for band-stop filtered mean and median sEMG frequency and mean normalized sEMGRMS amplitude of the 30Hz/2mm (ICC = 0.89-0.99) and 40Hz/4mm vibration (ICC = 0.95-0.99) indicated substantial reproducibility. The intraday reliability of high-pass filter at 100-450Hz for these parameters was also substantial (30Hz/2mm ICC of 0.92 to 0.98; 40Hz/4mm ICC of 0.88 to 0.98). The interday reliability (session 1 vs. session 3) of the mean normalized sEMGRMS amplitude for band-stop filtered means of 40 Hz/4mm and 30Hz/2mm vibration recordings was substantial (ICC = 0.82 and 0.93). However, ICCs of the mean and median frequency were indicative of fair reliability (ICC of 0.43 to 0.59). The interday reliability of mean normalized sEMGRMS amplitude for high-pass filter at 100-450Hz was substantial (30Hz/2mm ICC of 0.90; 40Hz/4mm ICC of 0.73) for the 30Hz/2mm S-WBV and moderate (ICC = 0.73) for the 40/4mm S-WBV. The ICCs for mean and median sEMG frequency ICCs indicated slight to fair reproducibility (ICC of 0.16 to 0.56). The intraday reliability of the strongest MVC contraction and average MVC turned out substantial (ICC = 0.91-0.98). The interday reliability coefficients of the strongest MVC contraction and average MVCs were 0.91 and 0.82, respectively. Concluded, the intraday reliability proved satisfactory for all variables; however, the interday comparison showed sufficient ICC levels only for the mean amplitude. We therefore recommend this parameter should be used when analyzing PFM sEMG recorded during vibration. ICCs of the mean and median frequency for both signal processing methods were indicative of insufficient reliability and did not reach the threshold for usefulness. Our study showed similar reliability of PFM sEMG during S-WBV in case of the two filtering methods used.

Project description:ObjectivesEvaluation of the inter-rater reliability of clinical assessment methods for pelvic floor muscles and diastasis recti abdominis post partum.DesignA multicentre inter-rater reliability study.SettingThree primary care rehabilitation centres in Sweden.ParticipantsA total of 222 participants were recruited via advertising at Swedish maternity care units and social media. Eligibility for participation included female gender, ≥18 years, at maximum 3 months after childbirth. Exclusion criteria were chronic pelvic girdle pain and/or low back pain and/or pelvic floor tear grade III/IV. At each centre, 2 physiotherapists, with training and experience in pelvic floor assessment, assessed the 222 women according to a standardised protocol in random order.Outcome measuresInter-rater reliability of the assessment of pelvic floor muscle function (involuntary and voluntary contraction and voluntary relaxation) and diastasis recti abdominis (width, depth and bulging).ResultsVaginal palpation of maximal voluntary contraction revealed a kappa value of 0.69 (95% CI 0.62 to 0.76). Assessments of involuntary contraction and voluntary relaxation yielded inconsistent results, with slight-to-moderate weighted kappa values ranging from 0.10 to 0.51. After 2 months of training in applying this method, diastasis recti abdominis width measured at the umbilicus by calliper yielded an intraclass correlation coefficient value of 0.83 (95% CI 0.76 to 0.87). Assessments of diastasis recti abdominis depth and bulging showed moderate kappa values, with reservation for some inconsistency between the centres.ConclusionsVaginal palpation of pelvic floor muscle strength is a reliable method for the postpartum muscle assessment. Additional research is needed to identify reliable assessment method for other pelvic floor muscle functions like involuntary contraction and voluntary relaxation. With some training, a calliper is a reliable instrument for measuring the postpartum diastasis recti abdominis width. This study provides novel thoughts about how to measure diastasis recti abdominis depth and bulging.Trial registration numberNCT03703804.

Project description:BackgroundTo investigate the effect of different delivery modes and related obstetric factors on the short-term strength of the pelvic floor muscle after delivery in Chinese primipara.MethodsA total of 4769 healthy Chinese primiparas at postpartum 6-8 weeks were interviewed. According to the difference of delivery mode, the selected primiparas were divided into 2 groups, including cesarean delivery group containing 2020 and vaginal delivery group containing 2749. All the vaginal deliveries were further divided into 3 groups, including episiotomy group containing 2279, perineal laceration group containing 398, and forceps assisted group containing72. The scales of their pelvic floor muscle (PFM) strengths were examined by specially trained personnel using digital palpation (Modified Oxford scale:0-5 grade). According to participants' willingness, if the PFM strength was weak (0 or 1 grade), at-home PFM training would be recommended and an electrical stimulation combined with biofeedback therapy would be conducted for them in hospital. Twelve weeks after delivery, the PFM strength would be measured again. For statistical analysis, t-test, one-way variance analysis, Chi-square analysis, Kruskal-Wallis test H, Mann-Whitney U test and Wilcoxon test were carried out.ResultsThe PFM strength in cesarean delivery group was higher than in vaginal delivery group (p < 0.05). Among 3 vaginal delivery groups, the PFM strength in perineal laceration group was the highest (p < 0.05); however, there was no difference in PFM strength between episiotomy group and forceps assisted group (p>0.05). After accepting PFM training at home and therapy in hospital, 305 women showed increased PFM strength (p < 0.05).ConclusionsVaginal delivery is an independent risk factor causing the damage of PFM, and episiotomy may cause injury of PFM. Through PFM training at home and therapy in hospital, those damage will resume as soon as possible in the short-time period after delivery.

Project description:ObjectiveThe objective of this study was to evaluate whether early postpartum exercise is associated with changes in pelvic symptom severity, pelvic floor muscle strength, and diastasis recti abdominis (DRA) from 3 to 12 months postpartum.MethodsIn this prospective cohort study, 504 participants with and without pelvic symptoms (pelvic girdle pain, stress urinary incontinence, vaginal heaviness) were followed. At 3, 6, 9, and 12 months postpartum, we assessed pelvic symptoms, exercise behavior (by questionnaires), pelvic floor muscle strength (by vaginal palpation), and DRA (by caliper measurement). Based on the 3-months questionnaire, participants were categorized as nonexercisers (n = 105), minimal low-impact exercisers (n = 249), regular low-impact exercisers (n = 117), and high-impact exercisers (n = 32). Between-group differences and within-group changes from 3 to 12 months were calculated using Chi-square tests, Kruskal-Wallis tests, and Friedman analysis of variance.ResultsAt 3 months, no differences in symptom prevalence were seen between the groups. Nonexercisers reported higher pelvic girdle pain severity and had weaker pelvic floor muscles. The within-group analysis showed that pelvic girdle pain severity did not change in nonexercisers or high-impact exercisers, but decreased in minimal and regular low-impact exercisers. Stress urinary incontinence increased in nonexercisers from 3 to 12 months, while it remained unchanged in regular low-impact and high-impact exercisers, and decreased in minimal low-impact exercisers. Across all groups, vaginal heaviness and DRA decreased, and pelvic floor strength increased from 3 to 12 months.ConclusionThe study indicates that early low-impact exercising is associated with reduced pelvic girdle pain severity during the first postpartum year. Minimal low-impact exercisers also showed a slight reduction in stress urinary incontinence. Conversely, nonexercisers reported an increase in stress urinary incontinence between 3 and 12 months postpartum.ImpactPhysical therapists should encourage women to start with low-impact exercise early after pregnancy.Lay summaryThis study highlights the positive effects of starting gentle, low-impact exercise early after childbirth to reduce pelvic girdle pain and urinary incontinence.

Project description:Background: Pregnancy and high-impact activity are considered as risk factors for pelvic floor dysfunctions, including urinary incontinence. Aim: To investigate whether a structured exercise program, including high- and low-impact aerobics and supported by pelvic floor muscle exercises, improves the neuromuscular activity of the pelvic floor and does not reduce the quality of life in terms of urinary incontinence in healthy pregnant women. Methods: This was a randomized control trial among 97 Caucasian healthy nulliparas in uncomplicated pregnancies (age 30 ± 4 years, 21 ± 5 weeks of gestation; mean ± SD). Women were assessed for pelvic floor muscle functions with surface electromyography (EMG) using vaginal probes and using the Incontinence Impact Questionnaire (IIQ). Only women able to contract pelvic floor muscles and with good quality of life based on IIQ were included for the study. Seventy women in the experimental group took part in a supervised exercise program including high-low impact aerobics and pelvic floor muscle exercises three times a week. Twenty-seven controls did not receive any exercise intervention. After 6 weeks both groups were re-tested with EMG and IIQ. Post- and pre-exercise program changes in each group were analyzed using a repeated-measures ANOVA. Results: Women in the experimental group improved the neuromuscular activity of the pelvic floor in some motor tasks without any adverse outcomes of the intervention. After the exercise program we observed in the experimental group significantly higher EMG amplitude in the pelvic floor muscles during 3-s contractions (p = 0.014). We also noticed a beneficial trend in the increase of neuromuscular activity during 10- and 60-s contractions, but the changes were not statistically significant. The exercising women substantially improved their abilities for relaxation following 3- and 10-s contractions (p = 0.013 and p < 0.001). In controls, we reported no statistically significant improvement in either of the motor tasks. All study participants maintained good quality of life related to urinary incontinence. Conclusion: Prenatal exercise programs that include high- and low-impact aerobics and are supported by pelvic floor muscle exercises should be recommended for pregnant women, especially those who are accustomed to higher exercise intensity before pregnancy. Nevertheless, these recommendations can be directed to continent women who can properly contract pelvic floor muscles. ISRCTN. DOI: 10.1186/ISRCTN92265528: "Pelvic floor muscle training with surface electromyography", retrospectively registered on the 25th of July, 2016.

Project description:BackgroundPelvic floor dysfunction is a public health issue, with 1 in 3 women experiencing symptoms at some point in their lifetime. The gold standard of treatment for pelvic floor dysfunction is supervised pelvic floor muscle training (PFMT); however, adherence to PFMT in women is poor. Mobile apps are increasingly being used in the National Health Service to enable equity in the distribution of health care and increase accessibility to services. However, it is unclear how PFMT mobile apps influence PFMT adherence in women.ObjectiveWe aimed to identify which behavior change techniques (BCTs) have been used in PFMT mobile apps, to distinguish the core "capability, opportunity, and motivation" (COM) behaviors targeted by the BCTs used in PFMT mobile apps, and to compare the levels of PFMT adherence in women between those using PFMT mobile apps and those receiving usual care.MethodsWe conducted a scoping review of the literature. Published quantitative literature that compared the use of a PFMT mobile app to a control group was included to address the objectives of the study. The electronic bibliographic databases searched included MEDLINE, CINAHL, Scopus, Web of Science, and PEDro, along with CENTRAL. Studies were also identified from reference searching of systematic reviews. Original articles written in English from 2006 onward were included. Nonexperimental quantitative studies, qualitative studies, studies that use male participants, case studies, web-based interventions, and interventions that use vaginal probes were excluded. Narrative synthesis was conducted on eligible articles based on the aims of the study.ResultsOf the 114 records retrieved from the search, a total of 6 articles met the eligibility and inclusion criteria. The total number of participants in the studies was 471. All PFMT mobile apps used the BCT "prompts and cues." Opportunity was the core COM behavior targeted by the PFMT mobile apps. Higher levels of adherence to PFMT were observed among women using PFMT mobile apps.ConclusionsDigital "prompts and cues" are a BCT commonly used in PFMT mobile apps, and further research is required to practically assess whether a future randomized controlled trial that investigates the effectiveness of digital "prompts and cues" on PFMT adherence in women can be conducted.

Dataset Information

Reliability and validity of pelvic floor muscle strength assessment using the MizCure perineometer.

Publications

Reliability and validity of pelvic floor muscle strength assessment using the MizCure perineometer.

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