Evaluation of Pelvic Floor Muscle Strength Using Four Different Techniques

Abstract: The aim of the study was to evaluate whether four different techniques were able to correctly measure pelvic floor muscle strength only. Sixteen volunteers performed a set of muscle contractions using the pelvic floor muscles (PFM) only, the abdominal muscles with and without PFM, gluteal muscles with and without PFM, adductor muscles with and without PFM and Valsalva maneuver with and without PFM. Pelvic floor muscle strength was evaluated by digital palpation, intravaginal EMG, pressure perineometry and perineal ultrasound. A “non-pelvic muscle induced” reading was defined as a significant increase even though the pelvic floor muscles were not contracted. Results were as follows: isolated abdominal muscle contraction: non-pelvic muscle induced readings in 3/8 women with EMG and in 3/8 with pressure perineometry; isolated gluteal muscle contraction: non-pelvic muscle induced readings in 1/2 women with EMG perineometry; isolated adductor muscle contraction: non-pelvic muscle induced readings in 6/11 women with EMG perineometry and in 2/11 women with pressure perineometry; Valsalva maneuver: non-pelvic muscle induced readings in 4/9 women with EMG perineometry and 9/9 women with pressure perineometry. It was concluded that EMG and pressure perineometry do not selectively depict pelvic floor muscle activity.

[1]  R. Stien,et al.  Clinical and Urodynamic Assessment of Nulliparous Young Women With and Without Stress Incontinence Symptoms: A Case-Control Study , 1994, Obstetrics and gynecology.

[2]  A. Kegel,et al.  Physiologic therapy for urinary stress incontinence. , 1951, Journal of the American Medical Association.

[3]  CAROLYN M. SAMPSELLE,et al.  Effect of Pelvic Muscle Exercise on Transient Incontinence During Pregnancy and After Birth , 1998, Obstetrics and gynecology.

[4]  J. Kaczorowski,et al.  Determinants of vaginal-perineal integrity and pelvic floor functioning in childbirth. , 1997, American journal of obstetrics and gynecology.

[5]  G. Schaer,et al.  Levator ani function before and after childbirth , 1997, British journal of obstetrics and gynaecology.

[6]  M. Dougherty,et al.  An Instrument to Assess the Dynamic Characteristics of the Circumvaginal Musculature , 1986, Nursing research.

[7]  O. Koechli,et al.  Perineal Ultrasound for Evaluating the Bladder Neck in Urinary Stress Incontinence , 1995, Obstetrics and gynecology.

[8]  M. Dougherty,et al.  Development and testing of the circumvaginal muscles rating scale. , 1986, Nursing research.

[9]  G. Dorey Pelvic floor muscle exercises for men. , 2003, Nursing times.

[10]  T. Wells,et al.  A Digital Test for Pelvic Muscle Strength in Older Women With Urinary Incontinence , 1989, Nursing research.

[11]  G. Schaer,et al.  Changes in Vesical Neck Mobility Following Vaginal Delivery , 1996, Obstetrics and Gynecology.

[12]  A. Kegel,et al.  Progressive resistance exercise in the functional restoration of the perineal muscles. , 1948, American journal of obstetrics and gynecology.

[13]  M. Dougherty,et al.  The circumvaginal musculature: correlation between pressure and physical assessment. , 1986, Nursing research.