Devreese Annemie, Staes Filip, De Weerdt Willy, Feys Hilde, Van Assche André, Penninckx Freddy, Vereecken Raoul
Department of Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, University of Leuven, Tervuursevest 101, B-3001 Leuven, Belgium.
Neurourol Urodyn. 2004;23(3):190-7. doi: 10.1002/nau.20018.
The aim of the study was to investigate the reliability of a scoring system for the investigation of voluntary and reflex co-contractions of abdominal and pelvic floor muscles in lying, sitting, and standing positions in continent and incontinent women.
A visual inspection and digital (strength, tone, speed, and endurance) palpation scale was developed to measure the coordination of the lower abdominal and pelvic floor muscles. Inter-observer reliability of the scales was investigated in 40 continent and 40 incontinent women. Differences between the continent and incontinent group were analysed.
Inter-observer reliability for the visual inspection scale showed kappa values between 0.91 and 1.00, for tone percentage of agreement ranged from 95 to 100% (superficial) and 95 to 98% (deep muscle). Weighted Kappa (K(w)) varied from 0.77 to 0.95 for strength and 0.75 to 0.98 for the inward movement of superficial and deep pelvic floor muscles. K(w) for coordination between the superficial and deep part of the pelvic floor muscles groups was from 0.87 to 0.88 and 0.97 to 1.00 for endurance and global speed of the pelvic floor contraction. The continent women exhibited significantly better coordination between the pelvic floor and lower abdominal muscles during coughing in all three positions. Also the superficial part of the inward movement, the feeling and the coordination of the pelvic floor muscles were significantly better in the continent group.
Visual inspection and digital tests are easy and reliable methods by which insight can be gained into the multi-muscular activity and coordination of the pelvic floor and lower abdominal muscles in continent and incontinent women.
本研究旨在调查一种评分系统的可靠性，该系统用于研究有节制和尿失禁女性在仰卧、坐姿和站立姿势下腹部和盆底肌肉的自主和反射性协同收缩。
开发了一种视觉检查和数字（力量、张力、速度和耐力）触诊量表，以测量下腹和盆底肌肉的协调性。在40名有节制和40名尿失禁女性中调查了量表的观察者间可靠性。分析了有节制组和尿失禁组之间的差异。
视觉检查量表的观察者间可靠性显示kappa值在0.91至1.00之间，张力一致性百分比在95%至100%（浅层）和95%至98%（深层肌肉）之间。力量的加权kappa（K(w)）在0.77至0.95之间，浅层和深层盆底肌肉向内运动的K(w)在0.75至0.98之间。盆底肌肉组浅层和深层之间协调性的K(w)，耐力和盆底收缩整体速度的K(w)在0.87至0.88之间和0.97至1.00之间。在所有三个姿势下咳嗽时，有节制的女性盆底和下腹肌肉之间的协调性明显更好。此外，有节制组盆底肌肉向内运动的浅层部分、感觉和协调性也明显更好。
视觉检查和数字测试是简单可靠的方法，通过这些方法可以了解有节制和尿失禁女性盆底和下腹肌肉的多肌肉活动及协调性。
