Arab Amir Massoud, Behbahani Roxana Bazaz, Lorestani Leila, Azari Afsaneh
J Man Manip Ther. 2009;17(3):e75-9. doi: 10.1179/jmt.2009.17.3.75E.
Pelvic floor muscle (PFM) dysfunction has been commonly associated with urinary disorders and lumbo-pelvic pain. Transabdominal (TA) ultrasound is currently used by physical therapists to assess PFM function. Controversy exists regarding the correlation between TA ultrasound measurement and vaginal palpation for assessment of PFM contraction, and this relationship has not yet been examined concurrently during the same contraction. The purpose of this study was to determine the correlation of digital palpation and TA ultrasound to assess PFM contraction when recorded 1) simultaneous to digital palpation during one contraction and 2) following digital palpation testing in another contraction. A descriptive correlational design was used to describe the relationship between variables. A total of 19 women (both asymptomatic women and those with incontinence or lumbo-pelvic pain) participated in the study. The modified Oxford scale was used to grade PFM contraction in digital palpation testing. The amount of bladder base movement on ultrasound was measured and considered as an indicator of PFM activity. Two trials were performed for TA ultrasound measurement: 1) simultaneous to digital palpation during one contraction, and 2) following digital palpation testing in another contraction. Spearman's correlation coefficient was used for analysis. There was a significant correlation between digital palpation and TA ultrasound for PFM assessment when measured simultaneously in one contraction (rho=0.62, p=0.01) and separately in a different contraction (rho=0.52, p=0.02), with a stronger correlation found in simultaneous testing. In conclusion, digital palpation and TA ultrasound measurement are significantly correlated and measure comparable parameters in evaluation of PFM contraction.
盆底肌（PFM）功能障碍通常与泌尿系统疾病和腰骶部疼痛有关。目前，物理治疗师使用经腹（TA）超声来评估盆底肌功能。对于经腹超声测量与阴道触诊在评估盆底肌收缩方面的相关性存在争议，并且在同一收缩过程中尚未同时检查这种关系。本研究的目的是确定在以下两种情况下进行记录时，指诊与经腹超声评估盆底肌收缩的相关性：1）在一次收缩过程中与指诊同时进行；2）在另一次收缩中在指诊测试之后进行。采用描述性相关设计来描述变量之间的关系。共有19名女性（包括无症状女性以及有尿失禁或腰骶部疼痛的女性）参与了该研究。在指诊测试中，使用改良牛津量表对盆底肌收缩进行分级。测量超声上膀胱底部的移动量，并将其视为盆底肌活动的指标。对经腹超声测量进行了两项试验：1）在一次收缩过程中与指诊同时进行；2）在另一次收缩中在指诊测试之后进行。采用Spearman相关系数进行分析。在一次收缩过程中同时测量时（rho = 0.62，p = 0.01）以及在不同收缩过程中分别测量时（rho = 0.52，p = 0.02），指诊与经腹超声在评估盆底肌方面存在显著相关性，并且在同时测试中发现相关性更强。总之，在评估盆底肌收缩时，指诊和经腹超声测量显著相关且测量的参数具有可比性。
