School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Department of Mechanical Engineering, University of Ottawa, Ottawa, Ontario, Canada.
Neurourol Urodyn. 2018 Aug;37(6):1875-1888. doi: 10.1002/nau.23575. Epub 2018 Apr 10.
(1) To determine the reliability of an automated dynamometer designed to assess pelvic floor muscle (PFM) strength and resistance to passive elongation. (2) To evaluate the impact of PFM length and rate of tissue elongation on dynamometric outcomes.
At each of two sessions, twenty nulliparous women performed three maximum voluntary contractions (MVC) of their PFMs with the dynamometer set to two different anteroposterior (AP) diameters (25 mm, 35 mm). Next, with PFMs relaxed, the arms of the dynamometer opened three times to 40 mm at two speeds (25 mm/s, 50 mm/s). Outcomes included baseline force, peak force, relative peak force, rate of force development (RFD), stiffness and stress relaxation. Repeated-measures ANOVAs were used to test trial, day, and task effects (α = 0.05), and intra-class correlation coefficients (ICCs) were computed.
Forces measured on MVC were higher with the larger AP diameter, and passive resistance was higher for the faster rate of tissue elongation. The between-trial reliability of all outcomes was excellent (0.82 < ICC < 0.98) for all measures except for peak force during the passive elongation task (0.56 < ICC < 0.93). Between-day reliability was good to excellent for active and passive RFD (0.75 < ICC < 0.93), stiffness (ICC = 0.77) and relative peak force (0.71 < ICC < 0.87); absolute force (0.11 < ICC < 0.85) and stress relaxation responses (0.19 < ICC < 0.98) tended to be less reliable.
The reliability of the dynamometer is adequate for both clinical and research applications. Relative forces were more reliable than absolute forces. Dimensions and rate of tissue elongation should be controlled and reported with all pelvic floor muscle assessments as these parameters impact outcomes.
(1) 确定一种用于评估盆底肌（PFM）力量和抵抗被动伸长的自动测力计的可靠性。(2) 评估 PFM 长度和组织伸长率对测力结果的影响。
在两次会议的每次会议中，二十名未生育的女性使用测力计进行三次最大自主收缩（MVC），测力计设置为两个不同的前后（AP）直径（25mm，35mm）。接下来，在 PFM 放松的情况下，测力计的臂三次张开至 40mm，速度为 25mm/s 和 50mm/s。结果包括基线力、峰值力、相对峰值力、力发展速率（RFD）、刚度和应力松弛。使用重复测量方差分析检验试验、天和任务效应（α=0.05），并计算组内相关系数（ICC）。
使用较大的 AP 直径测量的 MVC 力更高，而更快的组织伸长率的被动阻力更高。除了被动伸长任务中的峰值力（0.56<ICC<0.93）外，所有结果的试验间可靠性均为优秀（0.82<ICC<0.98）。主动和被动 RFD（0.75<ICC<0.93）、刚度（ICC=0.77）和相对峰值力（0.71<ICC<0.87）的日间可靠性良好至优秀；绝对力（0.11<ICC<0.85）和应力松弛反应（0.19<ICC<0.98）的可靠性较差。
测力计的可靠性适合临床和研究应用。相对力比绝对力更可靠。在所有的盆底肌评估中，应控制和报告尺寸和组织伸长率，因为这些参数会影响结果。
