Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Bern, Switzerland.
Bern University Hospital, Gynaecology, Bern, Switzerland.
Neurourol Urodyn. 2019 Feb;38(2):625-631. doi: 10.1002/nau.23911. Epub 2019 Jan 8.
Stress urinary incontinence (SUI) has also been attributed to a lower speed of contraction of the pelvic floor muscles (PFM). Therefore, PFM assessment and training implement fast voluntary contractions (FVC). The purpose of the study was to explore FVC regarding feasibility, on-/offset and rate of activity determination, as well as differences between continent (CON) and stress urinary incontinent (SUI) women.
Fifty women were included and examined by means of PFM EMG during rest, maximum voluntary contractions (MVC), and five FVC. MVC-peak activity was used to normalize EMG-data. On-/offset of muscle activity was determined as mean of rectified rest activity plus 1 standard deviation. Linear regression was calculated for rate of activity from onset to peak, peak to offset, and within 200 ms after both onset and peak. Peak activity and time variables related to onset, peak, and offset were calculated.
On-/offsets were evaluable for 234/222 of 250 FVC by a computer-based algorithm, 16/28 on-/offsets had to be determined manually. There was no significant difference between groups (CON/SUI) regarding FVC peak (92.1/99.3 %MVC), time to peak (514.2/525.6 ms), and increase of activity (182.8/182.1 %MVC/s). The SUI group showed a significantly slower activity decrease (-120.7/-74.4 %MVC/s).
FVC analyses were shown to be feasible. The significant difference observed between the groups did not refer to activity increase but instead to a prolonged relaxation phase in the SUI group. This prompts to reconsider the interpretation of FVC in PFM testing and training.
压力性尿失禁（SUI）也归因于盆底肌（PFM）收缩速度较低。因此，PFM 评估和训练采用快速自主收缩（FVC）。本研究旨在探讨 FVC 的可行性、起始/结束的确定以及活动率，以及尿控正常（CON）和压力性尿失禁（SUI）女性之间的差异。
50 名女性接受 PFM 肌电图检查，包括休息、最大自主收缩（MVC）和 5 次 FVC。使用 MVC 峰值活动对肌电图数据进行归一化。肌肉活动的起始/结束通过均方根静息活动加 1 个标准差来确定。对起始到峰值、峰值到结束以及起始和峰值后 200ms 内的活动率进行线性回归计算。计算峰值活动和与起始、峰值和结束相关的时间变量。
通过基于计算机的算法，可评估 250 次 FVC 中的 234/222 次起始/结束，16/28 次起始/结束需要手动确定。组间（CON/SUI）FVC 峰值（92.1%/99.3%MVC）、达到峰值的时间（514.2/525.6ms）和活动增加（182.8%/182.1%MVC/s）无显著差异。SUI 组的活动下降速度明显较慢（-120.7%/-74.4%MVC/s）。
FVC 分析可行。组间观察到的显著差异不是指活动增加，而是 SUI 组的放松阶段延长。这提示我们重新考虑 PFM 测试和训练中 FVC 的解释。
