Department of Health Professions, Division of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland.
, Lausen, Switzerland.
Int Urogynecol J. 2020 Oct;31(10):2051-2059. doi: 10.1007/s00192-020-04225-4. Epub 2020 Feb 17.
In pelvic floor muscle (PFM) electromyography (EMG) two different bipolar configurations are applied: "true differential" configuration (TD) measures neuromuscular activity with two ipsilateral electrodes, whereas "faux differential" configuration (FD) has two electrodes placed on each side of the PFMs. The aim of the study was to determine possible differences and the relationship between both configurations.
A secondary data analysis of 28 continent (CON) and 22 stress urinary incontinent (SUI) women was performed. Surface EMG was measured using a vaginal probe during maximal voluntary (MVC) and fast voluntary (FVC) contractions. TD and FD were explored with amplitude- and time-related EMG parameters, cross-correlation coefficients (R(0)) and statistical parametric mapping (SPM).
Of a total of 62 comparisons of EMG parameters of MVC and FVC, only one comparison showed significant differences between the two configurations (CON group, FVC TD versus FD, p = 0.015). R(0) were high in both groups for all MVC and FVC variables (R(0) ≥ 0.989). SPM detected 3 out of 28 comparisons with short (0.124-0.404 s) significant supra-threshold clusters (p < 0.025).
The findings suggest that TD and FD might measure neuromuscular activity almost the same. Very high cross-correlation coefficients and a very limited number of significant results from EMG parameters, as well as SPM, suggest that in the measured sample the choice of TD or FD might remain practically irrelevant. To gain further insight into the scientific and clinical relevance of choosing either of the electrode configurations, the comparisons should be re-evaluated on a sample with more severe incontinence symptoms.
在盆底肌肌电图（EMG）中，应用了两种不同的双极配置：“真正差分”配置（TD）通过两个同侧电极测量神经肌肉活动，而“假差分”配置（FD）则在 PFMs 的每一侧放置两个电极。本研究旨在确定这两种配置之间可能存在的差异和关系。
对 28 名continent（CON）和 22 名stress urinary incontinent（SUI）女性进行了二次数据分析。在最大自愿（MVC）和快速自愿（FVC）收缩期间，使用阴道探头测量表面 EMG。使用幅度和时间相关的 EMG 参数、互相关系数（R(0)）和统计参数映射（SPM）探索 TD 和 FD。
在 MVC 和 FVC 的 EMG 参数的总共 62 次比较中，只有一次比较显示两种配置之间存在显著差异（CON 组，FVC TD 与 FD，p=0.015）。对于所有 MVC 和 FVC 变量，R(0)在两组中均很高（R(0)≥0.989）。SPM 在 28 次比较中的 3 次检测到具有短（0.124-0.404 s）显著超阈值簇（p<0.025）。
研究结果表明，TD 和 FD 可能几乎以相同的方式测量神经肌肉活动。非常高的互相关系数和来自 EMG 参数的非常有限的显著结果，以及 SPM，表明在测量样本中，选择 TD 或 FD 可能在实践中无关紧要。为了更深入地了解选择电极配置中的任何一种的科学和临床相关性，应在具有更严重尿失禁症状的样本中重新评估比较。
