Physio Works Muskoka, Huntsville, Ontario, Canada.
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
Braz J Phys Ther. 2021 May-Jun;25(3):256-261. doi: 10.1016/j.bjpt.2020.05.013. Epub 2020 Jun 6.
Tenderness on palpation of the pelvic floor muscles (PFMs) is a clinical assessment tool used alongside other tests to identify PFM involvement in pelvic complaints including pelvic pain. Although reliability of PFM tenderness has been determined, validity has yet to be established.
To assess convergent validity of PFM tenderness on digital palpation with the presence of central pain mechanism, as determined by a score of greater than 40 on the Central Sensitization Inventory (CSI). A secondary objective was to assess the agreement between PFM tenderness and self-reported symptoms of PFM sensitivity.
Participants completed a battery of self-report questions, the CSI, and various physical assessments (blinded assessors). Convergent validity was assessed between tenderness on palpation and the CSI. Kappa statistics were used to determine agreement between tenderness on palpation and self-reported perineal pain, urinary urgency, dyspareunia, and dysmenorrhea.
Ninety-nine female participants with hip or back pain and at least one self-reported symptom of pelvic floor dysfunction were included in the study (mean age 40.56±12.72 years). Convergent validity was found between PFM tenderness on palpation and scores greater than 40 on the CSI (X=4.2,p=0.04). There was poor agreement between tenderness on palpation with dyspareunia (agreement 62.83%, Kappa=0.27), dysmenorrhea (agreement 55.75%, Kappa=0.14), or perineal pain (agreement 53.04%, Kappa=0.10).
PFM tenderness on digital palpation confirmed convergent validity with CSI scores, suggesting central pain mechanisms. Clinicians may need to consider the role of central pain mechanisms in their clinical decision making when treating PFM dysfunction.
对骨盆底肌肉（PFMs）进行触诊时的压痛是一种临床评估工具，与其他测试一起用于识别 PFMs 参与包括骨盆疼痛在内的骨盆投诉。尽管已经确定了 PFM 压痛的可靠性，但尚未确定其有效性。
评估数字触诊时 PFM 压痛与中央敏感化量表（CSI）评分大于 40 分的中央疼痛机制之间的收敛效度。次要目的是评估 PFM 压痛与自我报告的 PFM 敏感性症状之间的一致性。
参与者完成了一系列自我报告问题、CSI 以及各种身体评估（盲法评估员）。评估触诊时的压痛与 CSI 之间的收敛效度。Kappa 统计用于确定触诊压痛与自我报告的会阴疼痛、尿急、性交痛和痛经之间的一致性。
本研究纳入了 99 名患有髋部或背部疼痛且至少有一项自我报告的骨盆底功能障碍症状的女性参与者（平均年龄 40.56±12.72 岁）。触诊时 PFM 压痛与 CSI 评分大于 40 分之间存在收敛效度（X=4.2，p=0.04）。触诊压痛与性交痛（一致性 62.83%，Kappa=0.27）、痛经（一致性 55.75%，Kappa=0.14）或会阴疼痛（一致性 53.04%，Kappa=0.10）之间的一致性较差。
数字触诊时 PFM 压痛与 CSI 评分具有收敛效度，提示存在中央疼痛机制。在治疗 PFMs 功能障碍时，临床医生可能需要考虑中央疼痛机制在其临床决策中的作用。
