压力性尿失禁女性盆底肌肉表面肌电图评估的预后价值
The Prognostic Value of the Surface Electromyographic Assessment of Pelvic Floor Muscles in Women with Stress Urinary Incontinence.
作者信息
Ptaszkowski Kuba, Malkiewicz Bartosz, Zdrojowy Romuald, Paprocka-Borowicz Malgorzata, Ptaszkowska Lucyna
机构信息
Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Science, Wroclaw Medical University, Grunwaldzka 2, 50-355 Wroclaw, Poland.
Clinic of Urology and Urological Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
出版信息
J Clin Med. 2020 Jun 23;9(6):1967. doi: 10.3390/jcm9061967.
BACKGROUND
The use of surface electromyography (sEMG) measurements to evaluate the bioelectrical activity of the pelvic floor muscle (PFM) during therapeutic intervention is now well established. This study investigates the diagnostic possibilities of sEMG in women with stress urinary incontinence (SUI). The aim of this study was to carry out objective assessments of the bioelectrical activity of the PFM in women after menopause and determine the prognostic value of sEMG for assessing the PFM in patients with SUI.
METHODS
This was a prospective, observational study that evaluated the bioelectrical activity of the PFM in postmenopausal women with or without SUI (SUI group, = 89 vs. non-SUI group, = 62). The study was carried out between January 2013 and December 2018 at the Clinic of Urology (Wroclaw, Poland). The protocol for all sEMG measurements of PFM activity consisted of following elements: "baseline", "quick flicks", "contractions", "static hold", and "rest tone"; we then compared these results between groups. To determine the optimal cutoff level for sEMG activation of the PFM to detect the occurrence of SUI, we performed receiver operating characteristic (ROC) curve analysis (with Youden's index).
RESULTS
Significantly lower results were obtained for all PFM measurements in women with SUI. The optimum diagnostic cutoff for "baseline" was 3.7 μV (area under curve (AUC), 0.63), "quick flicks" was 9.15 μV (AUC, 0.84), "contractions" was 11.33 μV (AUC, 0.80), "static hold" was 9.94 μV (AUC, 0.84), and "rest" was 3.89 μV (AUC, 0.63).
CONCLUSIONS
Measuring sEMG activity in the PFM may be a useful diagnostic tool to confirm the absence of SUI. We can expect that the sEMG activity of subjects with SUI will be lower than that of healthy people. In order to determine appropriate reference values for assessing sEMG activity data in the PFM, it is now necessary to conduct multicenter studies.
背景
在治疗干预期间，使用表面肌电图（sEMG）测量来评估盆底肌（PFM）的生物电活动现已得到充分证实。本研究调查了sEMG在压力性尿失禁（SUI）女性中的诊断可能性。本研究的目的是对绝经后女性的PFM生物电活动进行客观评估，并确定sEMG在评估SUI患者PFM方面的预后价值。
方法
这是一项前瞻性观察性研究，评估了有或无SUI的绝经后女性（SUI组，n = 89 vs.非SUI组，n = 62）的PFM生物电活动。该研究于2013年1月至2018年12月在泌尿外科诊所（波兰弗罗茨瓦夫）进行。所有PFM活动的sEMG测量方案包括以下要素：“基线”、“快速轻弹”、“收缩”、“静态保持”和“静息张力”；然后我们比较了各组之间的这些结果。为了确定PFM的sEMG激活以检测SUI发生的最佳临界值，我们进行了受试者操作特征（ROC）曲线分析（使用约登指数）。
结果
SUI女性的所有PFM测量结果均显著较低。“基线”的最佳诊断临界值为3.7 μV（曲线下面积（AUC），0.63），“快速轻弹”为9.15 μV（AUC，0.84），“收缩”为11.33 μV（AUC，0.80），“静态保持”为9.94 μV（AUC，0.84），“静息”为3.89 μV（AUC，0.63）。
结论
测量PFM中的sEMG活动可能是确认无SUI的有用诊断工具。我们可以预期，SUI患者的sEMG活动将低于健康人。为了确定评估PFM中sEMG活动数据的适当参考值，现在有必要进行多中心研究。
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