Orthopaedic and Rehabilitation Department, Medical University of Warsaw, 02-091 Warsaw, Poland.
Oleksy Medical & Sports Sciences, 37-100 Łańcut, Poland.
Int J Environ Res Public Health. 2021 Jan 18;18(2):765. doi: 10.3390/ijerph18020765.
The aim of the study was to determine the between-trial and between-day reliability of the Glazer protocol and our multi-activity surface electromyography (sEMG) measurement protocol for pelvic floor muscle (PFM) evaluation. The bioelectrical activity of PFM was collected using an endovaginal electrode in 30 young, Caucasian, nulliparous women (age 22-27, 168.6 ± 5.1 cm, 57.1 ± 11.8 kg). The between-trial and between-day reliability of the original Glazer protocol and the new multi-activity sEMG protocol were assessed during the following phases: pre-baseline rest, phasic (flick) contractions, tonic contractions, endurance contraction, and post-baseline rest. The Glazer protocol was characterized by poor and moderate measurement reliability. The time-domain parameters for the rise and fall of the signal amplitude and median frequency showed poor between-trial and between-day reliability. The mean and peak amplitudes indicated mainly good between-trial and moderate between-days reliability. Our protocol showed moderate to excellent reliability of both time-domain and quantitative parameters of muscle recruitment. In our protocol, the frequency-domain parameters describing muscle fatigue demonstrated much higher reliability than in the case of the Glazer protocol. The most important information obtained in this study was the significant improvement of diagnostic validity in PFM bioelectrical activity evaluation. The higher reliability of our sEMG protocol compared to original Glazer protocol allowed us to suggest that protocol modifications and changes in sEMG signal processing methods were effective in the improvement of PFM assessment quality. The new parameters calculated from the sEMG signal proposed in our sEMG protocol allowed us to obtain additional clinically important information about PFM dysfunctions regarding specific deficits of muscle contraction such as decrease in muscle strength; endurance or coordination related to, e.g., stress urinary incontinence; or pelvic floor muscle imbalance after childbirth.
本研究旨在确定 Glazer 方案和我们的多活动表面肌电图（sEMG）测量方案评估盆底肌（PFM）的试验间和试验内可靠性。使用阴道内电极收集 PFM 的生物电活动，共纳入 30 名年轻的白种、未育的女性（年龄 22-27 岁，身高 168.6±5.1cm，体重 57.1±11.8kg）。在以下阶段评估原始 Glazer 方案和新的多活动 sEMG 方案的试验内和试验内可靠性：基线前休息、相性（闪烁）收缩、紧张性收缩、耐力收缩和基线后休息。Glazer 方案的特点是测量可靠性差和中等。信号幅度和中值频率的上升和下降的时域参数显示出较差的试验内和试验内可靠性。平均幅度和峰值幅度主要显示出良好的试验内和中度的试验内可靠性。我们的方案显示出肌肉募集的时域和定量参数具有中等至高的可靠性。在我们的方案中，描述肌肉疲劳的频域参数显示出比 Glazer 方案更高的可靠性。本研究获得的最重要信息是 PFM 生物电活动评估的诊断有效性显著提高。与原始 Glazer 方案相比，我们的 sEMG 方案具有更高的可靠性，这表明方案修改和 sEMG 信号处理方法的变化有效提高了 PFM 评估质量。我们的 sEMG 方案从 sEMG 信号中计算出的新参数允许我们获得关于 PFM 功能障碍的额外临床重要信息，例如肌肉收缩力量下降、与耐力或协调性相关的功能障碍（例如，与压力性尿失禁相关）或产后盆底肌肉失衡。
