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盆底肌表面肌电图和压力测定的可靠性、有效性和反应性。

Reliability, validity and responsiveness of pelvic floor muscle surface electromyography and manometry.

机构信息

Kolbotn Physiotherapy Institute, Health Department Northern Follo Municipality, Oslo, Norway.

Akershus University Hospital, Department of Obstetrics and Gynaecology, Lørenskog, Norway.

出版信息

Int Urogynecol J. 2021 Dec;32(12):3267-3274. doi: 10.1007/s00192-021-04881-0. Epub 2021 Jun 17.

Abstract

INTRODUCTION AND HYPOTHESIS

Vaginal surface electromyography (sEMG) is commonly used to assess pelvic floor muscle (PFM) function and dysfunction but there is a lack of studies regarding the assessment properties. The aim of the study was to test the hypotheses that sEMG has good test-retest intratester reliability, good criterion validity and is responsive to changes compared to manometry.

METHODS

PFM resting tone, maximum voluntary contraction (MVC) and endurance were measured in 66 women with pelvic floor dysfunction. One assessment by manometry was followed by two testing sessions with sEMG at baseline. After 4 to 42 weeks of supervised PFM strength training, 29 participants were retested with both devices.

RESULTS

Median age of the participants was 41 years (range 24-83) and parity 2 (range 0-10). Very good test-retest intratester reliability was found for all three sEMG measurements. The correlation between sEMG and manometry was moderate for vaginal resting tone (r = 0.42, n = 66, p < 0.001) and strong for MVC (r = 0.66, n = 66, p < 0.001) and endurance (r = 0.67, n = 66, p < 0.001). Following the strength training period, participants demonstrated increased MVC and endurance measured with manometry, but not with sEMG. A significant reduction in resting tone was found only with sEMG.

CONCLUSION

sEMG is reliable and correlates well with manometry. However, sEMG is not as responsive as manometry for changes in PFM MVC and endurance. For measurement of PFM resting tone, sEMG seems more responsive than manometry, but this requires further investigation.

摘要

引言和假设

阴道表面肌电图(sEMG)常用于评估盆底肌(PFM)的功能和功能障碍,但关于评估特性的研究较少。本研究的目的是检验以下假设:与压力测量相比,sEMG 具有良好的测试-重测内部测试者可靠性、良好的标准效度和对变化的反应性。

方法

对 66 名患有盆底功能障碍的女性进行 PFM 静息张力、最大自主收缩(MVC)和耐力测量。首先进行一次压力测量,然后在基线时进行两次 sEMG 测试。在经过 4 至 42 周的监督 PFM 力量训练后,对 29 名参与者使用两种设备进行了重新测试。

结果

参与者的中位年龄为 41 岁(范围 24-83 岁),产次为 2 (范围 0-10)。所有三种 sEMG 测量均具有非常好的测试-重测内部测试者可靠性。sEMG 与压力测量之间的相关性对于阴道静息张力为中度(r=0.42,n=66,p<0.001),对于 MVC(r=0.66,n=66,p<0.001)和耐力(r=0.67,n=66,p<0.001)为强。经过力量训练期后,参与者的 MVC 和耐力均有所增加,通过压力测量进行测量,但通过 sEMG 进行测量则没有增加。仅通过 sEMG 发现静息张力显著降低。

结论

sEMG 可靠且与压力测量相关性良好。然而,与压力测量相比,sEMG 对于 PFM MVC 和耐力的变化反应性较差。对于 PFM 静息张力的测量,sEMG 似乎比压力测量更敏感,但这需要进一步研究。

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