Rodrigues-de-Souza Daiana Priscila, Alcaraz-Clariana Sandra, García-Luque Lourdes, Carmona-Pérez Cristina, Garrido-Castro Juan Luis, Cruz-Medel Inés, Camargo Paula R, Alburquerque-Sendín Francisco
Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain.
Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, 14071 Córdoba, Spain.
Diagnostics (Basel). 2021 Dec 9;11(12):2315. doi: 10.3390/diagnostics11122315.
An analysis of the muscle mechanical properties (MMPs) of the pelvic floor muscles (PFMs) is relevant for understanding the physiopathology of urinary incontinence (UI). However, there is no objective and reliable methodology currently available for quantifying the MMPs of PFMs. Thus, the objective was to determine the intra-rater and inter-rater reliability of the MMPs of PFM assessment with a hand-held tonometer device, called the MyotonPRO, in young women with and without UI. Sociodemographic and pelvic floor questionnaires, plus MMPs of PFMs were assessed in 38 nulliparous women with UI and 40 matched healthy women by two trained physiotherapists on two different occasions, 48-72 h apart. Good to excellent absolute reliability was found for tone, stiffness, and decrement of both intra- and inter-rater analyses in both study groups (Intraclass Correlation Coefficient ranged from 0.75 to 0.92), with a trend of lower values for relaxation and creep. The standard error of measurement (SEM) did not achieve 10% of the mean values for any MMPs. The minimum detectable change (MDC) values were also provided for clinical applications. In conclusion, the relative reliability of tone, stiffness, and the assessment of the decrement of PFMs with MyotonPRO is good to excellent for UI and healthy women. The SEM and MDC values were acceptable for their application in clinical settings.
盆底肌肉（PFM）的肌肉力学特性（MMP）分析对于理解尿失禁（UI）的病理生理学具有重要意义。然而，目前尚无客观可靠的方法来量化PFM的MMP。因此，本研究的目的是确定在有和没有UI的年轻女性中，使用一种名为MyotonPRO的手持式眼压计设备评估PFM的MMP时，评估者内和评估者间的可靠性。38名患有UI的未生育女性和40名匹配的健康女性完成了社会人口统计学和盆底调查问卷，并由两名经过培训的物理治疗师在两次不同的时间（间隔48 - 72小时）对PFM的MMP进行了评估。在两个研究组中，评估者内和评估者间分析的肌张力、硬度和衰减的绝对可靠性均为良好至优秀（组内相关系数范围为0.75至0.92），松弛和蠕变值有降低趋势。任何MMP的测量标准误差（SEM）均未达到平均值的10%。还提供了最小可检测变化（MDC）值以供临床应用。总之，对于UI患者和健康女性，使用MyotonPRO评估PFM的肌张力、硬度和衰减的相对可靠性良好至优秀。SEM和MDC值在临床环境中的应用是可接受的。
