Department of Women's Health, Jinniu Maternity and Child Health Hospital of Chengdu, Cheng Du Shi, Si Chuan Sheng, China.
Department of Women's Health, Chengdu Women's and Children's Central Hospital, Cheng Du Shi, Si Chuan Sheng, China.
Medicine (Baltimore). 2023 May 26;102(21):e33851. doi: 10.1097/MD.0000000000033851.
To investigate the characteristics of pelvic floor surface electromyography parameters on the basis of Glazer assessment in women 42 days postpartum, and to analyze the predictive value of surface electromyography (sEMG) in postpartum stress urinary incontinence. This is a retrospective study. Three thousand twenty-nine females in total who were screened 42 days postpartum in Jinniu District Maternal and Children's Health Hospital of Chengdu from January 2019 to December 2020 were selected, and were randomly allocated into stress urinary incontinence (SUI) (n = 509) and the non-SUI group (n = 2520). Pelvic floor surface electromyography was performed by the same physiotherapists. The evaluation parameters included the average EMG value in the pre-resting baseline, the maximum sEMG value, the rising time, the descent time in the fast-twitch phase, and the average sEMG value in the slow-twitch phase. Mean value and modifiability of EMG value in post-resting stage. The disparities of the mentioned parameters hereinabove in the SUI and non-SUI groups were made comparison, and the relationship between stress urinary incontinence and sEMG parameters was analyzed by multiple logistic regression analysis. The prevalence of SUI was 16.8% in women 42 days after delivery. Body mass index and vaginal delivery were risk factors for SUI. Among the sEMG parameters of the SUI group and the non-SUI group, the maximum EMG values in the fast-twitch phase (28.81 ± 14.41 vs 30.41 ± 15.15), the rising time in the fast-twitch phase (0.55 ± 0.36 vs 0.51 ± 0.30), and the Phase descent time (0.76 ± 0.76 vs 0.68 ± 0.65), mean slow-twitch phase EMG (17.82 ± 10.10 vs 19.69 ± 15.62), slow-twitch phase variability (0.28 ± 0.12 vs 0.26 ± 0.10), are statistically different (P < .05). In the SUI group, body mass index (estimated parameter = 0.029, P = .023), mean EMG during slow-twitch phase (estimated parameter = -0.013, P = .004) were relevant to stress urinary incontinence after delivery. The sEMG based on Glazer protocol indicates the activity of slow-twitch muscle fibers in SUI patients are decreased, and there is a correlation with the occurrence of stress urinary incontinence. sEMG can be applied as a quantitative evaluation tool of the pelvic floor analysis in postpartum SUI.
基于 Glazer 评估,探讨产后 42 天女性盆底表面肌电图参数特征,并分析表面肌电图(sEMG)在产后压力性尿失禁中的预测价值。本研究为回顾性研究。纳入 2019 年 1 月至 2020 年 12 月在成都市金牛区妇幼保健院产后 42 天筛查的女性 3029 例,随机分为压力性尿失禁(SUI)组(n=509)和非 SUI 组(n=2520)。由同一名物理治疗师进行盆底表面肌电图检查。评估参数包括静息基线前的平均肌电图值、最大 sEMG 值、快肌上升时间、快肌下降时间和慢肌平均 sEMG 值。静息后阶段肌电图值的平均值和可变性。比较 SUI 组和非 SUI 组上述参数的差异,并通过多因素逻辑回归分析分析压力性尿失禁与 sEMG 参数的关系。产后 42 天女性 SUI 的患病率为 16.8%。体质量指数和阴道分娩是 SUI 的危险因素。在 SUI 组和非 SUI 组的 sEMG 参数中,快肌相的最大 EMG 值(28.81±14.41 vs 30.41±15.15)、快肌相上升时间(0.55±0.36 vs 0.51±0.30)和相下降时间(0.76±0.76 vs 0.68±0.65)、慢肌平均 EMG(17.82±10.10 vs 19.69±15.62)、慢肌相变异性(0.28±0.12 vs 0.26±0.10)差异有统计学意义(P<0.05)。在 SUI 组中,体质量指数(估计参数=0.029,P=0.023)、慢肌相平均 EMG(估计参数=-0.013,P=0.004)与产后压力性尿失禁相关。基于 Glazer 方案的 sEMG 表明,SUI 患者的慢肌纤维活动减少,与压力性尿失禁的发生相关。sEMG 可作为产后 SUI 盆底分析的定量评估工具。