Reliability and validity of pelvic floor muscle strength assessment using the MizCure perineometer

Yui Abe-Takahashi, Takeya Kitta, Mifuka Ouchi, Minori Okayauchi, Hiroki Chiba, Madoka Higuchi, Mio Togo, Nobuo Shinohara, Yui Abe-Takahashi, Takeya Kitta, Mifuka Ouchi, Minori Okayauchi, Hiroki Chiba, Madoka Higuchi, Mio Togo, Nobuo Shinohara

Abstract

Background: The purpose of this study was to clarify the reliability and validity of pelvic floor muscle (PFM) strength assessment using the MizCure perineometer in healthy women.

Methods: Twenty healthy women (age 20-45 years) participated in this study. The vaginal pressure measured using the MizCure and validated Peritron perineometers were repeated during PFM contraction in the supine and standing positions. All women were evaluated twice by examiners 1 and 2. Following the measurements in the first session (Test 1), they were repeated after an interval of between 2 and 6 weeks (Test 2). Within- and between-session intra- and inter-rater reliabilities in vaginal pressure were analyzed using intraclass correlation coefficients (ICC) (1, 1) and (2, 1), respectively. Validity was assessed by Pearson's product-moment correlation coefficient and Spearman's rank correlation analysis.

Results: Within-session intra-rater reliabilities for both examiners 1 and 2 for all vaginal pressures in Tests 1 and 2 were 0.90-0.96 for both perineometers. Between-session intra-rater reliability for the MizCure was 0.72-0.79 for both positions for examiner 1, and 0.63 in the supine position and 0.80 in the standing position for examiner 2. Inter-rater reliability for Test 1 was 0.91 in the supine position and 0.87 in the standing position for the MizCure. The vaginal pressures using the MizCure and Peritron were significantly associated with the supine position (r = 0.68, P < .001) and the standing position (rs = 0.82, P < .001).

Conclusion: MizCure perineometer is a validated tool to measure PFM strength in both supine and standing positions in healthy nulliparous women.

Keywords: MizCure; Pelvic floor muscles; Perineometer; Reliability; Vaginal pressure; Validity.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Perineometers used in this study: a Peritron 9300 perineometer (Laborie, Mississauga, ON, Canada) with a vaginal probe, 1: Perineometer's main body, 2: Diameter 26–33 (pressurized) mm, 3: Measurable length, 55 mm, 4: Length: 110 mm. b MizCure perineometer (OWOMED, Seoul, Korea) with a vaginal probe, 5: Perineometer's main body, 6: Diameter 21–27 (pressurized) mm, 7: Measurable length,50 mm, 8: Length 79 mm. These pictures were taken our devices in our institute. All rights reserved
Fig. 2
Fig. 2
Transperineal mid-sagittal plane ultrasound image in healthy women: At rest (a), during pelvic floor muscle contraction (b). Urogenital hiatus diameter was measured as the distance between the anorectal junction and the inferior border of the pubic symphysis (white double headed arrow). The levator ani muscle was determined based on the hyperechogenic region posterior to the anorectal junction. The correct pelvic floor muscle contraction indicated the cranial ventral displacement of the levator ani muscle, and urogenital hiatus diameter was shortened. A anus, B bladder, P pubic symphysis, R rectum

References

    1. Bø K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength. Phys Ther. 2005;85:269–282. doi: 10.1093/ptj/85.3.269.
    1. Laycock J, Jerwood D. Pelvic floor muscle assessment: the perfect scheme. Physiotherapy. 2001;87:631–642. doi: 10.1016/S0031-9406(05)61108-X.
    1. Frawley HC, Galea MP, Phillips BA, Sherburn M, Bø K. Reliability of pelvic floor muscle strength assessment using different test positions and tools. Neurourol Urodyn. 2006;25:236–242. doi: 10.1002/nau.20201.
    1. Morin M, Dumoulin C, Bourbonnais D, Gravel D, Lemieux MC. Pelvic floor maximal strength using vaginal digital assessment compared to dynamometric measurements. Neurourol Urodyn. 2004;23:336–341. doi: 10.1002/nau.20021.
    1. Sartori DVB, Gameiro MO, Yamamoto HA, Kawano PR, Guerra R, et al. Reliability of pelvic floor muscle strength assessment in healthy continent women. BMC Urol. 2015;15:29. doi: 10.1186/s12894-015-0017-6.
    1. Amaro JL, Moreira EC, De Oliveira Orsi Gameiro M, Padovani CR. Pelvic floor muscle evaluation in incontinent patients. Int Urogynecol J. 2005;16:352–354. doi: 10.1007/s00192-004-1256-3.
    1. Bø K, Finckenhagen HB. Is there any difference in measurement of pelvic floor muscle strength in supine and standing position? Acta Obstet Gynecol Scand. 2003;82:1120–1124. doi: 10.1046/j.1600-0412.2003.00240.x.
    1. Cacciari LP, Kruger J, Goodman J, Budgett D. Dumoulin C (2020) Reliability and validity of intravaginal pressure measurements with a new intravaginal pressure device: the FemFit®. Neurourol Urodyn. 2020;39:253–260. doi: 10.1002/nau.24179.
    1. Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29:213–240. doi: 10.1002/nau.20870.
    1. Rahmani N, Mohseni-Bandpei MA. Application of perineometer in the assessment of pelvic floor muscle strength and endurance: a reliability study. J Bodyw Mov Ther. 2011;15:209–214. doi: 10.1016/j.jbmt.2009.07.007.
    1. Ferreira CH, Barbosa PB, de Oliveira SF, Antônio FI, Franco MM, Bø K. Inter-rater reliability study of the modified Oxford Grading Scale and the Peritron manometer. Physiotherapy. 2011;97:132–138. doi: 10.1016/j.physio.2010.06.007.
    1. Yang SH, Huang WC, Yang SY, Yang E, Yang JM. Validation of new ultrasound parameters for quantifying pelvic floor muscle contraction. Ultrasound Obstet Gynecol. 2009;33:465–471. doi: 10.1002/uog.6338.
    1. Machin D, Campbell M, Fayers P, Pinol A. In sample size tables for clinical studies 2nd edn. In: Axford JS, editor. The correlation coefficient. Boston: Blackwell Science; 1997. pp. 168–173.
    1. Ouchi M, Kitta T, Suzuki S, Shinohara N, Kato K. Evaluating pelvic floor muscle contractility using two-dimensional transperineal ultrasonography in patients with pelvic organ prolapse. Neurourol Urodyn. 2019;38:1363–1369. doi: 10.1002/nau.23987.
    1. Laycock J. Clinical evaluation of the pelvic floor. In: Schussler B, Laycock J, Norton P, Stanton S, editors. Pelvic floor re-education. London: Springer; 1994. pp. 42–48.
    1. Sapsford RR, Hodges PW, Richardson CA, Cooper DH, Markwell SJ, Jull GA. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001;20:31–42. doi: 10.1002/1520-6777(2001)20:1<31::AID-NAU5>;2-P.
    1. Neumann P, Gill V. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13:125–132. doi: 10.1007/s001920200027.
    1. Braekken IH, Majida M, Engh ME, Bø K. Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol. 2010;203:170.e1–170.e7. doi: 10.1016/j.ajog.2010.02.037.
    1. Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018 doi: 10.1002/14651858.CD005654.pub4.
    1. Dumoulin C, Hunter KF, Moore K, Bradley CS, Burgio KL, Hagen S, et al. Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: summary of the 5th international consultation on incontinence. Neurourol Urodyn. 2016;35:15–20. doi: 10.1002/nau.22677.
    1. Vermandel A, De Wachter S, Beyltjens T, D'Hondt D, Jacquemyn Y, Wyndaele JJ. Pelvic floor awareness and the positive effect of verbal instructions in 958 women early postdelivery. Int Urogynecol J. 2015;26:223–228. doi: 10.1007/s00192-014-2483-x.
    1. Bø K. Pressure measurements during pelvic floor muscle contractions: the effect of different positions of the vaginal measuring device. Neurourol Urodyn. 1992;11:107–113. doi: 10.1002/nau.1930110205.
    1. Bø K, Finckenhagen HB. Vaginal palpation of pelvic floor muscle strength: inter-test reproducibility and comparison between palpation and vaginal squeeze pressure. Acta Obstet Gynecol Scand. 2001;80:883–887.
    1. Dougherty MC, Bishop KR, Mooney RA, Gimotty PA, Landy LB. Variation in intravaginal pressure measurements. Nurs Res. 1991;40:282–285. doi: 10.1097/00006199-199109000-00008.
    1. Guaderrama NM, Nager CW, Liu J, Pretorius DH, Mittal RK. The vaginal pressure profile. Neurourol Urodyn. 2005;24:243–247. doi: 10.1002/nau.20112.
    1. Cacciari LP, Pássaro AC, Amorim AC, Geuder M, Sacco ICN. Novel instrumented probe for measuring 3D pressure distribution along the vaginal canal. J Biomech. 2017;58:139–146. doi: 10.1016/j.jbiomech.2017.04.035.
    1. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174. doi: 10.2307/2529310.
    1. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126:1763–1768. doi: 10.1213/ANE.0000000000002864.
    1. Barbosa PB, Franco MM, Souza Fde O, Antônio FI, Montezuma T, Ferreira CH. Comparison between measurements obtained with three different perineometers. Clinics (Sao Paulo) 2009;64:527–533. doi: 10.1590/S1807-59322009000600007.
    1. Terry KK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15:155–163. doi: 10.1016/j.jcm.2016.02.012.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa