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THE JOURNAL OF FEMALE
URINARY INCONTINENCE


Poster Section
 
 

Objective assessment of pelvic floor muscle strength in nulliparous women: correlations among different positions.

Gameiro MO*; Miraglia LS*; Muchailh RC*; Souza VO*; Sartori D;
Baldacin DC**; Amaro JL***
Botucatu  Medical School– BMS/ São Paulo State Univerisity-UNESP
* physiotherapist ** Medical Student ***Urogynecologist


ABSTRACT

INTRODUCTION: Pelvic floor (PF) muscle strength is usually performed in gynecological position, which is questioned by some investigators1,2.

OBJECTIVE: To assess PF muscle strength in different body positions.

PATIENTS AND METHODS: Fifty healthy nulliparous women with mean age of 23 years were studied. Personal data, clinical history, and body mass index (BMI) were obtained.
Perineometry with inflatable vaginal probe (Figure 1) was performed in each of four positions: supine with extended legs (P1); bent-knee supine (P2), sitting (P3) , and standing (P4)(Figure 2) during 3 pelvic floor contractions sustained for the longest possible.

 
RESULTS: Perineometry revealed that PF strength was 16, 15, 19 and 28 cmH2O in P1, P2, P3 and P4, respectively. Muscle strength was significantly higher in the sitting and standing positions than in other positions, and significantly higher in the standing position than in the sitting position. PF muscle contraction was sustained longer in the standing position than in the other positions studied (Table 1).

CONCLUSION:
PF muscle strength was significantly higher in the sitting and standing positions demonstrating the importance of assessing this measure in different positions in incontinent women given that urine loss most frequently occurs in the standing position.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

REFERENCES

  1. Bo K, Kavarstein B, Hagen RR, Larsen S. Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: II.Validity of vaginal pressure measurements of pelvicfloor muscle strength and the necessity of supplementary methods for control of correct contraction. Neurology and Urodynamics.2005; 9(5): 479-87.
  2. Thompson Ja, O´Sullivan PB, Briffa NK, Neumann P. Assessment of voluntary pelvic floor muscle contraction in continent and incontinent women using transperineal ultrasond, manual muscle testing and vaginal squeeze pressure measuements. Int Urogynecl J Pelvic Floor Dysfunct.2006; 17(6): 624-30.
  3. Madill SJ, McLean L. Relatioship Between Abdominal and Pelvic Floor Muscle Activation and Intravaginal Pressure During Pelvic Floor Muscle Contractions Healthy Continent Women. Neurourology and Urodynamics.2006; 25:722-30. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Figures

Figure 1.
Dynamed Perineometer
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 

 
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Figure 3.
Positions P1, P2, P3 and P4.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table

Table 1.Correlation between PF muscle strength and contraction time in different positions.
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P1

P2

P3

P4

p (value)

           

FM(cm H2O)

16a

15a

19b

28c

P<0,05

           

Sustaining time (seg)

7,26a

7,16a

7,68a

8,45b

P<0,05

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