RESUMO
BACKGROUND: Although aging is considered a risk factor for pelvic floor muscle dysfunction (PFMD), the effect of aging on the function of the pelvic floor muscles (PFM) remains unclear. OBJECTIVE: To compare PFM function and activity in nulliparous women in different age groups. METHODS: This was a cross-sectional study in which 70 women with ages between 18 and 69 years were divided into five age groups for evaluation. Initially, medical histories were taken, and then the PFM function was assessed using digital palpation (Modified Oxford Scale), manometry and surface electromyography (sEMG). The Kruskal-Wallis test was applied to check the differences between the groups. The Spearman correlation coefficient was used to verify the correlations between age and PFM function, manometry values and sEMG. A significance level of 5% was adopted. RESULTS: No significant differences were observed between the different age groups in PFM digital palpation, manometry values and sEMG. There was a low negative correlation between age root mean square and peak of sEMG signals. CONCLUSION: This study found no difference in PFM function and activity between nulliparous women in the five different age groups. Future long-term large prospective studies are required to confirm these findings.
Assuntos
Fatores Etários , Eletromiografia , Músculo Esquelético/fisiologia , Diafragma da Pelve/fisiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Manometria , Pessoa de Meia-Idade , Palpação , Paridade , Distúrbios do Assoalho Pélvico , Adulto JovemRESUMO
Introdução: Diversas técnicas foram propostas para avaliação da musculatura do assoalho pélvico, porém, nenhum método mostrou-se capaz de medir as duas funções desses músculos: elevação e força de compressão. Na rotina de avaliação clínica é comumente empregada a palpação vaginal e, especialmente, o escore de Oxford modificado; entretanto, alguns trabalhos questionam a sensibilidade da escala de Oxford e sua correlação com medidas objetivas de força de contração muscular. Objetivo: neste estudo, propõe-se correlacionar as variáveis medidas na perineometria com o escore de Oxford modificado. Métodos: foram incluídas no estudo 45 pacientes com incontinência urinária que procuraram o ambulatório de Uroginecologia do Hospital de Clínicas de Porto Alegre. As pacientes foram submetidas à palpação vaginal, realizada por uma fisioterapeuta treinada na escala de Oxford, e a medição da força de compressão da musculatura pélvica por meio de balonete conectado a transdutor de pressão. As duas avaliações foram realizadas no mesmo dia. Resultados: encontrou-se correlação significativa (P <0,001) entre o escore de Oxford e as variáveis pressão máxima de contração e tempo de ativação muscular com coeficientes de Pearson de 0,69 e -0,532, respectivamente. Contudo, observa-se uma superposição entre as medidas perineométricas e do escore de Oxford entre categorias adjacentes. Conclusões: Os resultados mostram que apesar de estar incorporada a rotina clínica de avaliação, deve haver restrições quanto ao uso do escala de Oxford com propósitos científicos.
Background: Several techniques have been proposed for the assessment of pelvic floor muscles; however, none of them were able to measure the two main functions of these muscles: lifting and compressive force. Vaginal palpation and especially the Modified Oxford Scale (MOS) are frequently used during routine clinical evaluation, but some studies have questioned the sensitivity of the MOS and its correlation with objective measurements of muscle contraction force. Aim: the objective of this study is to correlate perineometry measurements with the MOS.Methods: Forty-five patients with urinary incontinence treated at the Urogynecology Outpatient Clinic of Hospital de Clínicas de Porto Alegre were included. The patients were submitted to vaginal palpation performed by a physical therapist trained in the MOS. The compression force of their pelvic muscles was measured by means of an air-filled ballonet connected to a pressure transducer. Both tests were carried out on the same day. Results: we found significant correlation (P < 0.001) between the MOS and the variables maximum contraction pressure andmuscular activation time with Pearson's coefficients of 0.69 and -0.532, respectively. However, we found overlapping results between the perineomtry measurements and the MOS scores in neighboring categories. Conclusions: these findings show that, although incorporated into routine clinical evaluation, there should be restrictions to the use of the MOS for scientific purposes.