Eletromiografia de superfície para avaliação dos músculos do assoalho pélvico feminino: revisão de literatura Evaluation of female pelvic floor muscles using surface electromyography: literature review

A eletromiografia de superfície tem grande importância clínica e de pesquisa para o fisioterapeuta. Apesar de captar a atividade elétrica promovida pelo recrutamento das unidades motoras, há boa correlação entre o número de unidades ativadas e a força muscular. É um dos métodos de maior especificidade na avaliação do assoalho pélvico, embora não haja consenso em relação à sua aplicação. Essa revisão de literatura foi desenvolvida com o objetivo de agrupar as informações sobre o uso da eletromiografia de superfície na avaliação do assoalho pélvico. Foram pesquisados artigos nas bases de dados Medline, PubMed, Lilacs, SciELO e Biblioteca Cochrane, e selecionados os que avaliassem o assoalho pélvico feminino por meio de eletromiografia de superfície. Apesar de sua metodologia ainda carecer de padronização, é um instrumento que deve ser considerado nas pesquisas científicas em nosso meio, pois parece apresentar boa reprodutibilidade e confiabilidade. Pacientes com disfunções do assoalho pélvico possuem alterações no tempo de ativação dos músculos do assoalho pélvico (MAP) e músculos abdominais. Quanto à gestação e puerpério, ainda faltam evidências sobre possíveis alterações da ativação elétrica dos MAP nesses períodos.<br>Surface electromyography has clinical and research importance for the physiotherapist. Although capturing electrical activity promoted by recruitment of motor units, there is a good correlation between the number of activated units and muscle strength. This is one of the methods of higher specificity in pelvic floor evaluation, although the lack of consensus regarding its application. The aim of this literature review was to cluster information regarding to the use of surface electromyography in the evaluation of pelvic floor. Papers were searched in Medline, Pubmed Lilacs, SciELO and Cochrane Library. Were selected papers which methods used surface electromyography to evaluate the pelvic floor. Although its methodology still lacks standardization, is an instrument that should be considered in scientific research in our country because it seems to have good reproducibility and reliability. Women with pelvic floor disorders have changes in the activation time of the pelvic floor muscles (PFM) and abdominal muscles. With respect to pregnancy and postpartum, there is a lack of evidence on possible changes in electrical activation of PFM in these periods

Pelvic floor muscle training for overactive bladder symptoms – A prospective study

Introduction: Pelvic floor muscle training (PFMT) involves the contraction of the puborectal, anal sphincter and external urethral muscles, inhibiting the detrusor contraction, what justify its use in the treatment of overactive bladder (OAB) symptoms. Objective: To verify the effects of isolated PFMT on the symptoms of OAB. Method: Prospective clinical trial with 27 women with mixed urinary incontinence (MUI), with predominance of OAB symptoms and loss >= 2 g in the pad test. It was evaluated: pelvic floor muscles (PFMs) function (digital palpation and manometry)urinary symptoms (nocturia, frequency and urinary loss)degree of discomfort of OAB symptomsand quality of life (Incontinence Quality-of-Life Questionnaire [I-QoL]). The PFMT program consisted of 24 outpatient sessions (2x/week + home PFMT). The Mann-Whitney and Wilcoxon tests (with a significance level of 5%) were used to analyse the data. Results: There was a significant improvement of the urinary symptoms to the pad test (5.8 +/- 9.7, p<0.001), urinary loss (0.7 +/- 1.1, p=0.005) and nocturia (0.8 +/- 0.9, p=0.011). Reduction in the degree of discomfort of urinary symptoms was observed according to OAB-V8 questionnaire (10.0 +/- 7.7, p=0.001). There were also significant results in PFMs function: Oxford (3.6 +/- 0.9, p=0.001), endurance (5.2 +/- 1.8, p<0.001), fast (8.9 +/- 1.5, p<0.001) and manometry (26.6 +/- 15.8, p=0.003). In addition, quality of life had a significant improvement in the three domains evaluated by I-QoL. Conclusion: The PFMT without any additional guidelines improves the symptomatology, the function of PFMs and the quality of life of women with OAB symptoms.Univ Fed Sao Paulo UNIFESP, Dept Gynecol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Gynecol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, EPM, Setor Uroginecol & Cirurgia Vaginal, Dept Gynecol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Gynecol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Gynecol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, EPM, Setor Uroginecol & Cirurgia Vaginal, Dept Gynecol, Sao Paulo, SP, BrazilWeb of Scienc

Correlation between maximum voluntary contraction and endurance measured by digital palpation and manometry: An observational study

Introduction: Digital palpation and manometry are methods that can provide information regarding maximum voluntary contraction (MVC) and endurance of the pelvic floor muscles (PFM), and a strong correlation between these variables can be expected. Objective: To investigate the correlation between MVC and endurance, measured by digital palpation and manometry. Method: Forty-two women, with mean age of 58.1 years (+/- 10.2), and predominant symptoms of stress urinary incontinence (SUI), were included. Examination was firstly conducted by digital palpation and subsequently using a Peritron manometer. MVC was measured using a 0-5 score, based on the Oxford Grading Scale. Endurance was assessed based on the PERFECT scheme. Results: We found a significant positive correlation between the MVC measured by digital palpation and the peak manometric pressure (r= 0.579, p< 0.001), and between the measurements of the endurance by Peritron manometer and the PERFECT assessment scheme (r= 0.559, p< 0.001). Conclusion: Our results revealed a positive and significant correlation between the capacity and maintenance of PFM contraction using digital and manometer evaluations in women with predominant symptoms of SUI.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Univ Fed Sao Paulo Unifesp, Dept Gynecol, Sao Paulo, SP, BrazilDepartment of Gynecology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, BrazilCNPq: 140190/2013-9Web of Scienc