#524
Assessing Pelvic Floor Muscle Tone using Digital Palpation in Women with Provoked Vestibulodynia: Association and Comparison with Dynamometry and Ultrasound Imaging
Abuani S1, Dumoulin C2, Morin M1
1. Université de Sherbrooke and Research Center of the Centre hospitalier universitaire de Sherbrooke, 2. Université de Montréal and Research Center of the Institut universitaire de gériatrie de Montréal
KEYWORDS: Pelvic Floor, Pain, Pelvic/Perineal, Sexual Dysfunction , Outcomes Research Methods, Physiotherapy
Chronic vulvar pain or vulvodynia is a frequent chronic pain condition with a population prevalence rate as high as 7% to 16% by the age of 40. Provoked vestibulodynia (PVD), the most common type of vulvodynia, is characterized by a sharp, burning pain located at the entry of the vagina when applying pressure or attempting vaginal penetration. Alterations in pelvic floor muscle (PFM) function have been suggested to play a key role in the pathophysiology of PVD [1]. More notably, heightened PFM tone was demonstrated in women with PVD compared to asymptomatic controls using dynamometry and transperineal 3D/4D ultrasound [1]. Increased PFM tone is suspected to be a contributing factor in the development of vestibular pain as well as a perpetuating factor, which may exacerbate pain even further, due to increasing alterations of muscle tone. Primarily targeting PFM alterations, pelvic floor physiotherapy is recommended as an effective first line treatment for PVD. This highlights the relevance of PFM tone assessment in understanding the pathophysiology of PVD and evaluating the effects of treatment.
Most physiotherapists in clinical practice rely on digital palpation to assess PFM tone because it is easy to use and requires no equipment. Among the several scales available, the Reissing scale, consisting of a 7-level grade ranging from -3 (hypotonic) to +3 (hypertonic), was reported to have a good inter-rater reliability [2]. Despite the widespread use of this gradation system, the concurrent validity, evaluated by comparing the scale with other validated and objective instruments, has never been assessed. An in vitro study done recently has suggested that digital palpation may lack sensitivity amongst physiotherapists in assigning stiffness values to the tested 7-point Reissing scale [3]. While using an electromechanical instrument that aimed to replicate the stiffness perceived by the clinician, they found large variability and overlap in stiffness values on the 7-point scale. The study emphasized the relevance to carry out an in vivo study to examine the ability of physiotherapists to assess PFM tone using the Reissing palpation scale. The aim of the present study was to assess the validity of digital palpation in assessing tone using the Reissing Scale by 1) examining the association of palpation scores with dynamometry and 3D/4D transperineal ultrasound imaging in women with PVD; and 2) evaluating whether the palpation grade scale can be discriminated against dynamometry and ultrasound imaging.
Read the full abstract text here: https://www.ics.org/2020/abstract/524
Смотрите видео #524 онлайн без регистрации, длительностью часов минут секунд в хорошем качестве. Это видео добавил пользователь icstelevision 20 Ноябрь 2020, не забудьте поделиться им ссылкой с друзьями и знакомыми, на нашем сайте его посмотрели 5,569 раз и оно понравилось 27 людям.