Association of index finger palpatory assessment of pubovisceral muscle body integrity with MRI‐documented tear

Sheng, Ying; Low, Lisa Kane; Li, Xuefeng; Ashton‐Miller, James A.; Miller, Janis M.

doi:10.1002/nau.23967

Cited by 4 publications

(6 citation statements)

References 29 publications

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“…Suggested psychometrically sound methods to diagnose PFM tear include various clinical appraisal estimates using one or more fingers for palpatory assessment, MRI, and three-or four-dimensional (3D or 4D) ultrasound for imaging assessment [38][39][40][41][42][43][44][45][46]. Importantly, though PFMT targets this very muscle whether women had a tear was not assessed in any of the articles.…”

Section: Potential Impact Of a Pfm Tear On Theorized Mechanismsmentioning

confidence: 99%

Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review

et al. 2022

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Background Pelvic floor muscle training is recommended as first line treatment for urinary incontinence in women based on three proposed theorized mechanisms: ‘Enhanced Pelvic Floor Muscle Strength,’ ‘Maximized Awareness of Timing,’ and ‘Strengthened Core Muscles’. The purpose of this scoping review was to systematically map evidence for and against theorized mechanisms through which pelvic floor muscle training interventions work to reduce urinary incontinence in women. Methods The scoping review is based upon a comprehensive search of relevant literature published from 1990 to 2020 in PubMed, CINAHL, PsycINFO, ClinialTrials.gov, reference lists from review articles, and hand searches of articles by known researchers in the field. We included English-language, peer-reviewed articles on pelvic floor muscle training as an intervention for adult women if they provided empirical evidence to testing the theorized intervention mechanisms. Two independent reviewers screened articles for inclusion and extracted data to describe details of each study (author, year, country, design, sampling), measures of pelvic floor muscle strength and urinary incontinence, statistical analysis of linkage between changes in the measures, and pelvic floor muscle training regimens. Data were summarized to facilitate the integration of diverse evidence to draw conclusions on supporting or refuting the three proposed theorized mechanisms for managing urinary incontinence in women. Results Of the 278 articles identified with the search, 13 (4.7%) met inclusion criteria. There was weak to no evidence for the mechanism of enhanced pelvic floor muscle strength, equivocal support for maximized awareness of timing, and no evidence for strengthened core muscles. Conclusions This review revealed extremely limited data supporting the proposed theorized mechanisms underlying pelvic floor muscle training programs to manage urinary incontinence in women. Such evidence is needed to help women and clinicians understand how, why and when a woman benefits from pelvic floor muscle training. Future studies should specifically state and report statistical analysis that relates the theorized mechanisms to the training outcomes observed.

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Section: Potential Impact Of a Pfm Tear On Theorized Mechanismsmentioning

confidence: 99%

Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review

et al. 2022

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“…5,6 Measurement was simplified as the presence or absence of the PV muscle as a categorical outcome with the option for "equivocal" if the examiner was uncertain. 13 There is evidence that loss of PV muscle fibers (tear) indicates/or is associated with LUTS and prolapse. The RISE study will determine if a physical assessment estimate of PV loss is associated with measures of BH.…”

Section: Discussionmentioning

confidence: 99%

“…The PV muscle integrity assessment was included as an estimate of prior tear away from its origin (which is chronic) 5,6 . Measurement was simplified as the presence or absence of the PV muscle as a categorical outcome with the option for “equivocal” if the examiner was uncertain 13 . There is evidence that loss of PV muscle fibers (tear) indicates/or is associated with LUTS and prolapse.…”

Section: Discussionmentioning

confidence: 99%

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Comprehensive pelvic muscle assessment: Developing and testing a dual e‐Learning and simulation‐based training program

Newman

Lowder

Meister

et al. 2023

Neurourology and Urodynamics

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Objective: The Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium launched the RISE FOR HEALTH (RISE) national study of women's bladder health which includes annual surveys and an in-person visit. For the in-person exam, a standardized, replicable approach to conducting a pelvic muscle (PM) assessment was necessary. The process used to develop the training, the products, and group testing results from the education and training are described. Methods: A comprehensive pelvic muscle assessment (CPMA) program was informed by literature view and expert opinion. Training materials were prepared for use on an electronicLearning (e-Learning) platform. An in-person hands-on simulation and certification session was then designed. It included a performance checklist assessment for use by Clinical Trainers, who in

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“…PV muscle (also known as pubococcygeus) assessment are performed using a transvaginal palpation technique to assess muscle body integrity where it passes along the vaginal sidewall; both right and left sides are separately assessed and pain documented as: PV present (the muscle body is definitely felt), PV equivocal (the examiner cannot clearly and confidently feel the PV is present or absent) or PV absent (the muscle body is not felt). 7 PFM strength and endurance are assessed using a modified Oxford scale described by Newman et al [8][9][10][11] PFMP are assessed using the method described by Meister et al 12 The PFMP assessment evaluates the obturator internus (OI) and levator ani (LA) muscles for tenderness to palpation. Additional details are provided in companion manuscripts in this issue.…”

Section: • Menmentioning

confidence: 99%

The RISE FOR HEALTH study: Methods for in‐person assessment and biospecimen collection

Brubaker,

Barthold,

Fitzgerald

et al. 2022

Neurourology and Urodynamics

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Objectives To describe the methods for the in‐person assessment of the RISE FOR HEALTH (RISE) study, a population‐based multicenter prospective cohort study designed to identify factors that promote bladder health and/or prevent lower urinary tract symptoms in adult women, conducted by the Prevention of Lower Urinary Tract Symptoms Research Consortium (PLUS). Methods and results A subset of RISE participants who express interest in the in‐person assessment will be screened to ensure eligibility (planned n = 525). Eligible consenting participants are asked to complete 15 physical assessments in addition to height and weight, to assess pelvic floor muscle function, musculoskeletal (MSK) status, and pain, and to provide urogenital microbiome samples. Pelvic floor muscle assessments include presence of prolapse, strength, levator attachment integrity (tear) and myofascial pain. MSK tests evaluate core stability, lumbar spine, pelvic girdle and hip pain and function. Participants are asked to complete the Short Physical Performance Battery to measure balance, lower extremity strength, and functional capacity. All participants are asked to provide a voided urine sample and a vaginal swab for microbiome analyses; a subset of 100 are asked to contribute additional samples for feasibility and validation of a home collection of urinary, vaginal, and fecal biospecimens. Results Online and in‐person training sessions were used to certify research staff at each clinical center before the start of RISE in‐person assessments. Standardized protocols and data collection methods are employed uniformly across sites. Conclusions The RISE in‐person assessment is an integral portion of the overall population‐based RISE study and represents an innovative approach to assessing factors hypothesized to promote bladder health and/or prevent lower urinary tract symptoms. Data collected from this assessment will be used to prioritize future research questions and prevention strategies and interventions. This description of the assessment methods is intended to provide methodologic transparency and inform other researchers who join efforts to understand and improve bladder health.

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Association of index finger palpatory assessment of pubovisceral muscle body integrity with MRI‐documented tear

Cited by 4 publications

References 29 publications

Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review

Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review

Comprehensive pelvic muscle assessment: Developing and testing a dual e‐Learning and simulation‐based training program

The RISE FOR HEALTH study: Methods for in‐person assessment and biospecimen collection

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