Normative values for Glazer Protocol in the evaluation of pelvic floor muscle bioelectrical activity

Abstract

The aim of the study was to evaluate pelvic floor muscle bioelectrical activity in healthy, young, and nulliparous women, and to present normative values for all phases and parameters measured with the Glazer Protocol. In this study, 96 healthy, young, nulliparous women (age 22–27 years; 168.6 ± 5.1 cm; 57.1 ± 11.8 kg) were tested. The bioelectrical activity of the pelvic floor muscles was collected using an endovaginal electrode with the Glazer Protocol, which included the following series of muscles contractions and relaxations: pre-baseline rest, phasic contractions, tonic contractions, isometric contractions for muscle endurance evaluation, and post-baseline rest. The following normative values of the bioelectrical signal for all phases of the Glazer Protocol were calculated: mean, minimal, and maximal values, 95% confidence interval, standard deviation, 95% standard deviation confidence interval, variance, coefficient of variation, and standard error of measurement. Average Mean Amplitude (μV) was as follows: pre-baseline rest (6.26 ± 3.33 μV), phasic contractions (49.76 ± 26.44 μV), tonic contractions (37.05 ± 25.99 μV), endurance contraction (16.10 ± 6.68 μV), and post-baseline rest (6.93 ± 3.99 μV). This study was the first in which normative values for all phases of the Glazer Protocol were reported. This protocol is very often used in electromyography devices as a tool for pelvic floor muscle assessment. Due to the fact that the interpretation of the pelvic floor muscle evaluation is complex and difficult, the authors believe that the normative values proposed in this study allow for comprehensive interpretation of this test (both qualitatively and quantitatively) and provide a reference point for parameters measured in women with different pelvic floor dysfunctions.

The Rolf Method of Structural Integration and Pelvic Floor Muscle Facilitation: Preliminary Results of a Randomized, Interventional Study

“…The participants were randomly assigned to the groups in a 1:1 ratio. The following stage involved an assessment of PFM bioelectrical activity with the Glazer Protocol, which includes the series of pre-baseline rest, phasic contractions, tonic contractions, isometric contraction, and post-baseline rest [ 24 ]. Then, each participant of the SI group underwent ten sessions of SI intervention (1 session once a week, 60 min per each).…”

“…All parameters were measured in the supine and standing position. The measurement procedure was developed based on guidelines from the Surface EMG for Non-Invasive Assessment of Muscles (SENIAM) project and Glazer Protocol [ 24 , 25 ]: “pre-baseline rest” (10 s of PFM activity at rest before functional measurements), “phasic contraction” (10 s measurements, in which participants performed short, quick contractions of the PFM), “tonic contraction” (5 × 10 s contractions, in which the participants tried to contract the PFM and hold for 10 s), “isometric contraction” (in which the participants attempted to hold the PFM contractions for 60 s), and “post-baseline rest” (10 s of the PFM at rest after the functional measurements). The electromyographic signals were subjected to standard post hoc processing.…”

“…(3) the timing patterns of muscle activity were not too early, late, or asynchronous; (4) the PFM contractions were isolated from synergistic muscles [24]; or (5) the participant stopped breathing or performed a pelvic tilt or straining during the PFM contraction [27]. The sEMG measurement was recorded without eye control (without visualization of sEMG activity on the monitor screen) and with eye control for each participant.…”

Efficacy of Yun-Type Optimized Pelvic Floor Training Therapy for Middle-Aged Women With Severe Overactive Bladder: A Randomized Clinical Trial

“…The secondary endpoints were outcomes related to PFM function such as type I/II muscle strength and PFM tension as well as sexual function-associated outcomes such as FSFI, sexual desire, arousal, damp, orgasm, pain, and satisfaction. The PFM assessment was measured using the Glazer Protocol as previous described ( 22 ). These outcomes were measured before treatment and 6 weeks and 12/14 weeks after.…”

Effect of Epidural Analgesia on Pelvic Floor Dysfunction at 6 Months Postpartum in Primiparous Women: A Prospective Cohort Study

“…21 The sEMG was conducted through a Glazer protocol. 22 The participants in a supine position with their bladders emptied were asked to flex their hips and knees while their legs were supported to keep them relaxed. Then, a probe with a tiny diameter was inserted into the vagina, and the sensor was positioned on the lateral vaginal wall.…”