Pelvic floor muscle tenderness in asymptomatic, nulliparous women: topographical distribution and reliability of a visual analogue scale

Kavvadias, Tilemachos; Pelikan, Stefanie; Roth, Petra; Baeßler, Kaven; Schuessler, Bernhard

doi:10.1007/s00192-012-1837-5

Cited by 21 publications

(16 citation statements)

References 11 publications

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“…For example, if the stiffness value was set at 462 N/m (mean of scale category 0: representing a “normal” muscle stiffness), participants assigned the stiffness value to anywhere between category −2 to +3 on the scale. Previous studies looking at repeatability of palpation scales in vivo have shown poor to moderate agreements, indicating the subjective nature of palpation …”

Section: Discussionmentioning

confidence: 95%

Is it time to rethink using digital palpation for assessment of muscle stiffness?

Davidson

Nielsen

Taberner

et al. 2019

Neurourology and Urodynamics

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Aim: Physiotherapists typically use digital palpation to determine residual tension in a muscle, referred to as muscle stiffness or tone. These assessments are subjective, and little is known about their accuracy or repeatability. Despite this, it is standard practice to base clinical treatment on these findings. The aim of this study was to assess physiotherapists' ability to assign a seven-point palpation scale to quantitative stiffness values generated by a novel device. Methods: Prospective observational study involving 125 musculoskeletal and pelvic floor physiotherapists. A novel device was developed that replicates the haptic feedback that clinicians assess as muscle stiffness. Measurements of displacement, force, and stiffness were recorded.Results: There was wide overlap between each scale category assigned to the stiffness values, from low stiffness at −3 (119 [106, 132] N/m) to moderate stiffness at 0 (462 [435,489] N/m); to high stiffness at +3 (897 [881,913] N/m). Consistency in applying the scale was poor, and the probability of a similar value of stiffness being assigned to the same scale category by different participants was low.Conclusions: While palpation is used globally by physiotherapists as a readily available and low-cost method of assessing muscle stiffness, these results indicate that it should be used with caution in diagnosing and defining patient care. Clinical assessment of muscle stiffness requires a validated and reliable palpation scale if this metric is to be used to diagnose pathology and develop treatment protocols. Training in this scale should then be recommended to improve reliability in patient assessment. K E Y W O R D S assessment, digital palpation, muscle stiffness, scale, tone

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Section: Discussionmentioning

confidence: 95%

Is it time to rethink using digital palpation for assessment of muscle stiffness?

Davidson

Nielsen

Taberner

et al. 2019

Neurourology and Urodynamics

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“…However, the responsiveness, reliability and validity of vaginal palpation for measurement of activation of the PFM have been challenged [23]. Kavvadias et al [24], investigating PFM tenderness of healthy nulliparous young women, found poor reliability while Reissing et al [9] found that palpation had almost perfect correspondence in discriminating between PVD and healthy controls. Our study showed no significant differences in sEMG between women with PVD and controls in resting or peak activity.…”

Section: Discussionmentioning

confidence: 99%

Pelvic floor muscle function in women with provoked vestibulodynia and asymptomatic controls

Næss

Bø

2015

Int Urogynecol J

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This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Naess, I., Bø, K. (2015). Pelvic floor muscle function in women with provoked vestibulodynia and asymptomatic controls. Young, nulliparous women with provoked vestibulodynia had higher vaginal resting pressure, but not higher vaginal surface EMG activity, pelvic floor muscle strength or endurance, than controls. Short version of title:Pelvic floor muscles function and provoked vestibulodynia Conclusion: Young, nulliparous women with PVD had significantly higher VRP, but this finding was not confirmed by vaginal surface EMG.

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“…FN31 Varying reliability has been found from pelvic floor muscle (PFM) studies assessing pain and tension using digital palpation scales. [73][74][75][76] Patients who present with alteration in the musculoskeletal structure need to be referred to a Physical Therapist well trained in the treatment of CPPS. FN32 Muscle tone is evaluated clinically as the resistance provided by a muscle when a pressure/deformation or a stretch is applied to it 46,77,78 Muscle tone may be altered in the presence or absence of pain.…”

Section: Musculoskeletalmentioning

confidence: 99%

“…Varying reliability has been found from pelvic floor muscle (PFM) studies assessing pain and tension using digital palpation scales …”

mentioning

confidence: 99%

A standard for terminology in chronic pelvic pain syndromes: A report from the chronic pelvic pain working group of the international continence society

Doggweiler

Whitmore

Meijlink

et al. 2016

Neurourology and Urodynamics

171

151

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Pelvic floor muscle tenderness in asymptomatic, nulliparous women: topographical distribution and reliability of a visual analogue scale

Abstract: Pain upon palpation of the pelvic floor muscle in asymptomatic, nulliparous women should be considered an uncommon finding.

Cited by 21 publications

References 11 publications

Is it time to rethink using digital palpation for assessment of muscle stiffness?

Is it time to rethink using digital palpation for assessment of muscle stiffness?

Pelvic floor muscle function in women with provoked vestibulodynia and asymptomatic controls

A standard for terminology in chronic pelvic pain syndromes: A report from the chronic pelvic pain working group of the international continence society

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