Physical Examination Techniques for the Assessment of Pelvic Floor Myofascial Pain: A Systematic Review

Meister, Melanie; Shivakumar, Nishkala; Sutcliffe, Siobhan; Spitznagle, Theresa; Lowder, Jerry L.

doi:10.1097/01.ogx.0000554821.40095.69

Cited by 5 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Algological assessment is also important because possible myofascial pain is related to the severity of urinary incontinence and bowel symptoms such as the sensation of incomplete voiding 32,33 . Assessment of myofascial pain is outside the scope of nursing expertise in many countries; a practical discussion of assessment methods is given in a 2019 study cited in the bibliography of this article 34 .…”

Section: Resultsmentioning

confidence: 99%

Assessing the patient undergoing pelvic rehabilitation for urinary incontinence: From theory to practice

Terzoni

Federica

Ferrara

et al. 2021

Int J of Uro Nursing

View full text Add to dashboard Cite

Urinary incontinence is linked to pelvic floor dysfunction; the delicate balance between bones, muscles, tendons, and nerves is fundamental for continence and can be altered for numerous reasons, also linked to anatomical areas other than the pelvis. The assessment of the patient is at the basis of treatment choices; the literature reports the need to assess the patient's postural, respiratory, muscular and neurological components. To date, however, there are no studies that provide the nurse with a compendium of evidence in the form of a practical guide to assessment. To present literature evidence regarding the assessment of patients with urinary incontinence, undergoing pelvic conservative rehabilitation and to discuss the practical implications. This evaluation refers to the first contact with the patient and aims to understand how to set up the rehabilitation pathway and whether specific investigations or consultations are needed before starting rehabilitation. Narrative reviews of the literature on the PubMed, CINAHL, Cochrane Library, EMBASE, Scopus, Web of Science, PEDro database. We included studies published in the last 10 years, with no design restrictions, on the topic of assessment criteria for patients with urinary incontinence undergoing pelvic floor conservation rehabilitation, with regard to the role of the nurse. Thirty‐two references were retrieved including two systematic reviews. Assessment should focus on physical activity, bowel habits, spine and posture, nutrition and food habits, breathing and clinical history. Physical examination is aimed at (1) collecting data for establishing the correct rehabilitation programme and (2) excluding the need for evaluation/intervention by other healthcare professionals. Nurses play a key role in pelvic rehabilitation teams. Assessment and decision making about rehabilitation methods are complex tasks which require specialistic education. This paper summarizes the key points of both areas. Conservative rehabilitation of urinary incontinence requires a complex assessment in order to correctly set up the rehabilitation pathway. Aspects to be assessed include muscular, postural, respiratory, neurological and medical history. There are no works in the literature offering a compendium of the information to be considered. A complete overview of the evaluation phases and their characteristics including a practical description of the nursing assessment of the patient undergoing pelvic rehabilitation for urinary incontinence.

show abstract

Section: Resultsmentioning

confidence: 99%

Assessing the patient undergoing pelvic rehabilitation for urinary incontinence: From theory to practice

Terzoni

Federica

Ferrara

et al. 2021

Int J of Uro Nursing

View full text Add to dashboard Cite

show abstract

“…Although there has always been criticism of the low intra‐ and inter‐rater reliability of physical exams, 55 there are recent investigations into a standardized set of objective measures of physical exam for pelvic floor 56 . Another possibility is to use physical measures of pelvic floor dysfunction to supplement the outcomes, including the strength (eg dynamometer), tone (eg myotonometry) and pain threshold (eg algometer).…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin injection for chronic pelvic pain: A systematic review

Luo

Nasr-Esfahani

Jarrell

et al. 2020

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

show abstract

“…This review suggests that standardized physical vaginal examination of pelvic floor muscles to detect tenderness be utilized to detect PFMP with the addition of an algometer or pressure device not required to improve diagnostic capability. Physical examination to detect tenderness appears most practical [15,16] with good reported inter- [18][19][20][21][22] and intra-rater [18,19,22] reliability. PFMP may occur either as an isolated diagnosis or in conjunction with other conditions including musculoskeletal [32,33], gastrointestinal [34][35][36], genitourinary [31,[37][38][39], gynaecological [6,40,41] and persistent pelvic pain [20,42] conditions.…”

Section: Principal Findingsmentioning

confidence: 99%

“…This review revealed a number of diagnostic tests for assessing PFMP including dynamometer [66], surface electromyography [66,76], algometry [53], morphometry [77,78], manometry [76] and questionnaires [7,8,22]. A recent systematic review of physical examination techniques to detect PFMP included 55 studies, however, only two assessed the examination itself, with most included studies being clinical reviews and prevalence studies [15]. In contrast, our review only reviewed studies designed to assess diagnostic capabilities to detect PFMP compared with physical examination.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Whilst there is no consensus on diagnostic criteria for PFMP, physical vaginal examination is considered the reference standard test to assess PFMP as it is easy to perform [15,16] with tenderness on examination considered an uncommon finding in asymptomatic individuals [17]. Vaginal examination of pelvic floor muscles appears reproducible as an assessment tool with good inter- [18][19][20][21][22] and intra-rater [18,19,22] reliability being reported.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review of diagnostic tests to detect pelvic floor myofascial pain

et al. 2022

View full text Add to dashboard Cite

Introduction and hypothesis Myofascial pain arising from pelvic floor muscles occurs in women with vaginismus, interstitial cystitis and endometriosis but is often overlooked. The aim is to examine alternative diagnostic tests to detect pelvic floor myofascial pain compared with standardized vaginal palpation of pelvic floor muscles as the reference test. Methods A systematic review was prospectively conducted (PROSPERO-CRD42020183092) according to PRISMA guidelines. Databases searched included Ovid Medline 1946–, Embase 1957–, Scopus 1960–, Cochrane Combined, Clinical trials, Google Scholar (top 200 articles), Web of Science, TRIP, BIOSIS, DARE, CINHAL, EmCare, PEDro, ProQuest and EBSCOhost up to July 2020. Articles were independently screened by two authors and assessed for bias using QUASDAS-2 tool. Results A total of 26,778 articles were screened and 177 were selected for full text review, of which 5 were selected for final analysis. Five studies included 9694 participants of which 1628 had pelvic floor myofascial pain. Only one study reported data to calculate sensitivities and specificities of the index test, which utilized a score of > 40 on the Central Sensitization Inventory to detect women with pelvic floor myofascial pain and revealed a sensitivity of 34.8% and a specificity of 84.9% compared to the reference test. Conclusions This systematic review did not reveal any diagnostic test superior to the pre-defined reference test. There is a lack of consensus on the definition of pelvic floor myofascial pain and a lack of a validated diagnostic criteria which must be addressed to progress with meaningful research in this field.

show abstract

Physical Examination Techniques for the Assessment of Pelvic Floor Myofascial Pain: A Systematic Review

Cited by 5 publications

References 0 publications

Assessing the patient undergoing pelvic rehabilitation for urinary incontinence: From theory to practice

Assessing the patient undergoing pelvic rehabilitation for urinary incontinence: From theory to practice

Botulinum toxin injection for chronic pelvic pain: A systematic review

A systematic review of diagnostic tests to detect pelvic floor myofascial pain

Contact Info

Product

Resources

About