Reliability of ultrasound imaging of pelvic floor morphology and function among females who have undergone pelvic radiotherapy

Bernard, Stéphanie; Frenette, Anne-Gabrielle; McLean, Linda; Noël, Patricia; Froment, Marie-Anne; Hébert, Luc J.; Moffet, Hélène

doi:10.1002/nau.24656

Cited by 4 publications

(2 citation statements)

References 41 publications

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“…Ultrasound imaging was then used to assess PFM morphology. Using an Aplio 500 with a twodimensional 3-7-Mhz curved-array transducer, measures of the levator plate length were made in the mid-sagittal plane with the PFMs at rest, during an MVC and during a maximal Valsalva maneuver, and urethral length was measured at rest, as described elsewhere [21].…”

Section: Discussionmentioning

confidence: 99%

An in-home rehabilitation program for the treatment of urinary incontinence symptoms in endometrial cancer survivors: a single-case experimental design study

et al. 2021

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Introduction and hypothesis There is a high prevalence of urinary incontinence among endometrial cancer survivors. They are also known to present with pelvic floor muscle alterations. Evidence on the effects of conservative interventions for the management of UI is scarce. This study aims at verifying the effects of an in-home rehabilitation program, including the use of a mobile technology, to reduce UI severity in endometrial cancer survivors. Methods This study used a single-case experimental design with replications. Primary outcome for UI severity was the pad test, and secondary outcomes were the ICIQ-UI SF questionnaire and 3-day bladder diary. Pelvic floor muscle function was assessed using 2D-transperineal ultrasound and intravaginal dynamometry. Adherence was documented using mobile technology and an exercise log. Visual and non-parametric analyses of longitudinal data were conducted. Results Results show a reduction in UI severity for 87.5% of participants, with a significant relative treatment effect of moderate size (RTE: 0.30). Significant small relative treatment effects were found for the quick contraction and endurance dynamometric tests. Conclusion This study provides new evidence that endometrial cancer survivors can improve the severity of their UI following an in-home rehabilitation program, including the use of a mobile technology. This mode of delivery has the potential to address a gap in access to pelvic floor physiotherapy services for survivors of EC living in rural and remote communities.

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Section: Discussionmentioning

confidence: 99%

An in-home rehabilitation program for the treatment of urinary incontinence symptoms in endometrial cancer survivors: a single-case experimental design study

et al. 2021

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“…In a study measuring the inter‐ and intra‐rater reliability of 2D TPUS, Bernard et al. found a standard error measure of the APD at rest to be 1.5 mm between two raters 14 . Given that no movement could also be defined as a resting state, this information was assumed to be transferable.…”

Section: Methodsmentioning

confidence: 99%

Assessment of the bearing‐down manoeuvre in pregnancy and detection of paradoxical levator ani muscle contraction using 2D transperineal ultrasound and vaginal palpation: a concurrent validity and inter‐rater reliability study

Murdoch‐Ward,

Nahon,

De‐Vitry Smith

et al. 2023

BJOG

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ObjectiveTo examine the concurrent validity and inter‐rater reliability of vaginal palpation as a measure of the quality of the bearing‐down manoeuvre (BDM) and the detection of a paradoxical levator ani muscle contraction (LAM) in pregnant women, compared with 2D transperineal ultrasound (TPUS).DesignConcurrent validity and inter‐rater reliability study.SettingPhysiotherapy clinic.PopulationTwenty pregnant women in their third trimester.MethodsThe anterior posterior diameter (APD) was measured during the BDM using TPUS by one experienced physiotherapist. An APD that shortened by >2 mm from rest was described as LAM shortening, an APD that moved by 0–2 mm was described as no change and an APD that lengthened by >2 mm was described as LAM lengthening. Vaginal palpation described the LAM during the BDM as no movement, shortening or lengthening. Participants were allowed two attempts and the best attempt was measured.Main outcome measuresAPD using TPUS and the assessor's subjective description of LAM during the BDM using vaginal palpation.ResultsTPUS detected more paradoxical LAM contractions during the BDM than palpation. Agreement between vaginal palpation and TPUS assessment for BDM was poor. The Fleiss kappa coefficients were 0.457 (90% CI 0.16–0.71) between TPUS and one assessor and 0.326 (90% CI 0.01–0.6) between TPUS and the other assessor. In addition, inter‐rater reliability was poor between observers palpating the BDM, with a Fleiss kappa coefficient of 0.375 (90% CI 0.13–0.64).ConclusionsThis study did not find vaginal palpation of the BDM in pregnant women to have concurrent validity or inter‐rater reliability. Clinicians should be aware of potential inaccuracies when palpating the BDM, and, where possible, seek an assessment via TPUS.

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Evidence for increased tone or overactivity of pelvic floor muscles in pelvic health conditions: a systematic review

Worman

Stafford

Cowley

et al. 2023

American Journal of Obstetrics and Gynecology

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Reliability of ultrasound imaging of pelvic floor morphology and function among females who have undergone pelvic radiotherapy

Cited by 4 publications

References 41 publications

An in-home rehabilitation program for the treatment of urinary incontinence symptoms in endometrial cancer survivors: a single-case experimental design study

An in-home rehabilitation program for the treatment of urinary incontinence symptoms in endometrial cancer survivors: a single-case experimental design study

Assessment of the bearing‐down manoeuvre in pregnancy and detection of paradoxical levator ani muscle contraction using 2D transperineal ultrasound and vaginal palpation: a concurrent validity and inter‐rater reliability study

Evidence for increased tone or overactivity of pelvic floor muscles in pelvic health conditions: a systematic review

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