The Prognostic Value of the Surface Electromyographic Assessment of Pelvic Floor Muscles in Women with Stress Urinary Incontinence

Abstract

Background: The use of surface electromyography (sEMG) measurements to evaluate the bioelectrical activity of the pelvic floor muscle (PFM) during therapeutic intervention is now well established. This study investigates the diagnostic possibilities of sEMG in women with stress urinary incontinence (SUI). The aim of this study was to carry out objective assessments of the bioelectrical activity of the PFM in women after menopause and determine the prognostic value of sEMG for assessing the PFM in patients with SUI. Methods: This was a prospective, observational study that evaluated the bioelectrical activity of the PFM in postmenopausal women with or without SUI (SUI group, n = 89 vs. non-SUI group, n = 62). The study was carried out between January 2013 and December 2018 at the Clinic of Urology (Wroclaw, Poland). The protocol for all sEMG measurements of PFM activity consisted of following elements: “baseline”, “quick flicks”, “contractions”, “static hold”, and “rest tone”; we then compared these results between groups. To determine the optimal cutoff level for sEMG activation of the PFM to detect the occurrence of SUI, we performed receiver operating characteristic (ROC) curve analysis (with Youden’s index). Results: Significantly lower results were obtained for all PFM measurements in women with SUI. The optimum diagnostic cutoff for “baseline” was 3.7 μV (area under curve (AUC), 0.63), “quick flicks” was 9.15 μV (AUC, 0.84), “contractions” was 11.33 μV (AUC, 0.80), “static hold” was 9.94 μV (AUC, 0.84), and “rest” was 3.89 μV (AUC, 0.63). Conclusions: Measuring sEMG activity in the PFM may be a useful diagnostic tool to confirm the absence of SUI. We can expect that the sEMG activity of subjects with SUI will be lower than that of healthy people. In order to determine appropriate reference values for assessing sEMG activity data in the PFM, it is now necessary to conduct multicenter studies.

The effects of one‐time soft tissue therapy on pelvic floor muscle electromyographic signals in women with urinary incontinence: A randomized intervention trial

“…Observation of changes in EMG signal would be beneficial, especially in view of the results of studies by some authors who found lower electromyographic activity in women with UI compared with healthy women. 19 Thus, it appears that the existing dysfunction which is UI could be related to dysfunction also of the passive component of muscle tone, such as soft tissue stiffness and elasticity, as in the study by Barrasi et al 17 In this study, neuromuscular manual therapy and vibration were used to treat UI symptoms, flexibility, stiffness, and myofascial tone in 60 women aged 50-70 years. The intervention protocol included eight sessions of vibration therapy and manual techniques that resulted in significant changes in all parameters of flexibility and stiffness of the myofascial structures studied and treated.…”

“…Our results, as well as previous studies, indicate that manual therapy has no significant effect on the active component of muscle tone, that is, electromyographic activity. Observation of changes in EMG signal would be beneficial, especially in view of the results of studies by some authors who found lower electromyographic activity in women with UI compared with healthy women 19 . Thus, it appears that the existing dysfunction which is UI could be related to dysfunction also of the passive component of muscle tone, such as soft tissue stiffness and elasticity, as in the study by Barrasi et al 17 In this study, neuromuscular manual therapy and vibration were used to treat UI symptoms, flexibility, stiffness, and myofascial tone in 60 women aged 50–70 years.…”

“…6 However, currently, it is unknown whether a onetime session of STT of the muscles surrounding the PFM may have an impact on electromyographic signals of the PFM which differs women with UI from controls. 19 Our aim was therefore to investigate the immediate effect of one-time STT on PFM electromyographic signals in women with stress or mixed UI with predominant stress UI symptoms.…”

Multifunctional Evaluation Technology for Diagnosing Malfunctions of Regional Pelvic Floor Muscles Based on Stretchable Electrode Array Probe

“…Fifteen PSUI patients and fifteen postpartum asymptomatic women with matching personal information participated in the clinical trial. They conducted Glazer protocol [ 25 , 26 ] and we applied MET to comparing the evaluation parameters. Results showed that the PSUI patients had weaker PFM reactivity and strength than those of the health control group, and the type-I and type-II muscle dysfunctional regions are mostly located in the iliococcygeus, pubococcygeus, and urethral sphincter regions.…”

Assessment of the Elastographic and Electromyographic of Pelvic Floor Muscles in Postmenopausal Women with Stress Urinary Incontinence Symptoms

“…The weakening of the particular components of the pelvis and PF may lead to the occurrence of pathological symptoms associated with the deterioration of their function. Therefore, a proper diagnosis and therapeutic management play a crucial role in preventing and moderating the discussed dysfunctions, especially during menopause [4,[14][15][16][17][18][19].…”