Showing papers by "Kari Bø published in 2006"

Reliability of pelvic floor muscle strength assessment using different test positions and tools

Abstract: Aims The aims of this study were to determine the intra-therapist reliability for digital muscle testing and vaginal manometry on maximum voluntary contraction strength and endurance. In addition, we assessed how reliability varied with different tools and different testing positions. Methods Subjects included 20 female physiotherapists. The modified Oxford scale was used for the digital muscle testing, and the Peritron™ perineometer was used for the vaginal resting pressure and vaginal squeeze pressure assessments. Strength and endurance testing were performed. The highest of the maximum voluntary contraction scores was used in strength analysis, and a fatigue index value was calculated from the endurance repetitions. Bent-knee lying, supine, sitting, and standing positions were used. The time interval for between-session reliability was 2–6 weeks. Results Kappa values for the between-session reliability of digital muscle testing were 0.69, 0.69, 0.86, and 0.79 for the four test positions, respectively. Intra-class correlation coefficient (ICC) values for squeeze pressure readings for the four positions were 0.95, 0.91, 0.96, and 0.92 for maximum voluntary contraction, and 0.05, 0.42, 0.13, and 0.35 for endurance testing. ICC values for resting pressure were 0.74, 0.77, 0.47, and 0.29. Conclusions Reliability of digital muscle testing was very good in sitting and good in the other three positions. vaginal resting pressure demonstrated very good reliability in all four positions for maximum voluntary contraction, but was unreliable for endurance testing. Vaginal resting pressure was not reliable in upright positions. Both measurement tools are reliable in certain positions, with manometry demonstrating higher reliability coefficients. Neurourol. Urdynam. 25:236–242, 2006. © 2005 Wiley-Liss, Inc.

Can pelvic floor muscle training prevent and treat pelvic organ prolapse

Abstract: Background and methods. Pelvic floor muscle dysfunction may cause urinary and fecal incontinence, pelvic organ prolapse (POP), pain, and sexual disturbances. The aim of the present study is to review the literature on the effectiveness of pelvic floor muscle training (PFMT) to prevent and treat POP, and the possible theories and mechanisms on how PFMT could prevent or reverse prolapse. Results. No studies were found on prevention of POP. One uncontrolled study and one low-quality RCT were found in the treatment of prolapse. The results showed a positive effect of PFMT in severe, but not in mild prolapse. A review is presented of the main hypothesis of mechanisms on how PFMT may be effective. The two mechanisms are morphological changes occurring after strength training and use of a conscious contraction during increase in abdominal pressure in daily activities. Conclusions. In addition to the theory of functional anatomy and exercise science, one randomized controlled trial (RCT) is supportive for a positive effect of PFMT in the treatment of POP. There is an urgent need for more RCT with high methodological quality, use of valid and reproducible methods to assess degree of prolapse, and appropriate training protocols to evaluate the effect of PFMT in the prevention and treatment of POP.

Effect of test position on pelvic floor muscle assessment

Abstract: The aims of this study were to analyse the effect of different body positions on pelvic floor muscle (PFM) assessment using digital muscle testing, manometry and transabdominal ultrasound. In addition, subject acceptance of each testing position was recorded. Subjects were 20 women's health physiotherapists. The testing protocol included the best of three maximum voluntary contractions tested in each of four positions (crook lying, supine, sitting and standing). Significant differences in muscle strength and subject acceptance between positions were found with each tool, most often between lying and upright positions. Digital muscle testing and vaginal squeeze-pressure scores were highest in the lying position, and vaginal resting pressure and transabdominal ultrasound scores were highest in the standing position. Subjects preferred the lying positions for internal examinations. The clinical significance of these differences and the reasons for these variations require further investigation.

Do elite athletes experience low back, pelvic girdle and pelvic floor complaints during and after pregnancy?

Abstract: The aim of the present investigation was to study prevalence of low back pain, pelvic girdle pain (PGP) and pelvic floor disorders during pregnancy and after childbirth in elite athletes. A postal questionnaire was sent to all elite athletes who had given birth registered with The Norwegian Olympic Committee and Confederation of Sports (n=40). Eighty age-matched women served as the control group. The response rates were 77.5% and 57.5% in the elite athletes and control groups, respectively. There were no significant differences in the prevalence of low back and PGP, urinary or fecal incontinence among elite athletes and controls at any time point. The prevalence of low back pain without radiation to the leg in elite athletes was 25.8%, 18.5%, 9.7% and 29% the year before pregnancy, during pregnancy, 6 weeks postpartum and at the time of completing the questionnaire, respectively. The prevalence of PGP was 0, 29.6%, 12.9% and 19.4%. Prevalence of stress urinary incontinence was 12.9%, 18.5%, 29% and 35.5%. None of the elite athletes had fecal incontinence at any time point. There were no differences in mode of delivery or birthweight between elite athletes and controls. The elite athletes had a significantly lower body mass index at 6 weeks postpartum and at present compared with the control group.