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Advisor(s)
Abstract(s)
Hypothesis 3rd and 4th-degree perineal tears extend into or through the anal sphincter complex and may be associated with pelvic floor dysfunction. To date, there is scant knowledge of pelvic floor muscle (PFM) function after severe perineal tears. This study aimed to test the association between measurement with surface electromyography (sEMG) of the PFM and transperineal ultrasound of levator hiatus (LH) dimensions during maximum voluntary contraction (MVC) of the PFM in women with diagnosed 3rd and 4th-degree perineal tears. Study design, materials, and methods This was a cross-sectional study of 16 primi- and multiparous women, mean age 32.9 years (±7.8) with 3rd and 4th-degree perineal tears identified during and corrected after delivery. Both evaluations for each participant were conducted on the same day at the hospital birth clinic, an average of 16.7 months after delivery (range 4 -27). Before the assessments, women answered a questionnaire with sociodemographic and obstetric data, the ICIQ-UI-SF14, and were asked about AI symptoms. The ability to perform a correct PFM contraction was assessed by a physical therapist using vaginal palpation before sEMG and 3/4D transperineal ultrasound evaluation of LH dimensions (anteroposterior and transverse diameters; LH area) at rest and during MVC. sEMG was performed with a portable EMG biofeedback device, Physioplux Clinical, and the Periform intravaginal probe. To reduce crosstalk and ensure isolated contraction of the PFM, bipolar adhesive electrodes were unilaterally placed on the right rectus abdominal muscle and the right hip adductor muscle. Any activation of the gluteal muscles was controlled by visual observation. The 3D/4D transperineal ultrasound was performed with an empty bladder, in the dorsal lithotomy position, using the GE Voluson Expert 8 ultrasound with a 4-8 MHz curved array volume transducer, with an acquisition angle of 85 degrees. LH area, anteroposterior (AP), and transversal (TR) diameters were measured in the plane of minimal hiatal dimensions, defined as the minimal distance between the symphysis pubis and the anterior margin of the central aspect of the puborectalis muscle. Results MVC of the PFM measured through sEMG resulted in a signal amplitude of 23.3 ± 13.9 µV (peak) (range 4-50).
Description
Keywords
Physiotherapy Rehabilitation Severe perineal tear Surface electromyography
Citation
Pinto-Coelho M, Bø K, Henriques A, Mota P. Surface electromyography and three/four-dimension ultrasound assessment of the pelvic floor in women with severe perineal tear. In: ICS 2023, Toronto (Canada) September 27-29, 2023.