The Reliability of Pelvic Floor Muscle Bioelectrical Activity (sEMG) Assessment Using a Multi-Activity Measurement Protocol in Young Women
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Procedures
The sEMG Measurement
- One 60-s rest (pre-baseline).
- Five phasic (flick) contractions (2-s contraction with a 2-s rest in-between).
- Five phasic (flick) contractions (2-s contraction with a 10-s rest in-between).
- Five 10-s tonic contractions, with a 10-s rest in-between.
- One 60-s endurance contraction.
- One 60-s rest (post-baseline).
- One 60-s rest (pre-baseline)—the women were instructed to feel the PFM in rest.
- Five phasic (flick) contractions—the women were instructed to contract the PFM as quickly as possible (2-s contraction with a 2-s rest in-between).
- Five 10-s tonic contractions, with a 10-s rest in-between—the women were instructed to contract the PFM as strongly as possible, hold the contraction for 10 s, and then fully relax the PFM after contraction remaining relaxed for 10 s.
- One 60-s endurance contraction—the women were instructed to contract the PFM at such a level as to hold it for 60 s.
- One 60-s rest (post-baseline)—the women were instructed to feel the PFM in rest.
- One 60-s rest (pre-baseline):
- Average mean amplitude (μV)
- Mean amplitude variability (%)
- Five 2-s phasic (flick) contractions with 2-s rest in-between:
- Average peak amplitude (μV)—the result was the mean value from 5 contractions.
- Time before peak (s)—the result was the mean value from 5 contractions.
- Time after peak (s)—the result was the mean value from 5 contractions.
- Five 10-s tonic contractions, with a 10-s rest in-between:
- Average mean amplitude (μV)—the result was the mean value from 5 contractions.
- Average peak amplitude (μV)—the result was the mean value from 5 contractions.
- Time before peak (s)—the result was the mean value from 5 contractions.
- Time after peak (s)—the result was the mean value from 5 contractions.
- One 60-s endurance contraction:
- Median frequency (Hz)
- Average mean amplitude (μV)
- Mean amplitude variability (%)
- One 60-s rest (post-baseline):
- Average mean amplitude (μV)
- Mean amplitude variability (%)
- One 60-s rest (pre-baseline—divided into 3 intervals: I-5s, II-5s, III-50s)—the women were instructed to feel the PFM in rest.
- Five 2-s phasic (flick) contractions, with a 10-s rest in-between—the women were instructed to contract the PFM as quickly as possible, and then quickly and fully relax the PFM immediately after contraction.
- Five 10-s tonic contractions, with a 10-s rest in-between—the women were instructed to contract the PFM as strongly as possible, hold the contraction for 10 s, and then fully relax the PFM after contraction remaining relaxed for 10 s.
- One 60-s endurance contraction—the women were instructed to contract the PFM at such a level as to hold it for 60 s.
- One 60-s rest (post-baseline)—the women were instructed to feel the PFM in resting position.
- One 60-s rest (pre-baseline):
- Average mean amplitude (μV)—the value was calculated separately for each of the 3 intervals: I-5s, II-5s, III-50s.
- Mean amplitude variability (%)—the value was calculated separately for each of the 3 intervals: I-5s, II-5s, III-50s.
- Five 2-s phasic (flick) contractions with 10-s rest in-between:
- Average peak amplitude from contraction phase (μV)—the result was the mean value from 5 contractions.
- Onset to offset time (s) (contraction duration)—the result was the mean value from 5 contractions.
- Average mean amplitude from rest in-between phase (μV)—the result was the mean value from 5 rests.
- Onset to peak time (s) (time of amplitude increase)—the result was the mean value from 5 contractions.
- Peak to offset time (s) (time of amplitude decrease)—the result was the mean value from 5 contractions.
- Five 10-s tonic contractions, with a 10-s rest in-between:
- Average mean amplitude (μV)—the result was the mean value from 5 contractions.
- Mean amplitude variability (%)—the result was the mean value from 5 contractions.
- Median frequency (Hz)—the result was the mean value from 5 contractions.
- Mean frequency (Hz)—the result was the mean value from 5 contractions.
- One 60-s endurance contraction:
- Median frequency (Hz)—the result was the mean value from 6 intervals lasting 10 s each.
- Mean frequency (Hz)—the result was the mean value from 6 intervals lasting 10 s each.
- Average mean amplitude (μV)—the result was the mean value from 6 intervals lasting 10 s each.
- Mean amplitude variability (%)—the result was the mean value from 6 intervals lasting 10 s each.
- One 60-s rest (post-baseline):
- Average mean amplitude (μV)
- Mean amplitude variability (%)
2.3. Statistical Analysis
3. Results
3.1. The Glazer sEMG Protocol
3.1.1. Between-Trial Reliability
3.1.2. Between-Day Reliability
3.2. Our Multi-Activity sEMG Protocol
3.2.1. Between-Trial Reliability
3.2.2. Between-Day Reliability
4. Discussion
5. Conclusions
Clinical Perspectives
- There is a lack of studies in which the reliability of PFM sEMG assessment would be comprehensively evaluated. The purpose of this study was to determine the between-trial and between-day reliability of the multi-activity sEMG measurement protocol for PFM clinical evaluation with the broad aspect of muscle contraction and full signal processing standardisation.
- The higher reliability of our sEMG protocol compared to original Glazer protocol allowed us to suggest that protocol modifications and changes in sEMG signal processing methods were effective in the improvement of PFM assessment quality. The new parameters calculated from the sEMG signal that were proposed in our sEMG protocol allowed us to obtain additional clinically important information about PFM dysfunctions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Outcome Measure | ICC | r | Mean ± SD (1) | CV (%) (1) | Mean ± SD (2) | CV (%) (2) |
---|---|---|---|---|---|---|
Rest (pre-baseline)—average mean (μV) | 0.83 | 0.72 * | 7.09 ± 3.9 | 55.6 | 6.13 ± 3.8 | 62.0 |
Rest (pre-baseline)—variability (%) | 0.37 | 0.47 * | 10.9 ± 3.5 | 32.2 | 10.5 ± 3.1 | 30.2 |
Flick contractions—average peak (μV) | 0.81 | 0.69 * | 55.2 ± 32.1 | 58.2 | 51.4 ± 35.4 | 68.7 |
Flick contractions—time before peak (s) | 0.05 | 0.18 | 0.27 ± 0.10 | 36.9 | 0.29 ± 0.1 | 38.0 |
Flick contractions—time after peak (s) | 0.08 | 0.11 | 0.35 ± 0.17 | 50.4 | 0.36 ± 0.1 | 45.8 |
Tonic contractions—average mean (μV) | 0.72 | 0.59 * | 39.6 ± 25.7 | 64.9 | 34.9 ± 27.8 | 79.6 |
Tonic contractions—average peak (μV) | 0.73 | 0.64 * | 47.4 ± 30.5 | 64.4 | 42.6 ± 33.6 | 78.9 |
Tonic contractions—time before peak (s) | 0.12 | 0.07 | 1.33 ± 1.35 | 101.2 | 1.2 ± 0.9 | 78.1 |
Tonic contractions—time after peak (s) | 0.70 | 0.80 * | 0.68 ± 0.69 | 101.4 | 0.69 ± 0.5 | 74.8 |
Endurance contraction—median frequency (Hz) | 0.19 | 0.13 | 59.0 ± 13.3 | 22.6 | 65.0 ± 18.2 | 92.1 |
Endurance contraction—average mean (μV) | 0.95 | 0.91 * | 17.3 ± 9.06 | 52.2 | 16.9 ± 9.6 | 56.6 |
Endurance contraction—variability (%) | 0.81 | 0.72 * | 17.08 ± 4.5 | 32.3 | 20.29 ± 8.9 | 44.0 |
Rest (post-baseline)—average mean (μV) | 0.95 | 0.90 * | 7.86 ± 4.3 | 55.0 | 7.68 ± 4.3 | 56.5 |
Rest (post-baseline)—variability (%) | 0.68 | 0.52 * | 17.5 ± 14.1 | 84.0 | 16.4 ± 12.9 | 84.3 |
Outcome Measure | ICC | r | Mean ± SD (1) | CV (%) (1) | Mean ± SD (2) | CV (%) (2) |
---|---|---|---|---|---|---|
Rest (pre-baseline)—average mean (μV) | 0.80 | 0.68 * | 7.09 ± 3.9 | 55.6 | 6.19 ± 3.65 | 59.0 |
Rest (pre-baseline)—variability (%) | 0.39 | 0.39 | 10.9 ± 3.5 | 32.2 | 10.4 ± 2.9 | 27.8 |
Flick contractions—average peak (μV) | 0.51 | 0.41 | 55.2 ± 32.1 | 58.2 | 47.5 ± 27.74 | 58.3 |
Flick contractions—time before peak (s) | 0.08 | 0.08 | 0.27 ± 0.10 | 36.9 | 0.28 ± 0.10 | 36.0 |
Flick contractions—time after peak (s) | 0.10 | 0.12 | 0.35 ± 0.17 | 50.4 | 0.37 ± 0.17 | 45.7 |
Tonic contractions—average mean (μV) | 0.54 | 0.37 | 39.6 ± 25.7 | 64.9 | 33.8 ± 23.9 | 72.4 |
Tonic contractions—average peak (μV) | 0.59 | 0.42 * | 47.4 ± 30.5 | 64.4 | 40.4 ± 29.1 | 71.9 |
Tonic contractions—time before peak (s) | 0.14 | 0.11 | 1.33 ± 1.35 | 101.2 | 1.34 ± 1.37 | 102.2 |
Tonic contractions—time after peak (s) | 0.70 | 0.76 * | 0.68 ± 0.69 | 101.4 | 1.02 ± 1.01 | 98.2 |
Endurance contraction—median frequency (Hz) | 0.16 | 0.11 | 59.0 ± 13.3 | 22.6 | 62.2 ± 21.0 | 94.3 |
Endurance contraction—average mean (μV) | 0.76 | 0.64 * | 17.3 ± 9.06 | 52.2 | 17.42 ± 11.0 | 63.1 |
Endurance contraction—variability (%) | 0.44 | 0.28 | 17.08 ± 4.5 | 32.3 | 18.29 ± 5.7 | 31.2 |
Rest (post-baseline)—average mean (μV) | 0.77 | 0.63 * | 7.86 ± 4.3 | 55.0 | 6.66 ± 3.7 | 55.0 |
Rest (post-baseline)—variability (%) | 0.68 | 0.68 * | 17.5 ± 14.1 | 84.0 | 13.4 ± 7.9 | 59.0 |
Outcome Measure | ICC | r | Mean ± SD (1) | CV (%) (1) | Mean ± SD (2) | CV (%) (2) |
---|---|---|---|---|---|---|
Rest (pre-baseline) phase 1—average mean (μV) | 0.83 | 0.72 * | 7.36 ± 3.93 | 53.4 | 5.94 ± 3.74 | 63.0 |
Rest (pre-baseline) phase 2—average mean (μV) | 0.89 | 0.82 * | 7.07 ± 4.01 | 56.8 | 5.97 ± 3.73 | 62.5 |
Rest (pre-baseline) phase 3—average mean (μV) | 0.89 | 0.81 * | 7.06 ± 3.98 | 56.3 | 6.16 ± 3.82 | 61.9 |
Rest (pre-baseline) phase 1—variability (%) | 0.22 | 0.14 | 10.29 ± 3.91 | 38.0 | 9.80 ± 3.29 | 33.6 |
Rest (pre-baseline) phase 2—variability (%) | 0.54 | 0.56 | 10.38 ± 5.24 | 50.5 | 8.78 ± 3.26 | 37.1 |
Rest (pre-baseline) phase 3—variability (%) | 0.38 | 0.48 | 10.55 ± 3.27 | 31.0 | 10.19 ± 3.08 | 30.2 |
Flick contractions—average peak from contraction (μV) | 0.85 | 0.71 * | 57.66 ± 27.3 | 47.3 | 47.73 ± 27.8 | 58.3 |
Flick contractions—time onset to offset (s) | 0.91 | 0.85 * | 0.91 ± 0.38 | 42.0 | 0.94 ± 0.41 | 43.3 |
Flick contractions—average mean from rest in-between (μV) | 0.94 | 0.81 * | 8.20 ± 3.87 | 47.2 | 6.71 ± 3.91 | 58.2 |
Flick contractions—time onset to peak (s) | 0.85 | 0.77 * | 0.36 ± 0.13 | 37.2 | 0.38 ± 0.14 | 37.8 |
Flick contractions—time peak to offset (s) | 0.86 | 0.77 * | 0.51 ± 0.24 | 48.5 | 0.52 ± 0.25 | 47.9 |
Tonic contractions—average mean (μV) | 0.73 | 0.58 * | 30.7 ± 16.4 | 53.6 | 29.0 ± 15.0 | 51.7 |
Tonic contractions—average mean frequency (Hz) | 0.81 | 0.71 * | 88.6 ± 13.8 | 16.8 | 90.2 ± 17.7 | 19.6 |
Tonic contractions—average median frequency (Hz) | 0.86 | 0.79 * | 71.9 ± 12.1 | 16.8 | 73.3 ± 16.3 | 22.2 |
Tonic contractions—variability (%) | 0.83 | 0.82 * | 15.10 ± 3.6 | 24.0 | 14.5 ± 3.3 | 23.1 |
Endurance contraction—median frequency (Hz) | 0.80 | 0.79 * | 62.1 ± 11.7 | 18.8 | 62.2 ± 12.8 | 20.6 |
Endurance contraction—mean frequency (Hz) | 0.82 | 0.71 * | 79.88 ± 13.6 | 17.1 | 79.96 ± 12.8 | 16.1 |
Endurance contraction—average mean (μV) | 0.80 | 0.67 * | 16.34 ± 5.06 | 49.2 | 16.9 ± 7.6 | 47.3 |
Endurance contraction—variability (%) | 0.81 | 0.84 * | 16.10 ± 3.2 | 28.0 | 17.5 ± 3.1 | 26.3 |
Rest (post-baseline)—average mean (μV) | 0.95 | 0.90 * | 7.86 ± 4.3 | 55.0 | 7.68 ± 4.3 | 56.5 |
Rest (post-baseline)—variability (%) | 0.68 | 0.52 * | 17.5 ± 14.1 | 84.0 | 16.4 ± 12.9 | 84.3 |
Outcome Measure | ICC | r | Mean ± SD (1) | CV (%) (1) | Mean ± SD (2) | CV (%) (2) |
---|---|---|---|---|---|---|
Rest (pre-baseline) phase 1—average mean (μV) | 0.78 | 0.65 * | 7.36 ± 3.93 | 53.4 | 6.18 ± 3.63 | 58.7 |
Rest (pre-baseline) phase 2—average mean (μV) | 0.78 | 0.66 * | 7.07 ± 4.01 | 56.8 | 6.29 ± 3.74 | 59.4 |
Rest (pre-baseline) phase 3—average mean (μV) | 0.80 | 0.68 * | 7.06 ± 3.98 | 56.3 | 6.18 ± 3.66 | 59.1 |
Rest (pre-baseline) phase 1—variability (%) | 0.29 | 0.26 | 10.29 ± 3.91 | 38.0 | 9.07 ± 3.12 | 34.4 |
Rest (pre-baseline) phase 2—variability (%) | 0.54 | 0.59 | 10.38 ± 5.24 | 50.5 | 8.42 ± 2.63 | 31.2 |
Rest (pre-baseline) phase 3—variability (%) | 0.47 | 0.39 | 10.55 ± 3.27 | 31.0 | 9.99 ± 2.37 | 23,7 |
Flick contractions —average peak from contraction (μV) | 0.62 | 0.44 * | 57.66 ± 27.3 | 47.3 | 43.79 ± 27.5 | 62.8 |
Flick contractions—time onset to offset (s) | 0.90 | 0.82 * | 0.91 ± 0.38 | 42.0 | 0.97 ± 0.45 | 46.3 |
Flick contractions—average mean from rest in-between (μV) | 0.80 | 0.50 * | 8.20 ± 3.87 | 47.2 | 6.04 ± 3.89 | 64.4 |
Flick contractions—time onset to peak (s) | 0.64 | 0.52 * | 0.36 ± 0.13 | 37.2 | 0.33 ± 0.10 | 30.6 |
Flick contractions—time peak to offset (s) | 0.66 | 0.68 * | 0.51 ± 0.24 | 48.5 | 0.59 ± 0.28 | 48.1 |
Tonic contractions—average mean (μV) | 0.69 | 0.53 * | 30.7 ± 16.4 | 53.6 | 27.4 ± 21.9 | 79.8 |
Tonic contractions—average mean frequency (Hz) | 0.63 | 0.55 * | 88.6 ± 13.8 | 16.8 | 84.9 ± 13.9 | 16.4 |
Tonic contractions—average median frequency (Hz) | 0.75 | 0.68 * | 71.9 ± 12.1 | 16.8 | 69.0 ± 17.1 | 24.8 |
Tonic contractions—variability (%) | 0.56 | 0.51 * | 15.10 ± 3.6 | 24.0 | 14.1 ± 3.8 | 27.1 |
Endurance contraction—median frequency (Hz) | 0.61 | 0.66 * | 62.1 ± 11.7 | 18.8 | 57.7 ± 11.7 | 20.4 |
Endurance contraction—mean frequency (Hz) | 0.73 | 0.68 * | 79.88 ± 13.6 | 17.1 | 73.89 ± 11.4 | 15.4 |
Endurance contraction—average mean (μV) | 0.72 | 0.75 * | 16.34 ± 5.06 | 49.2 | 17.12 ± 5.8 | 51.3 |
Endurance contraction—variability (%) | 0.58 | 0.48 * | 16.10 ± 3.2 | 28.0 | 19.4 ± 4.8 | 33.3 |
Rest (post-baseline)—average mean (μV) | 0.77 | 0.63 * | 7.86 ± 4.3 | 55.0 | 6.66 ± 3.7 | 55.0 |
Rest (post-baseline)—variability (%) | 0.68 | 0.68 * | 17.5 ± 14.1 | 84.0 | 13.4 ± 7.9 | 59.0 |
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Oleksy, Ł.; Mika, A.; Sulowska-Daszyk, I.; Rosłoniec, E.; Kielnar, R.; Stolarczyk, A. The Reliability of Pelvic Floor Muscle Bioelectrical Activity (sEMG) Assessment Using a Multi-Activity Measurement Protocol in Young Women. Int. J. Environ. Res. Public Health 2021, 18, 765. https://doi.org/10.3390/ijerph18020765
Oleksy Ł, Mika A, Sulowska-Daszyk I, Rosłoniec E, Kielnar R, Stolarczyk A. The Reliability of Pelvic Floor Muscle Bioelectrical Activity (sEMG) Assessment Using a Multi-Activity Measurement Protocol in Young Women. International Journal of Environmental Research and Public Health. 2021; 18(2):765. https://doi.org/10.3390/ijerph18020765
Chicago/Turabian StyleOleksy, Łukasz, Anna Mika, Iwona Sulowska-Daszyk, Ewelina Rosłoniec, Renata Kielnar, and Artur Stolarczyk. 2021. "The Reliability of Pelvic Floor Muscle Bioelectrical Activity (sEMG) Assessment Using a Multi-Activity Measurement Protocol in Young Women" International Journal of Environmental Research and Public Health 18, no. 2: 765. https://doi.org/10.3390/ijerph18020765