Electromyography Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2011;33(4):188-195
DOI 10.1590/S0100-72032011000400007
PURPOSE: to evaluate the prevalence of urinary symptoms and association between pelvic floor muscle function and urinary symptoms in primiparous women 60 days after vaginal delivery with episiotomy and cesarean section after labor. METHODS: a cross-sectional analysis was conducted on women from an out patient clinic in São Paulo state, Brazil, 60 days after delivery. Pelvic floor muscle function was assessed by surface electromyography (basal tone, maximal voluntary contraction and mean sustained contraction) and by a manual muscle test (grades 0-5). In an interview, the urinary symptoms were identified and women with difficulty to understand, with motor/neurological impairment, pelvic surgery, diabetes, restriction for vaginal palpation and practicing exercises forpelvic floor muscles were excluded. The χ2 and Fisher Exact test were used to compare proportions and the Mann-Whitney test was used to analyze mean differences. RESULTS: 46 primiparous were assessed on average 63.7 days postpartum. The most prevalent symptoms were nocturia (19.6%), urgency (13%) and increased daytime urinary frequency (8.7%). Obese and overweight women had 4.6 times more of these symptoms (PR=4.6 [95%CI; 1.2-18.6; p value=0.0194]). Stress urinary incontinence was the most prevalent incontinence (6.5%). The mean values found for the basic tone, maximal voluntary contraction and sustained contraction were: 3 µV, 14.6 µV and 10.3 µV. Most of the women (56.5%) had grade 3 muscular strength. There was no association between urinary symptoms and pelvic floor muscle function. CONCLUSION: the prevalence of urinary symptoms was low 60 days postpartum and there was no association between pelvic floor muscle function and urinary symptoms.
Summary
Rev Bras Ginecol Obstet. 2011;33(4):188-195
DOI 10.1590/S0100-72032011000400007
PURPOSE: to evaluate the prevalence of urinary symptoms and association between pelvic floor muscle function and urinary symptoms in primiparous women 60 days after vaginal delivery with episiotomy and cesarean section after labor. METHODS: a cross-sectional analysis was conducted on women from an out patient clinic in São Paulo state, Brazil, 60 days after delivery. Pelvic floor muscle function was assessed by surface electromyography (basal tone, maximal voluntary contraction and mean sustained contraction) and by a manual muscle test (grades 0-5). In an interview, the urinary symptoms were identified and women with difficulty to understand, with motor/neurological impairment, pelvic surgery, diabetes, restriction for vaginal palpation and practicing exercises forpelvic floor muscles were excluded. The χ2 and Fisher Exact test were used to compare proportions and the Mann-Whitney test was used to analyze mean differences. RESULTS: 46 primiparous were assessed on average 63.7 days postpartum. The most prevalent symptoms were nocturia (19.6%), urgency (13%) and increased daytime urinary frequency (8.7%). Obese and overweight women had 4.6 times more of these symptoms (PR=4.6 [95%CI; 1.2-18.6; p value=0.0194]). Stress urinary incontinence was the most prevalent incontinence (6.5%). The mean values found for the basic tone, maximal voluntary contraction and sustained contraction were: 3 µV, 14.6 µV and 10.3 µV. Most of the women (56.5%) had grade 3 muscular strength. There was no association between urinary symptoms and pelvic floor muscle function. CONCLUSION: the prevalence of urinary symptoms was low 60 days postpartum and there was no association between pelvic floor muscle function and urinary symptoms.
Summary
Rev Bras Ginecol Obstet. 2010;32(5):234-240
DOI 10.1590/S0100-72032010000500006
PURPOSE: to evaluate the effect of pelvic floor muscle training (PFMT) on female sexual dysfunctions. METHODS: twenty-six women with a diagnosis of sexual dysfunction (sexual desire, arousal, orgasmic disorders and/or dyspareunia) were included in a clinical trial with a before/after approach . The assessment was carried out before, during (after five sessions) and at the end of the treatment (after ten sessions) by two-digit palpation (assessment of pelvic floor muscle, PFM, strength), intravaginal electromyography (EMG) (capture of PFM contraction amplitudes) and Female Sexual Function Index (FSFI, a questionnaire for the evaluation of sexual function). The women underwent PFMT in different positions for ten sessions (once or twice a week). For statistical analysis, absolute and relative frequencies were used for clinical characteristics and PFM strength. The Friedman test was used to compare the FSFI domain scores and EMG values, the Students t-test was used to determine the association between these values and the characteristics of the women, and the Wilcoxon test for percent modification of the EMG. The Mann-Whitney test permitted us to compare these values with clinical characteristics. The Spearman correlation test was used to correlate the EMG values with mean total score. Results were considered statistically significant if p<0.05. RESULTS: a significant improvement (p<0.0001) of FSFI scores was observed at the end of treatment compared to the values observed before and in the middle of treatment. Regarding the EMG, the amplitudes of tonic and phasic contractions increased significantly during treatment (p<0.0001). Pelvic floor strength increased, which 69% of the women presenting grade 4 or 5 at the end of treatment, with a total improvement of sexual complaints. CONCLUSIONS: the PFMT improved muscle strength and electromyography contraction amplitudes, with improved sexual function, indicating that this physiotherapy approach may be successfully used for the treatment of female sexual dysfunctions.
Summary
Rev Bras Ginecol Obstet. 2010;32(5):234-240
DOI 10.1590/S0100-72032010000500006
PURPOSE: to evaluate the effect of pelvic floor muscle training (PFMT) on female sexual dysfunctions. METHODS: twenty-six women with a diagnosis of sexual dysfunction (sexual desire, arousal, orgasmic disorders and/or dyspareunia) were included in a clinical trial with a before/after approach . The assessment was carried out before, during (after five sessions) and at the end of the treatment (after ten sessions) by two-digit palpation (assessment of pelvic floor muscle, PFM, strength), intravaginal electromyography (EMG) (capture of PFM contraction amplitudes) and Female Sexual Function Index (FSFI, a questionnaire for the evaluation of sexual function). The women underwent PFMT in different positions for ten sessions (once or twice a week). For statistical analysis, absolute and relative frequencies were used for clinical characteristics and PFM strength. The Friedman test was used to compare the FSFI domain scores and EMG values, the Students t-test was used to determine the association between these values and the characteristics of the women, and the Wilcoxon test for percent modification of the EMG. The Mann-Whitney test permitted us to compare these values with clinical characteristics. The Spearman correlation test was used to correlate the EMG values with mean total score. Results were considered statistically significant if p<0.05. RESULTS: a significant improvement (p<0.0001) of FSFI scores was observed at the end of treatment compared to the values observed before and in the middle of treatment. Regarding the EMG, the amplitudes of tonic and phasic contractions increased significantly during treatment (p<0.0001). Pelvic floor strength increased, which 69% of the women presenting grade 4 or 5 at the end of treatment, with a total improvement of sexual complaints. CONCLUSIONS: the PFMT improved muscle strength and electromyography contraction amplitudes, with improved sexual function, indicating that this physiotherapy approach may be successfully used for the treatment of female sexual dysfunctions.
Summary
Rev Bras Ginecol Obstet. 2009;31(5):224-229
DOI 10.1590/S0100-72032009000500004
PURPOSE: to identify the pattern of myoelectrical activity of muscles from the scapular region, after axillary lymphadenectomy in breast cancer. METHODS: prospective cohort study including all the women submitted to axillary lymphadenectomy for surgical treatment of breast cancer, in a breast cancer reference center, from June to August 2006. The women were evaluated before, and after 3 and 12 months from the surgery, through physical and electromyographic examinations of the serratus anterior, upper trapezius and middle deltoid muscles. RESULTS: the patients' average age was 60.3 years old (DP±14.1), and the incidence of winged scapula at the physical examination was 64.9%. At the third-months evaluation, a reduction of 28.3 µV was observed in the myoelectrical activity of the serratus anterior muscle. At the twelveth-months evaluation and between the 3rd and the 12th month, there was an increment of 23.3 µV and 43.6 µV, respectively. For the upper trapezius, the increase was of 23.1 µV at the third-months evaluation, and 23.3 µV and 43.6 µV between the 3rd and the 12th months. As compared to before the surgery, the evaluation of the middle deltoid muscle did no present significant differences. CONCLUSIONS: considering muscle activity evaluated by surface electromyography, there was a decrease in the myoelectrical activity of the serratus anterior, due to lesion of the long thoracic nerve (neuropraxia), in the immediate postoperative evaluation. The increase of the mean square root of the electromyographic signal of the upper trapezius muscle, since the preoperative evaluation, suggests a muscular compensation related to the serratus anterior muscle's deficit.
Summary
Rev Bras Ginecol Obstet. 2009;31(5):224-229
DOI 10.1590/S0100-72032009000500004
PURPOSE: to identify the pattern of myoelectrical activity of muscles from the scapular region, after axillary lymphadenectomy in breast cancer. METHODS: prospective cohort study including all the women submitted to axillary lymphadenectomy for surgical treatment of breast cancer, in a breast cancer reference center, from June to August 2006. The women were evaluated before, and after 3 and 12 months from the surgery, through physical and electromyographic examinations of the serratus anterior, upper trapezius and middle deltoid muscles. RESULTS: the patients' average age was 60.3 years old (DP±14.1), and the incidence of winged scapula at the physical examination was 64.9%. At the third-months evaluation, a reduction of 28.3 µV was observed in the myoelectrical activity of the serratus anterior muscle. At the twelveth-months evaluation and between the 3rd and the 12th month, there was an increment of 23.3 µV and 43.6 µV, respectively. For the upper trapezius, the increase was of 23.1 µV at the third-months evaluation, and 23.3 µV and 43.6 µV between the 3rd and the 12th months. As compared to before the surgery, the evaluation of the middle deltoid muscle did no present significant differences. CONCLUSIONS: considering muscle activity evaluated by surface electromyography, there was a decrease in the myoelectrical activity of the serratus anterior, due to lesion of the long thoracic nerve (neuropraxia), in the immediate postoperative evaluation. The increase of the mean square root of the electromyographic signal of the upper trapezius muscle, since the preoperative evaluation, suggests a muscular compensation related to the serratus anterior muscle's deficit.
Summary
Rev Bras Ginecol Obstet. 2005;27(1):12-19
DOI 10.1590/S0100-72032005000100005
PURPOSE: to evaluate and compare results of female pelvic floor surface electromyography in different positions: lying, sitting and standing. METHODS: twenty-six women with the diagnosis of stress urinary incontinence treated with a protocol of exercises to strengthen the pelvic floor muscle were evaluated. Pelvic floor surface electromyography was performed with an intravaginal sensor connected to Myotrac 3G TM equipment, as follows: initial rest of 60 s, five phasic contractions, one 10-s tonic contraction and one 20-s tonic contraction. The amplitudes were obtained from the difference between the final contraction amplitude and the amplitude at rest (in µV). Wilcoxon test was applied for nonparametric data (p value <0.05). RESULTS: the amplitudes of contractions were higher in the lying position, decreasing in the sitting and standing positions. In the lying position, the median values of phasic and tonic contractions were 23.5 (5-73), 18.0 (3-58) and 17.0 (2-48), respectively. In the sitting position, they were 20.0 (2-69), 16.0 (0-58) and 15.5 (1-48). In the standing position they were 16.5 (3-67), 12.5 (2-54) and 13.5 (2-41). All amplitude values were significantly lower in the standing position compared to the lying position (p<0.001, p<0.001 and p=0.003). Similar results were also found in comparison to the sitting position. However, there was no significant difference between the lying and the sitting positions. CONCLUSION: all female pelvic floor contraction amplitudes were lower in the standing position, suggesting that the muscle strength should be intensified in that position.
Summary
Rev Bras Ginecol Obstet. 2005;27(1):12-19
DOI 10.1590/S0100-72032005000100005
PURPOSE: to evaluate and compare results of female pelvic floor surface electromyography in different positions: lying, sitting and standing. METHODS: twenty-six women with the diagnosis of stress urinary incontinence treated with a protocol of exercises to strengthen the pelvic floor muscle were evaluated. Pelvic floor surface electromyography was performed with an intravaginal sensor connected to Myotrac 3G TM equipment, as follows: initial rest of 60 s, five phasic contractions, one 10-s tonic contraction and one 20-s tonic contraction. The amplitudes were obtained from the difference between the final contraction amplitude and the amplitude at rest (in µV). Wilcoxon test was applied for nonparametric data (p value <0.05). RESULTS: the amplitudes of contractions were higher in the lying position, decreasing in the sitting and standing positions. In the lying position, the median values of phasic and tonic contractions were 23.5 (5-73), 18.0 (3-58) and 17.0 (2-48), respectively. In the sitting position, they were 20.0 (2-69), 16.0 (0-58) and 15.5 (1-48). In the standing position they were 16.5 (3-67), 12.5 (2-54) and 13.5 (2-41). All amplitude values were significantly lower in the standing position compared to the lying position (p<0.001, p<0.001 and p=0.003). Similar results were also found in comparison to the sitting position. However, there was no significant difference between the lying and the sitting positions. CONCLUSION: all female pelvic floor contraction amplitudes were lower in the standing position, suggesting that the muscle strength should be intensified in that position.