Factors Associated with Pelvic Floor Muscle Strength in Women with Pelvic Floor Dysfunction Assessed by the Brink Scale
Abstract
Material and Methods: From January 2011 and December 2014, women with at least one pelvic floor symptom attending the urogynecology clinic were included in a medical record review. Demographic and pelvic floor symptoms were assessed. The Brink scoring system was used to assess the PFM function. The association between factors and Brink scale scores was measured using Pearson’s Correlation Coefficient.
Results: Five hundred and seventy-nine women with a mean age of 64.40±10.11 years were included in the analysis. Forty-seven women (8.1%) were unable to contract their pelvic floor muscle at all, while 55 (9.5%) could both powerfully and properly. The mean Brink scale score was 7.82±2.56. Elderly women had a significantly lower score than younger women (mean scores of 7.56±2.60 and 8.08±2.50, respectively) with the mean score in nulliparous and parous women being 8.66±2.63 and 7.76±2.55, respectively (p-value=0.046). A negatively weak correlation was found among those with higher total scores and advancing age (correlation (r)=-0.106), advanced anterior (r=-0.095) and apical compartment (r=-0.105) prolapse (p-value<0.05).
Conclusion: Almost all the women with pelvic floor dysfunction had compromised pelvic floor function. Important factors affecting PFM strength are age, parity, and history of hysterectomy. Increasing age, higher stage of anterior and apical compartment prolapse were negatively correlated with PFM function.
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Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010;21:5-26.
Arnouk A, De E, Rehfuss A, Cappadocia C, Dickson S, Lian F. Physical, complementary, and alternative Medicine in the treatment of pelvic floor disorders. Curr Urol Rep 2017;18:47.
Angelini K. Pelvic floor muscle training to manage overactive bladder and urinary incontinence. Nurs Womens Health 2017;21:51-7.
Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev 2018. doi: 10.1002/14651858.CD005654.pub4.
Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J 2017; 28:191-213.
Messelink B, Benson T, Berghmans B, Bo K, Corcos J, Fowler C, et al. Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society. Neurourol Urodyn 2005;24:374-80.
Hundley AF, Wu JM, Visco AG. A comparison of perineometer to brink score for assessment of pelvic floor muscle strength. Am J Obstet Gynecol 2005;192:1583-91.
Peterson TV, Karp DR, Aguilar VC, Davila GW. Validation of a global pelvic floor symptom bother questionnaire. Int Urogynecol J 2010;21:1129-35.
Manonai J, Wattanayingcharoenchai R. Relationship between pelvic floor symptoms and POP-Q measurements. Neurourol Urodyn 2016;35:724-7
Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 1996;175:10-7.
Brink CA, Sampselle CM, Wells TJ, Diokno AC, Gillis GL. A digital test for pelvic floor muscle strength in older women with urinary incontinence. Nurs Res 1989;38:196-9.
Bo K, Sherburn M. Evaluation of female pelvic-muscle function and strength. Phys Ther 2005;85:269-82.
Borello-France DF, Handa VL, Brown MB, Goode P, Kreder K, Scheufele LL, et al. Pelvic-floor muscle function in women with pelvic organ prolapse. Phys Ther 2007;87:399-407.
FitzGerald MP, Burgio KL, Borello-France DF, Menefee SA, Schaffer J, Kraus S, et al. Pelvic-floor strength in women with incontinence as assessed by the brink scale. Phys Ther 2007;87:1316-24.
King VG, Boyles SH, Worstell TR, Zia J, Clark AL, Gregory WT. Using the Brink score to predict postpartum anal incontinence. Am J Obstet Gynecol 2010;203:486.e1-5.
DeLancey JO, Morgan DM, Fenner DE, Kearney R, Guire K, Miller JM, et al. Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse. Obstet Gynecol 2007;109:295-30.
Delancey JO. Surgery for cystocele III: do all cystoceles involve apical descent? Observations on cause and effect. Int Urogynecol J 2012;23:665-7.
Delancey JO. What’s new in the functional anatomy of pelvic organ prolapse? Curr Opin Obstet Gynecol 2016;28:420-9.
DeLancey JO, Sørensen HC, Lewicky-Gaupp C, Smith TM. Comparison of the puborectal muscle on MRI in women with POP and levator ani defects with those with normal support and no defect. Int Urogynecol J 2012;23:73-7.
Bo K, Morkved S, Frawley H, Sherburn M. Evidence for benefit of transversus abdominis training alone or in combination with pelvic floor muscle training to treat female urinary incontinence: a systematic review. Neurourol Urodyn 2009;28:368-73.
Soljanik I, Janssen U, May F, Fritsch H, Stief CG, Weissenbacher ER, et al. Functional interactions between the fossa ischioanalis, levator ani and gluteus maximus muscles of the female pelvic floor: a prospective study in nulliparous women. Arch Gynecol Obstet 2012;286:931-8.
Halski T, Ptaszkowski K, Stupska L, Dymarek R, PaprockaBorowicz M. Relationship between lower limb position and pelvic floor muscle surface electromyography activity in menopausal women: a prospective observational study. Clin Intervent Aging 2017;12:75-83.
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