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Pelvic Floor Muscle Evaluation Findings in Patients With Urinary Incontinence

Unger, Cecile A. MD, MPH; McKinney, Jessica L. PT, MS; Weinstein, Milena M. MD; Pulliam, Samantha J. MD

Journal of Women's Health Physical Therapy: May/August 2014 - Volume 38 - Issue 2 - p 90–94
doi: 10.1097/JWH.0000000000000010
Research Reports

Objective: We hypothesized that there are differences in the pelvic floor physical therapy (PFPT) assessment findings between those with and without urinary incontinence; findings differ among patients with stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence (MUI).

Study Design: This was a retrospective cohort study of women referred to PFPT for a pelvic floor disorder between January 2009 and January 2011.

Background: Although the literature supports the role of PFPT for treatment of female urinary incontinence (UI), there is sparse literature on the correlation between pelvic floor muscle (PFM) assessment findings and UI.

Methods and Measures: The initial myofascial assessment—Manual Muscle Test (MMT), PFM tone, lengthening, and relaxation—was compared among women referred to PFPT for UUI, SUI, and MUI as well as non-UI pelvic floor dysfunction. A standardized scale was used for each assessment.

Results: A total of 297 women were referred for PFPT. Urinary incontinence was identified in 217 women: 53 (25%) SUI, 35 (16%) UUI, and 129 (59%) MUI. Women without UI had significantly higher MMT scores (P ≤ 0.001), whereas MMT was decreased in all groups with UI. The UUI group had significantly lower MMT scores (P ≤ 0.005) when compared with other UI groups. Up to 83% of women without UI had normal PFM tone, whereas less than 10% of patients with UI had normal PFM tone.

Conclusions: PFM evaluation identifies dysfunction unique to UI and specific incontinence subtypes. Patients may benefit from targeted PFPT to address these symptoms.

Department of Urogynecology and Pelvic Reconstructive Surgery, Massachusetts General Hospital, Boston.

Cecile A. Unger contributed to protocol/project development, data collection and management, data analysis, and manuscript writing and editing. Milena M. Weinstein and Samantha J. Pulliam contributed to protocol/project development, data analysis, and manuscript writing and editing; Jessica L. McKinney contributed to protocol/project development.

The authors declare no conflicts of interest.

Copyright © 2014 by the Section on Women's Health, American Physical Therapy Association.
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