Pelvic floor maximal strength using vaginal digital assessment compared to dynamometric measurements

Area of Science:

• Pelvic floor muscle (PFM) biomechanics and functional assessment.

Background:

• Pelvic floor muscle (PFM) strength is crucial for female continence.
• Vaginal digital assessment is a common clinical method for evaluating PFM strength.
• Dynamometric measurement offers a more objective quantification of PFM force.

Purpose of the Study:

• To compare the accuracy of vaginal digital assessment against dynamometric measurements for PFM maximal strength.
• To evaluate the correlation and potential overlaps between these two assessment methods.

Main Methods:

• Eighty-nine women (21-44 years) underwent PFM strength assessment using both the modified Oxford grading system (digital) and an instrumented speculum (dynamometric).
• Statistical analyses, including ANOVAs and Spearman's rho correlation, were employed to compare the results.
• Participants included continent women and those with stress urinary incontinence (SUI).

Main Results:

• Dynamometric measurements showed significant overlaps between adjacent digital assessment categories.
• While overall force values differed across digital categories (P < 0.001), adjacent categories (e.g., 1-2, 2-3) did not show significant force differences.
• Significant correlations were observed between digital and dynamometric assessments (r = 0.450 to 0.727, P < 0.01).

Conclusions:

• The modified Oxford grading system for PFM strength has limitations due to non-significant differences between adjacent categories.
• Clinicians and researchers should consider these limitations when interpreting digital assessment results for treatment planning and outcome evaluation.
• Dynamometric measurement provides a more granular assessment of PFM strength compared to digital palpation.