Confiabilidade teste-reteste das diferentes variáveis dinamométricas utilizadas na avaliação dos músculos do assoalho pélvico durante o ciclo menstrual

Abstract

Introduction: urinary incontinence is defined as any involuntary loss of urine that affects adult women and may be due to neuromuscular changes of the pelvic floor. These changes can be verified by means of the dynamometer, since this equipment measures the contraction force proportional to the pelvic floor muscles (PFM). Aim: it`s evaluate the reliability of the different dynamometric variables of the pelvic floor muscles in healthy women during the menstrual cycle. Methods: the pelvic floor muscle (PFM) contractions of 20 women with a mean age of 30.85 (20-41) years, and no complaints of urinary loss, were evaluated in the sagittal (anteroposterior) and frontal (right-left) planes by two experienced examiners using a dynamometer. The collections were performed over three consecutive weeks from the first day after the end of the menstrual period. The peak time (PT) (time at which the peak of force occurred from the beginning of the PFM contraction), baseline (passive force), maximum PFM strength value, impulse of contraction, and average contraction force were calculated and the reproducibility tested. The intra-class correlation coefficients (ICC2,k) and the standard error of measurement (SEM) were used to determine the inter session and intra- and inter examiner reliability of the values obtained between three test sessions (test/retest). Results: For the intra and inter-day reliability between examiners all the parameters collected in the sagittal plane presented excellent reproducibility (ICC2,k= 0.86 to 0.98). In the frontal plane, the peak time and contraction impulse presented fair intra-day reproducibility (ICC2,k= 0.23 and 0.59, respectively) and good inter-day collection reproducibility (ICC2,k= 0.73 to 0.71, respectively). In general, the SEM values demonstrated that the data collected in the sagittal plane presented smaller measurement error compared to those collected in the frontal plane. Conclusions: The present findings demonstrate that the hormonal alterations that occur during the menstrual cycle do not influence the PFM contraction. The baseline, maximum strength value, impulse of contraction, and average contraction force variables presented excellent reproducibility and can be safely used as a method of PFM evaluation.