Abstract
Abstract Introduction: The effectiveness of pelvic floor muscle training (PFMT) depends on the correct prescription of intensity, repetition and endurance of muscle contractions, which are provided by an adequate assessment of pelvic floor muscle. Objective: Verify the techniques, resources and strategies used for clinical functional evaluation of female pelvic floor (PF) described in literature. Methods: It’s an integrative review of published studies and books from 2010 until December 2015. Relevant articles with complete description of PF evaluation were found through the use of Scielo, LILACS, PubMed and Medline databases. Results: 34 articles that fulfilled all the criteria were selected. Conclusion: The most used techniques, resources and strategies were: anamnesis, physical examination, measurement of pelvic floor muscle activity using Modified Oxford Scale or perineometry, and use of questionnaires to analyze patient's perspective of their own symptoms. Thus, we could use the parameters obtained in the evaluation to plan an ideal PFMT for each patient, so the physiotherapist would have a good database to analyze the evolution and define the end of therapy.
Highlights
The effectiveness of pelvic floor muscle training (PFMT) depends on the correct prescription of intensity, repetition and endurance of muscle contractions, which are provided by an adequate assessment of pelvic floor muscle
Since the 1990s, it has been demonstrated in the literature that the weakness of the pelvic floor muscles (PFM) in women generates an imbalance in the region, causing dysfunctions such as urinary (UI) and anal incontinence (AI), pelvic organs prolapse (POP) and sexual dysfunctions (SD) [1, 2, 4 - 6]
The resources and strategies used for clinical functional evaluation of the female PF described in the literature are: the awareness of PFM location and function; the initial physical examination; the assessment of the capacity of PFM contraction by digital palpation with the use of Modified Oxford Scale (MOS) complemented or not by the PERFECT method, Ortiz, Amaro or Telfim-perineal; quantification of aspects of muscle contraction through perineometry, electromyography, vaginal cones and palpometer; and the analysis of the patient's perspective on their symptoms by the King's Health Questionnaire (KHQ), ICIQ-SF, Female Sexual Function Index (FSFI), Overactive Bladder Questionnaire (OAB-q), ICIQ-OAB and Short Form-36 (SF-36) questionnaires
Summary
The effectiveness of pelvic floor muscle training (PFMT) depends on the correct prescription of intensity, repetition and endurance of muscle contractions, which are provided by an adequate assessment of pelvic floor muscle. The pelvic floor (PF) is a muscle-fascial structure that inferiorly limits the pelvic cavity and is composed of the pelvic and urogenital diaphragms [1] They function as a single functional unit, promoting support for the pelvic organs and maintaining the urinary and anal continence with their contraction in the anterior-superior direction, with participation in sexual function [1, 2]. The treatment recognized as golden pattern by the International Continence Society (ICS) for these dysfunctions is pelvic floor muscle training (PFMT) [7 - 9] It aims to increase the sphincteric function around the urethra, the support of the pelvic organs, local blood circulation, re-education and hypertrophy of PFM, as well as to contribute to the improvement of sexual activity [10]. The PFMT may be associated with other resources such as surgeries and medications, biofeedback and vaginal cones, as well as changes in habits [7 - 9]
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