Linking Pelvic Floor Muscle Function Terminology to the International Classification of Functioning, Disability and Health.

OBJECTIVE: A previous systematic review on pelvic floor muscle function (PFMF) identified a miscellaneity of terms. The lack of consensual terminology might have come from the complexity of neuromusculoskeletal function itself. This study sought to link the previously identified PFMF terms to the International Classification of Functioning, Disability and Health (ICF) terminology. METHODS: In this secondary analysis study, 10 linkage rules were applied to link 196 previously identified PFMF terms to the ICF. Two researchers performed the linking process independently. Disagreements were solved by open dialogue with a third researcher. Percentage agreement was computed for main outcome. RESULTS: A total of 184 (93.9%) PFMF terms were subsumed into the following 6 ICF terms: tone, involuntary movement reaction, control, coordination, strength, and endurance. The most frequently investigated PFMF was strength (25.5%), followed by involuntary movement reaction (22.9%), endurance (17.2%), control (14.1%), coordination (9.9%), and tone (4.2%). Only 6.2% PFMF could not be linked to ICF terminology. A wide variation of instruments/methods was used to measure PFMF. Vaginal palpation was the only method employed to measure all 6 PFMF. Percentage agreement between raters was 100%. CONCLUSIONS: Linking PFMF terminology to the ICF was feasible and valid. It allowed the identification of the most investigated PFMF and their measuring methods. ICF terminology to describe PFMF should be used since it may improve communication, data gathering, and the advance in scientific knowledge. IMPACT: Standardized terminology anchored in a theoretical framework is crucial to data gathering, communication, and dissemination of evidence-based practice. PFMF terminology based on ICF can be used to improve data pooling and communication.

Pelvic floor muscle function in women with and without urinary incontinence: are strength and endurance the only relevant functions? a cross-sectional study.

OBJECTIVES: To investigate if pelvic floor muscle functions (PFMFs), besides strength and endurance, are associated with the occurrence of urinary incontinence (UI) in women, and to investigate which functions predict the occurrence of UI. DESIGN: Cross-sectional study. SETTING: Public health service and community. PARTICIPANTS: Two hundred and ten women (101 with UI and 109 without UI). MAIN OUTCOME MEASURES: PFMF was investigated by the Pelvic Floor Sensory and Muscle Function Exam (Exame das Funções Sensoriais e Musculares do Assoalho Pélvico), a valid and reliable instrument that measures the following functions: tone, reaction, control (contraction), control (relaxation), coordination, strength and endurance. The International Consultation on Incontinence Questionnaire-Short Form was used to document the occurrence and type of UI. Sociodemographic and clinical data were collected through the questionnaire. Chi-squared test, Student's t-test and Mann-Whitney test were used to evaluate the association of each function with UI. Two logistic regression models tested the predictive value of each function for UI: Model a included all of the above PFMFs and Model b included all of the above PFMFs except strength and endurance. RESULTS: Most sociodemographic and clinical risk factors differed between women with UI and women without UI. On univariate analysis, tone, reaction, control (contraction), coordination, strength and endurance were found to be significantly associated (P<0.05) with the occurrence of UI. On multivariate analysis, Model a explained 69% and Model b explained 61% of the likelihood of UI, respectively. CONCLUSIONS: Besides strength and endurance, pelvic floor muscle tone, reaction, control (contraction) and coordination were significantly associated with the occurrence of UI, and should be investigated further.