Repeatability and reproducibility of the pressure biofeedback unit.

INTRODUCTION: Although the pressure biofeedback unit (PBU) is used for muscular assessment and training, there is little evidence of its reproducibility and repeatability. OBJECTIVE: This study aims to assess intra- and inter-rater reproducibility and repeatability of the PBU in the assessment of the transverse abdominal (TrA), internal oblique (IO), low back multifidi, and deep neck flexors (DNF). METHODS: Fifty individuals had three muscular groups tested: TrA/IO, lower back multifidi, and DNF. For repeatability, one rater did three consecutive measures; for intra-rater reproducibility the same rater did two measures with seven-day intervals, and for inter-rater reproducibility, three raters, on the same day, did the measures. Data were analyzed with: Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM), and Minimal Detectable Change (MDC). (α = 0,05). RESULTS: Repeatability: TrA/IO (ICC = 0.847), Multifidi (ICC = 0.860), DNF (ICC = 0.831). Inter-rater reproducibility: TrA/IO (ICC = 0.876), Multifidi (ICC = 0.508), DNF (ICC = 0.442). Intra-rater reproducibility: TrA/IO (ICC = 0.747), Multifidi (ICC = 0.293), DNF (ICC = 0.685). Except for Multifidi, all the SEM values were less than 10 mmHg and the MDC values were less than 15 mmHg. CONCLUSIONS: The PBU can be used with reliability by different evaluators, although the evaluation of multifidi is not indicated.

Comparison of methods for evaluating upper limb strength by hand-held dynamometry / Comparação entre métodos na avaliação de dinamometria hand-held para músculos dos membros superiores / Comparación entre métodos en la evaluación de dinamometría hand-held para músculos de los miembros superiores

ABSTRACT Introduction The upper limbs are segments of the human body responsible for primary activities of daily life, and the muscles are essential structures for performing these activities. There have been few studies on intra- and inter-examiner reliability of the hand-held dynamometer (HHD) in healthy subjects, and none have been published that compare dynamometric evaluation methods in the main muscles in this segment. Objective Evaluate intra-examiner and inter-examiner assessment reliability of the hand-held dynamometry of upper limb muscles in healthy individuals, as well as comparing the assessment reliability between fixed and non-fixed methods. Methods Healthy subjects aged over 18 years were recruited for the study. The isometric contraction for ten muscle groups of the dominant upper limb was tested. For the fixed method, we used a system of suction cups, connected to the HHD by an inelastic belt. For the non-fixed method, the examiner supported the device by hand. The isometric contraction was sustained for three seconds. Each measurement was repeated three times, considering the highest value obtained. The reliability was calculated using the intraclass correlation coefficient (ICC). The dispersion between measurements was expressed by a Bland-Altman plot. Results The sample consisted of 25 volunteers, all right-handed. The intra-examiner ICC was 0.89-0.99 for the non-fixed method, and 0.43 to 0.85 for the fixed method. Inter-examiner reliability showed equivalent behavior. This study showed that evaluation of upper limb muscle strength using an isometric dynamometer has excellent intra-examiner and inter-examiner reliability. The supine position was chosen due to the need to propose a feasible protocol for clinical practice that could be replicated for the majority of publics and in different environments. The non-fixed method showed better reliability overall, demonstrating the feasibility of this tool without the need for adaptations, additional devices, or increased operating costs for this evaluation. Conclusion Comparison between the fixed and non-fixed HHD methods demonstrated superiority of the non-fixed method in terms of reliability. Level of evidence II; Investigation of a diagnostic exam - Development of diagnostic criteria with consecutive patients.

RESUMO Introdução Os membros superiores são segmentos do corpo humano responsáveis por atividades primordiais do nosso cotidiano, e os músculos são estruturas imprescindíveis para isso. Ainda são escassos na literatura os estudos sobre a confiabilidade intra e interexaminadores da dinamometria Hand-Held em indivíduos saudáveis, sendo inédita a comparação entre os métodos de avaliação da dinamometria nos principais músculos desse segmento. Objetivo Avaliar a confiabilidade da avaliação intraexaminador e interexaminador da dinamometria manual de músculos do membro superior em indivíduos saudáveis, bem como comparar a confiabilidade da avaliação entre métodos fixos e não fixos. Métodos Foram recrutados indivíduos saudáveis, maiores de 18 anos. A contração isométrica para dez grupos musculares do membro superior dominante foi testada. Para o método fixado, foi empregado um sistema de ventosas conectado ao Dinamomêtro Hand-Held (DHH) por um cinto inelástico. No método não fixado, o examinador apoiou o aparelho com a mão. A contração isométrica foi sustentada por três segundos. Cada medida foi repetida três vezes, considerando o maior valor obtido. A confiabilidade foi calculada através do coeficiente de correlação intraclasse (CCI). A dispersão entre as medidas foi expressa pelo diagrama de Bland-Altman. Resultados A amostra foi composta por 25 voluntários, todos destros. O coeficiente de correlação intraclasse (CCI) dos intraexaminadores para método não fixado foi de 0,89 a 0,99 e, para o método fixado, situou-se entre 0,43 e 0,85. A confiabilidade interexaminadores teve comportamento equivalente. O presente estudo demonstrou que a avaliação da força dos músculos dos MMSS com dinamômetro isométrico apresenta excelente confiabilidade tanto intra como interexaminadores. A escolha do posicionamento em supino vem da necessidade de propor um protocolo factível na prática clínica, replicável para a maioria dos públicos e em ambientes diversos. O fato de o método não fixado demonstrar maior confiabilidade, em geral, expõe a viabilidade do uso dessa ferramenta sem necessidade de adaptações, dispositivos adicionais ou aumento do custo operacional nessa avaliação. Conclusão A comparação entre os métodos fixados e os não fixados da dinamometria Hand-Held demonstrou superioridade do método não fixado quanto à confiabilidade. Nível de evidência II; Estudos diagnósticos - Investigação de um exame para diagnóstico - Desenvolvimento de critérios diagnósticos com pacientes consecutivos.

RESUMEN Introducción Los miembros superiores son segmentos del cuerpo humano responsables de las actividades primordiales de nuestro cotidiano, y los músculos son estructuras imprescindibles para eso. Aún son escasos los estudios sobre la confiabilidad intra e interexaminadores de la dinamometría Hand-Held en individuos saludables, siendo inédita la comparación entre los métodos de evaluación de la dinamometría en los músculos principales de ese segmento. Objetivos Evaluar la confiabilidad de la evaluación intraexaminador e interexaminador de la dinamometría manual de músculos del miembro superior en individuos saludables, bien como comparar la confiabilidad der la evaluación entre métodos fijos y no fijos. Métodos Se reclutaron individuos saludables, mayores de 18 años. Se probó la contracción isométrica para diez grupos musculares del miembro superior dominante. Para el método fijado, se utilizó un sistema de ventosas, conectado al Dinamómetro Hand-Held (DHH) a través de un cinturón inelástico. En el método no fijado, el examinador apoyó el aparato con la mano. La contracción isométrica fue sustentada por tres segundos. Cada medición fue repetida tres veces, considerando el valor más alto obtenido. La confiabilidad fue calculada a través del coeficiente de correlación intraclase (CCI). La dispersión entre las mediciones se expresó por el diagrama de Bland-Altman. Resultados La muestra fue compuesta por 25 voluntarios, todos diestros. El coeficiente de correlación intraclase (CCI) de los intraexaminadores para método no fijado fue de 0,89 a 0,99 y, para el método fijado fue entre 0,43 y 0,85. La confiabilidad intraexaminadores tuvo comportamiento equivalente. El presente estudio demostró que la evaluación de la fuerza de los músculos de los MMSS con un dinamómetro isométrico presenta excelente confiabilidad tanto intra como interexaminadores. La elección del posicionamiento en supino viene de la necesidad de proponer un protocolo factible en la práctica clínica, replicable para la mayoría de los públicos y en ambientes diversos. El hecho de que el método no fijado demuestre mayor confiabilidad, en general, expone la viabilidad del uso de esa herramienta sin necesidad de adaptaciones, dispositivos adicionales o aumento del costo operacional, en esa evaluación. Conclusión La comparación entre los métodos fijados y no fijados de la dinamometría Hand-Held demostró superioridad del método no fijado cuanto a la confiabilidad. Nivel de evidencia II; Estudios diagnósticos - Investigación de un examen para diagnóstico - Desarrollo de criterios diagnósticos con pacientes consecutivos.

Pelvic floor muscle strength is correlated with sexual function.

PURPOSE: Sexual performance is related to proprioception and pelvic floor muscle strength (PFMS). The aim of this study was to correlate sexual activity and orgasm with PFMS. MATERIALS AND METHODS: A total of 140 healthy continent female were prospectively distributed into 4 groups according to age: Group 1 (G1), 30-40; Group 2 (G2), 41-50; Group 3 (G3), 51-60; Group 4 (G4), over 60 years old. Evaluated parameters were: frequency of sexual activity and orgasm achievement; body mass index (BMI) and objective evaluation of PFMS using perineometer and surface electromyography. RESULTS: BMI was higher in G4 compared to G1 (p=0.042). Women who reported sexual activity was significantly higher in G1 compared to G3 and G4 (94.1% vs. 66.7% and 37.5%, respectively; p=0.001). Orgasm was more frequently in G1 compared to G3 and G4 (91.2% vs. 63.9% and 28.1%, respectively; p=0.001), demonstrating that sexual activity and orgasm decrease after age 51. The duration of PFM contraction was significantly higher in women who had sexual intercourse (p=0.033) and orgasm (p=0.018). CONCLUSIONS: Although the frequency of sexual intercourse and orgasm may decrease with aging, a relationship between sexual activity and PFMS remains apparent, once both sexually active women and those who have orgasms showed better PFM endurance than non-sexually active ones.