Effect of test position on pelvic floor muscle assessment

Investigators: Ms Helena Frawley, Ms Margaret Sherburn, Prof Mary Galea, Dr Bev Phillips

The aims of this study were to analyze the effect of different body positions on pelvic floor muscle (PFM) assessment using digital muscle testing, manometry and transabdominal ultrasound (US). In addition, subject acceptance of each testing position was recorded. Twenty pelvic floor physiotherapists participated in the study. The testing protocol included the best of 3 maximum voluntary contractions, tested in each of four positions (crook-lie, supine, sitting and standing).

Figure 1 . The examination of pelvic floor muscle function using transabdominal ultrasound in the supine (left) and sitting (right) positions.

Significant differences in muscle strength and subject acceptance between positions were found with each tool, most often between lying and upright positions. Digital muscle testing and vaginal squeeze pressure scores were highest in lying, and vaginal resting pressure and transabdominal US scores were highest in standing. Subjects preferred the lying positions for internal examinations. The clinical significance of these differences and the reasons for these changes require further investigation.

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