Electromyography of pelvic floor muscles with true differential versus faux differential electrode configuration
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ORIGINAL ARTICLE
Electromyography of pelvic floor muscles with true differential versus faux differential electrode configuration Claudia Ballmer 1,2 Lorenz Radlinger 1
&
Patric Eichelberger 1 & Monika Leitner 1 & Helene Moser 1 & Helena Luginbuehl 1 & Annette Kuhn 3 &
Received: 7 November 2019 / Accepted: 14 January 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis In pelvic floor muscle (PFM) electromyography (EMG) two different bipolar configurations are applied: “true differential” configuration (TD) measures neuromuscular activity with two ipsilateral electrodes, whereas “faux differential” configuration (FD) has two electrodes placed on each side of the PFMs. The aim of the study was to determine possible differences and the relationship between both configurations. Methods A secondary data analysis of 28 continent (CON) and 22 stress urinary incontinent (SUI) women was performed. Surface EMG was measured using a vaginal probe during maximal voluntary (MVC) and fast voluntary (FVC) contractions. TD and FD were explored with amplitude- and time-related EMG parameters, cross-correlation coefficients (R(0)) and statistical parametric mapping (SPM). Results Of a total of 62 comparisons of EMG parameters of MVC and FVC, only one comparison showed significant differences between the two configurations (CON group, FVC4peak TD versus FD, p = 0.015). R(0) were high in both groups for all MVC and FVC variables (R(0) ≥ 0.989). SPM detected 3 out of 28 comparisons with short (0.124–0.404 s) significant supra-threshold clusters (p < 0.025). Conclusions The findings suggest that TD and FD might measure neuromuscular activity almost the same. Very high crosscorrelation coefficients and a very limited number of significant results from EMG parameters, as well as SPM, suggest that in the measured sample the choice of TD or FD might remain practically irrelevant. To gain further insight into the scientific and clinical relevance of choosing either of the electrode configurations, the comparisons should be re-evaluated on a sample with more severe incontinence symptoms. Keywords Urinary incontinence . Vaginal probe . Muscle activation . Cross-correlation . Statistical parametric mapping
Introduction Assessment of the neuromuscular function of the pelvic floor muscles (PFMs) is of great clinical and scientific importance in understanding PFM functioning and disorders. Surface electromyography (EMG) is one of the most
* Claudia Ballmer
1
Department of Health Professions, Division of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
2
Lausen, Switzerland
3
Urogynaecology, Bern University and University Hospital, Women’s Hospital, Bern, Switzerland
common methods used in the assessment and treatment of various pelvic floor disorders because of its practicability [1]. It was demonstrated to be a reliable method of assessing PFM activity [2–6]. To train the PFMs, it is widely applied as biofeedback in physical therapy practice [7]. Several vaginal probes
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