Cronje, H. S.Prollius, A.Krause, M. W.Nieuwoudt, Elizabeth Maria2017-02-022017-02-022006http://hdl.handle.net/11660/5469English: The objective of the study was to research the relationship between pelvic floor muscle strength (PFMS) and pelvic organ prolapse (POP), and to find a threshold of PFMS where POP will manifest itself. A clinical cross-sectional analytic study was indicated. PFMS was tested with digital assessment using the modified Oxford scale and EMG testing with a vaginal electrode. Prolapse was assessed with the Pelvic Organ Prolapse Quantification (POP-Q) terminology. The analysis included 117 women. The correlation (-0.57) of the digital assessment of PFMS with POP is significant (p < 0.0001). 100% of women with grade 0 PFMS had a POP (POP-Q stage I-IV), while only 30% of women with a grade 5 PFMS had a POP of lesser severity (only stage I). Regarding EMG measurement of PFMS, there was a moderately significant correlation (r = -0.62; p < 0,001). However, one of the most interesting findings of the study was a significant correlation (-0.55) between the endurance of the PFM as was measured with EMG and POP (p < 0.0001). Women with either a stage 0 or I POP could hold a PFM contraction at a target set at 50% of the average of their three maximum contractions for a median of 12 seconds, while women with a more severe POP (stage II, III and IV) could hold the contraction for only 1 to 3 seconds. The results confirm clinical observations of the correlation between a weak PFM and a more severe POP. The study demonstrated that the threshold of PFMS where symptomatic POP manifests itself is grade 2 regarding digital testing using a modified Oxford scale (positive predictive value 60%; negative predictive value 85%; accuracy 73%) and 15μV when using EMG-testing (positive predictive value 60%; negative predictive value 68%; accuracy 74%). These results have clinical implications: women with a risk for developing symptomatic POP can be identified earlier and treated conservatively.Afrikaans: Die doelstellings van die studie was eerstens om die verhouding tussen die spiersterkte van die pelviese vloer en bekkenorgaanprolaps na te vors en tweedens om ‘n drempelwaarde te vind in terme van spiersterkte van die pelviese vloer waar simptomatiese bekkenorgaanprolaps begin. Daarom was ‘n kliniese analitiese dwarssnitstudie aangedui. Die spiersterkte van die pelviese vloer is getoets met digitale vaginale ondersoek volgens ‘n gemodifiseerde Oxford-skaal en deur middel van EMG-toetsing met ‘n vaginale elektrode. Bekkenorgaanprolalaps is gemeet volgens die “Pelvic Organ Prolapse Quantification (POP-Q)” terminologie. Die analise het 117 vroue ingesluit. Daar was ‘n betekenisvolle assosiasie tussen spiersterkte van die pelviese vloer en bekkenorgaanprolaps (r = -0.57; p < 0.0001). 100% van die vroue met graad 0 pelviese vloer spiersterkte het ‘n bekkenorgaanprolaps (POP-Q stadium I –IV) teenoor 30% van die vroue met ‘n graad V spiersterkte van die pelviese vloer wat slegs ‘n mindere mate van bekkenorgaanprolaps het (slegs stadium I). Wat die EMG-meting van die spiersterkte van die pelviese vloer betref, is daar ook ‘n matige betekenisvolle korrelasie (r = -0.62; p < 0.001). Een van die mees interessantste bevindinge van die studie was egter ‘n betekenisvolle korrelasie (r = -0.55; p < 0.0001) tussen die uithouvermoë van die pelviese vloerspier en bekkenorgaanprolaps. Vroue met ‘n stadium 0 of I bekkenorgaanprolaps kon ’n pelviese vloer spierkontraksie vir ‘n mediaan van 12 sekondes hou by ‘n doel wat gestel is op 50% van die gemiddeld van hul drie maksimum kontraksies. Vroue met ‘n ernstiger graad van bekkenorgaanprolaps (stadia II, III en IV) kon die sametrekking vir slegs 1 tot 3 sekondes hou. Die resultate bevestig die kliniese waarneming van die korrelasie tussen ‘n swak pelviese vloerspier en ‘n ernstiger graad van bekkenorgaanprolaps. Die studie demonstreer ook dat die drempelwaarde van die spiersterkte van die pelviese vloer waar simptomatiese prolaps begin, graad 2 is volgens digitale toetsing (gemodifiseerde Oxford-skaal) en 15 μV volgens EMG-toetsing. Dit het kliniese implikasies: vroue met ‘n risiko vir simptomatiese bekkenorgaanprolaps kan vroeër geïdentifiseer word en konserwatief behandel word.enDissertation (M.Sc. (Physiotherapy))--University of the Free State, 2006Pelvic Organ Prolapse (POP)Pelvic Floor Muscle Strength (PFMS)RelationshipThresholdUrinary incontinence -- TreatmentGenerative organs, FemaleUterus -- ProlapsePelvic floor -- Diseases -- Physical therapyDissertationUniversity of the Free State