Clinical Study On Evaluation Of Characteristic Changes In Pelvic Floor Structure And Electrophysiology Of Pelvic Floor Muscle In Female Patients With Stroke

Objective: To investigate the characteristics of pelvic floor structure and electrophysiological changes of pelvic floor muscle in female patients with stroke by perineal ultrasound and pelvic floor surface electromyography(s EMG).To provide a basis for assessment of pelvic floor function and long-term prognosis in patients with stroke.Methods: A total of 21 patients with stroke(stroke group)and 20 no-stroke subjects(control group)were recruited as study objects,and then the stroke group was divided into either urinary incontinence group(UI group,n=6)or non-urinary incontinence group(NUI group,n=15).Pelvic floor ultrasonography and pelvic floor muscle s EMG assessment were performed in the all subjects.The changes of pelvic floor muscle electrophysiology and pelvic floor ultrasound evaluation indexes were compared among the three groups.Results:(1)Changes of pelvic floor structure: Bladder neck position and Bladder neck angle(resting state and largest Valsalva action)were not statistically significant among the three groups(P>0.05).Bladder neck mobility,urethral rotation angle,anteroposterior diameter(AP),left-right diameter(LR)and area(HA)of levator ani muscle hiatus after Valsalva’s action in UI group were larger than that of NUI group and control group,but the difference was not statistically significant(P>0.05).There was no significant difference between the NUI group and the control group(P>0.05).(2)Changes of pelvic floor muscle electrophysiology: The average amplitude of electromyography(AEMG),integral electromyography value(IM),root mean square value(RMS),mean power frequency(MPF),median frequency(MF),maximum value of rapid contractions,average value of tonic contractions and average value of endurance contractions in the UI group and NUI group were lower than that of the control group,the difference was statistically significant(P < 0.05).There was no significant difference between the UI group and NUI group.(P > 0.05).In all subjects,AEMG was correlated with the maximum value of rapid contractions,average value of tonic contractions and average value of endurance contractions(P < 0.05).Conclusion: With or without urinary incontinence,the s EMG of pelvic floor muscle in female patients with stroke decreased in varying degrees,but the morphology and structure of pelvic floor related supporting tissues have not changed significantly.The AEMG is positively correlated with pelvic floor muscle contraction.The electrophysiological index of pelvic floor muscle is a sensitive index to evaluate the pelvic floor muscle function of female patients with stroke.