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Is there correlation between electromyography and digital palpation as means of measuring pelvic floor muscle contractility in nulliparous, pregnant, and postpartum women?§


  • Mickey Karram led the peer-review process as the Associate Editor responsible for the paper.

  • Conflict of interest: none.

  • §

    Study conducted by the Division of Female Urology of Department of Surgery, Faculty of Medical Sciences of the State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.

  • This study was presented in the Podium Session at the 41st Annual Meeting of International Continence Society in Glasgow, UK, 2011.



The continence mechanisms depend on the integrity of the pelvic floor muscles. It is therefore important to find simple, reliable, and safe methods to assess its contractility in a clinical setting. This study aims to investigate if digital palpation of the pelvic floor muscles presents correlation with its electromyographic activity.


The sample consisted of 307 women with mean age of 23.93 years, including 39 nulliparous, 117 primigravid pregnant, 64 primiparous, in post-vaginal delivery, and 87 primiparous women, in post-cesarean section delivery. The assessment consisted of both digital palpation and surface electromyography. One, and the same, highly skilled and experienced physiotherapist, who was able to classify the different grades of contractility accurately, performed digital palpation using the Modified Oxford Grading Scale. Surface electromyography was performed using an intravaginal probe. For electromyography evaluation, three contractions of 5 sec each were recorded, and an average of three Root Mean squares was considered for analysis. Spearman's Coefficient, Jonckheere–Terpstra Test, Kruskal–Wallis as well as Dunn Test were used for statistical analysis.


The strong correlation found between the two methods (P < 0.001) indicates that both digital palpation and electromyography can be used in everyday practice, both for clinical use and scientific research, although both have their specific limitations and requirements to avoid the risk of biases.


There was a correlation between pelvic floor muscle contractility measured by surface electromyography and by digital palpation. Both methods can be used to validate data in research and clinical setting. Neurourol. Urodynam. 32: 420–423, 2013. © 2012 Wiley Periodicals, Inc.