The pelvic floor muscle hyperalgesia (PFMH) scoring system: a new classification tool to assess women with chronic pelvic pain: multicentre pilot study of validity and reliability

Abstract Objective The contribution of pelvic floor muscle tenderness to chronic pelvic pain (CPP) is well established in the literature. However pelvic floor muscle hyperalgesia (PFMH) is often missed during vaginal examination of women with CPP. To our knowledge criteria for diagnosing PFMH has no...

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Veröffentlicht in:European journal of obstetrics & gynecology and reproductive biology 2015-10, Vol.193, p.111-113
Hauptverfasser: Bhide, Alka A, Puccini, Federica, Bray, Rhiannon, Khullar, Vik, Digesu, G. Alessandro
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container_start_page 111
container_title European journal of obstetrics & gynecology and reproductive biology
container_volume 193
creator Bhide, Alka A
Puccini, Federica
Bray, Rhiannon
Khullar, Vik
Digesu, G. Alessandro
description Abstract Objective The contribution of pelvic floor muscle tenderness to chronic pelvic pain (CPP) is well established in the literature. However pelvic floor muscle hyperalgesia (PFMH) is often missed during vaginal examination of women with CPP. To our knowledge criteria for diagnosing PFMH has not been established or validated so far. The aim of this study is to assess the validity and reliability of the PFMH scoring system. Study design Women with and without PFMH were recruited prospectively. Digital pelvic examination was performed to detect any pain. All women were asked to report of any discomfort or pain evoked by digital palpation of the PFMs and to rate the severity of pain/discomfort as none (grade 0), mild (grade I) moderate (grade II) or severe (grade III). All women were also asked to describe the severity of the pain/discomfort using a visual analogue scale (VAS). Following examination a PFMH score was given according to each patient's reactions. Intra-observer and inter-observer reliability was assessed. Construct and content validity was also determined. Results 111 (44 symptomatic and 67 controls) were recruited. Intraobserver reliability had ICCs between 0.426 and 0.804. Interobserver reliability had ICCs between 0.724 and 0.917. There was a good correlation between PFMH scores and VAS scores (rho 0.994, p < 0.01). Total scores between symptomatic and controls were significantly different ( p < 0.01 Mann–Whitney U test). Conclusion The PFMH scoring system is a simple, reliable, valid and easy screening tool for in the assessment of women with CPP.
doi_str_mv 10.1016/j.ejogrb.2015.07.008
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Alessandro</creator><creatorcontrib>Bhide, Alka A ; Puccini, Federica ; Bray, Rhiannon ; Khullar, Vik ; Digesu, G. Alessandro</creatorcontrib><description>Abstract Objective The contribution of pelvic floor muscle tenderness to chronic pelvic pain (CPP) is well established in the literature. However pelvic floor muscle hyperalgesia (PFMH) is often missed during vaginal examination of women with CPP. To our knowledge criteria for diagnosing PFMH has not been established or validated so far. The aim of this study is to assess the validity and reliability of the PFMH scoring system. Study design Women with and without PFMH were recruited prospectively. Digital pelvic examination was performed to detect any pain. All women were asked to report of any discomfort or pain evoked by digital palpation of the PFMs and to rate the severity of pain/discomfort as none (grade 0), mild (grade I) moderate (grade II) or severe (grade III). All women were also asked to describe the severity of the pain/discomfort using a visual analogue scale (VAS). Following examination a PFMH score was given according to each patient's reactions. Intra-observer and inter-observer reliability was assessed. Construct and content validity was also determined. Results 111 (44 symptomatic and 67 controls) were recruited. Intraobserver reliability had ICCs between 0.426 and 0.804. Interobserver reliability had ICCs between 0.724 and 0.917. There was a good correlation between PFMH scores and VAS scores (rho 0.994, p &lt; 0.01). Total scores between symptomatic and controls were significantly different ( p &lt; 0.01 Mann–Whitney U test). Conclusion The PFMH scoring system is a simple, reliable, valid and easy screening tool for in the assessment of women with CPP.</description><identifier>ISSN: 0301-2115</identifier><identifier>EISSN: 1872-7654</identifier><identifier>DOI: 10.1016/j.ejogrb.2015.07.008</identifier><identifier>PMID: 26291685</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>Adult ; Case-Control Studies ; Chronic Pain - etiology ; Chronic pelvic pain ; Female ; Humans ; Hyperalgesia - classification ; Hyperalgesia - complications ; Hyperalgesia - diagnosis ; Middle Aged ; Myofascial Pain Syndromes - classification ; Myofascial Pain Syndromes - complications ; Myofascial Pain Syndromes - diagnosis ; Observer Variation ; Obstetrics and Gynecology ; Pain Measurement - methods ; Palpation ; Pelvic Floor ; Pelvic floor examination ; Pelvic floor muscle hyperalgesia ; Pelvic Pain - etiology ; Pilot Projects ; Prospective Studies ; Reproducibility of Results ; Self Report ; Touch</subject><ispartof>European journal of obstetrics &amp; gynecology and reproductive biology, 2015-10, Vol.193, p.111-113</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2015 Elsevier Ireland Ltd</rights><rights>Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-6c0dc0c192942c46c336d24cb72de7c451b650848ea237170cfaa20288359bec3</citedby><cites>FETCH-LOGICAL-c417t-6c0dc0c192942c46c336d24cb72de7c451b650848ea237170cfaa20288359bec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejogrb.2015.07.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26291685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bhide, Alka A</creatorcontrib><creatorcontrib>Puccini, Federica</creatorcontrib><creatorcontrib>Bray, Rhiannon</creatorcontrib><creatorcontrib>Khullar, Vik</creatorcontrib><creatorcontrib>Digesu, G. Alessandro</creatorcontrib><title>The pelvic floor muscle hyperalgesia (PFMH) scoring system: a new classification tool to assess women with chronic pelvic pain: multicentre pilot study of validity and reliability</title><title>European journal of obstetrics &amp; gynecology and reproductive biology</title><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><description>Abstract Objective The contribution of pelvic floor muscle tenderness to chronic pelvic pain (CPP) is well established in the literature. However pelvic floor muscle hyperalgesia (PFMH) is often missed during vaginal examination of women with CPP. To our knowledge criteria for diagnosing PFMH has not been established or validated so far. The aim of this study is to assess the validity and reliability of the PFMH scoring system. Study design Women with and without PFMH were recruited prospectively. Digital pelvic examination was performed to detect any pain. All women were asked to report of any discomfort or pain evoked by digital palpation of the PFMs and to rate the severity of pain/discomfort as none (grade 0), mild (grade I) moderate (grade II) or severe (grade III). All women were also asked to describe the severity of the pain/discomfort using a visual analogue scale (VAS). Following examination a PFMH score was given according to each patient's reactions. Intra-observer and inter-observer reliability was assessed. Construct and content validity was also determined. Results 111 (44 symptomatic and 67 controls) were recruited. Intraobserver reliability had ICCs between 0.426 and 0.804. Interobserver reliability had ICCs between 0.724 and 0.917. There was a good correlation between PFMH scores and VAS scores (rho 0.994, p &lt; 0.01). Total scores between symptomatic and controls were significantly different ( p &lt; 0.01 Mann–Whitney U test). Conclusion The PFMH scoring system is a simple, reliable, valid and easy screening tool for in the assessment of women with CPP.</description><subject>Adult</subject><subject>Case-Control Studies</subject><subject>Chronic Pain - etiology</subject><subject>Chronic pelvic pain</subject><subject>Female</subject><subject>Humans</subject><subject>Hyperalgesia - classification</subject><subject>Hyperalgesia - complications</subject><subject>Hyperalgesia - diagnosis</subject><subject>Middle Aged</subject><subject>Myofascial Pain Syndromes - classification</subject><subject>Myofascial Pain Syndromes - complications</subject><subject>Myofascial Pain Syndromes - diagnosis</subject><subject>Observer Variation</subject><subject>Obstetrics and Gynecology</subject><subject>Pain Measurement - methods</subject><subject>Palpation</subject><subject>Pelvic Floor</subject><subject>Pelvic floor examination</subject><subject>Pelvic floor muscle hyperalgesia</subject><subject>Pelvic Pain - etiology</subject><subject>Pilot Projects</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Self Report</subject><subject>Touch</subject><issn>0301-2115</issn><issn>1872-7654</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks9uEzEQxlcIREPhDRDysRw22N6_6QGpqihFKgKJcra8s7PJBK8dbG-ifS5eEEcJHLhgWbZsfTOfPb_JsteCLwUX9bvtErdu7bul5KJa8mbJefskW4i2kXlTV-XTbMELLnIpRHWRvQhhy9MoitXz7ELWciXqtlpkvx43yHZo9gRsMM55Nk4BDLLNvEOvzRoDaXb19e7z_VsWwHmyaxbmEHG8ZppZPDAwOgQaCHQkZ1l0zqSFpUsMgR3ciJYdKG4YbLyzyedst9Nkr5OdiQRoo0_vIOMiC3HqZ-YGtteGeooz07ZnHg3pjkw6v8yeDdoEfHXeL7Pvdx8eb-_zhy8fP93ePORQiibmNfAeOIiVXJUSyhqKou5lCV0je2ygrERXV7wtW9SyaETDYdBactm2RbXqEIrL7OqUd-fdzwlDVCMFQGO0RTcFJZpU2jLNIknLkxS8C8HjoHaeRu1nJbg64lJbdcKljrgUb1TClcLenB2mbsT-b9AfPknw_iTA9M89oVcBCC1gTx4hqt7R_xz-TQCGEgRtfuCMYesmb1MNlVBBKq6-HVvm2DGi4lyWVV38Bk19wFY</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Bhide, Alka A</creator><creator>Puccini, Federica</creator><creator>Bray, Rhiannon</creator><creator>Khullar, Vik</creator><creator>Digesu, G. Alessandro</creator><general>Elsevier Ireland Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>The pelvic floor muscle hyperalgesia (PFMH) scoring system: a new classification tool to assess women with chronic pelvic pain: multicentre pilot study of validity and reliability</title><author>Bhide, Alka A ; Puccini, Federica ; Bray, Rhiannon ; Khullar, Vik ; Digesu, G. Alessandro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-6c0dc0c192942c46c336d24cb72de7c451b650848ea237170cfaa20288359bec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Case-Control Studies</topic><topic>Chronic Pain - etiology</topic><topic>Chronic pelvic pain</topic><topic>Female</topic><topic>Humans</topic><topic>Hyperalgesia - classification</topic><topic>Hyperalgesia - complications</topic><topic>Hyperalgesia - diagnosis</topic><topic>Middle Aged</topic><topic>Myofascial Pain Syndromes - classification</topic><topic>Myofascial Pain Syndromes - complications</topic><topic>Myofascial Pain Syndromes - diagnosis</topic><topic>Observer Variation</topic><topic>Obstetrics and Gynecology</topic><topic>Pain Measurement - methods</topic><topic>Palpation</topic><topic>Pelvic Floor</topic><topic>Pelvic floor examination</topic><topic>Pelvic floor muscle hyperalgesia</topic><topic>Pelvic Pain - etiology</topic><topic>Pilot Projects</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>Self Report</topic><topic>Touch</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bhide, Alka A</creatorcontrib><creatorcontrib>Puccini, Federica</creatorcontrib><creatorcontrib>Bray, Rhiannon</creatorcontrib><creatorcontrib>Khullar, Vik</creatorcontrib><creatorcontrib>Digesu, G. Alessandro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of obstetrics &amp; gynecology and reproductive biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bhide, Alka A</au><au>Puccini, Federica</au><au>Bray, Rhiannon</au><au>Khullar, Vik</au><au>Digesu, G. Alessandro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The pelvic floor muscle hyperalgesia (PFMH) scoring system: a new classification tool to assess women with chronic pelvic pain: multicentre pilot study of validity and reliability</atitle><jtitle>European journal of obstetrics &amp; gynecology and reproductive biology</jtitle><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>193</volume><spage>111</spage><epage>113</epage><pages>111-113</pages><issn>0301-2115</issn><eissn>1872-7654</eissn><abstract>Abstract Objective The contribution of pelvic floor muscle tenderness to chronic pelvic pain (CPP) is well established in the literature. However pelvic floor muscle hyperalgesia (PFMH) is often missed during vaginal examination of women with CPP. To our knowledge criteria for diagnosing PFMH has not been established or validated so far. The aim of this study is to assess the validity and reliability of the PFMH scoring system. Study design Women with and without PFMH were recruited prospectively. Digital pelvic examination was performed to detect any pain. All women were asked to report of any discomfort or pain evoked by digital palpation of the PFMs and to rate the severity of pain/discomfort as none (grade 0), mild (grade I) moderate (grade II) or severe (grade III). All women were also asked to describe the severity of the pain/discomfort using a visual analogue scale (VAS). Following examination a PFMH score was given according to each patient's reactions. Intra-observer and inter-observer reliability was assessed. Construct and content validity was also determined. Results 111 (44 symptomatic and 67 controls) were recruited. Intraobserver reliability had ICCs between 0.426 and 0.804. Interobserver reliability had ICCs between 0.724 and 0.917. There was a good correlation between PFMH scores and VAS scores (rho 0.994, p &lt; 0.01). Total scores between symptomatic and controls were significantly different ( p &lt; 0.01 Mann–Whitney U test). Conclusion The PFMH scoring system is a simple, reliable, valid and easy screening tool for in the assessment of women with CPP.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>26291685</pmid><doi>10.1016/j.ejogrb.2015.07.008</doi><tpages>3</tpages></addata></record>
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subjects Adult
Case-Control Studies
Chronic Pain - etiology
Chronic pelvic pain
Female
Humans
Hyperalgesia - classification
Hyperalgesia - complications
Hyperalgesia - diagnosis
Middle Aged
Myofascial Pain Syndromes - classification
Myofascial Pain Syndromes - complications
Myofascial Pain Syndromes - diagnosis
Observer Variation
Obstetrics and Gynecology
Pain Measurement - methods
Palpation
Pelvic Floor
Pelvic floor examination
Pelvic floor muscle hyperalgesia
Pelvic Pain - etiology
Pilot Projects
Prospective Studies
Reproducibility of Results
Self Report
Touch
title The pelvic floor muscle hyperalgesia (PFMH) scoring system: a new classification tool to assess women with chronic pelvic pain: multicentre pilot study of validity and reliability
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