Abstract：
Pelvic floor muscle tone, which includes active and passive components, is argued to be increased in many pelvic health conditions, including those involving pain. This study systematically reviewed evidence for increased pelvic floor muscle tone in pelvic health conditions.
Electronic databases (PubMed, CINAHL, and Embase) were searched up to May 31, 2021. The search strategy included variants of pelvic and/or floor, muscle, and tone using keywords and Medical Subject Headings (MeSH) terms.
Studies were included if they investigated increased tone of the pelvic floor muscle and reported measures of active or mechanical properties of the pelvic floor muscle in humans with any pelvic health condition, including pain, bowel, urogenital, or sexual dysfunctions. Studies of any design were included, except systematic and narrative reviews. Reference lists of studies, reviews, and book chapters were searched for additional studies.
Data were extracted using a standardized form, including measurement tool and outcome measure. Risk of bias was analyzed using a modified ROBINS-I (Risk of Bias In Non-randomized Studies - of Interventions) tool, and a score was allocated to determine whether the study provided \"convincing\" interpretation (comparison with condition-free control group, valid measure, no application issues).
In total, 151 studies were included, reporting 8 different tools (electromyography, dynamometry, manometry, digital palpation, defecography, ultrasound, magnetic resonance imaging, other). The most common pelvic health condition was pelvic pain (n=16 conditions), followed by bowel and urogenital conditions. Most studies (57%) were cross-sectional. A healthy control group was infrequently included for comparison (27%). Unvalidated methods or methods applied in a manner that precluded convincing interpretation were common (94%). Of the 15 measurement tools that provided convincing evidence, 10 demonstrated greater tone in a pelvic health condition (all pain) compared with controls, and 5 showed no difference.
Despite the large literature, few studies provide convincing evidence for increased tone/overactivity of pelvic floor muscles in pelvic health conditions. Interpretation is hampered by design and measurement issues. Terminology was often inaccurate. Few studies investigate male, transgender, and pediatric groups.
Electronic databases (PubMed, CINAHL, and Embase) were searched up to May 31, 2021. The search strategy included variants of pelvic and/or floor, muscle, and tone using keywords and Medical Subject Headings (MeSH) terms.
Studies were included if they investigated increased tone of the pelvic floor muscle and reported measures of active or mechanical properties of the pelvic floor muscle in humans with any pelvic health condition, including pain, bowel, urogenital, or sexual dysfunctions. Studies of any design were included, except systematic and narrative reviews. Reference lists of studies, reviews, and book chapters were searched for additional studies.
Data were extracted using a standardized form, including measurement tool and outcome measure. Risk of bias was analyzed using a modified ROBINS-I (Risk of Bias In Non-randomized Studies - of Interventions) tool, and a score was allocated to determine whether the study provided \"convincing\" interpretation (comparison with condition-free control group, valid measure, no application issues).
In total, 151 studies were included, reporting 8 different tools (electromyography, dynamometry, manometry, digital palpation, defecography, ultrasound, magnetic resonance imaging, other). The most common pelvic health condition was pelvic pain (n=16 conditions), followed by bowel and urogenital conditions. Most studies (57%) were cross-sectional. A healthy control group was infrequently included for comparison (27%). Unvalidated methods or methods applied in a manner that precluded convincing interpretation were common (94%). Of the 15 measurement tools that provided convincing evidence, 10 demonstrated greater tone in a pelvic health condition (all pain) compared with controls, and 5 showed no difference.
Despite the large literature, few studies provide convincing evidence for increased tone/overactivity of pelvic floor muscles in pelvic health conditions. Interpretation is hampered by design and measurement issues. Terminology was often inaccurate. Few studies investigate male, transgender, and pediatric groups.
摘要：
目标：盆底肌张力，其中包括有源和无源组件，被认为在许多骨盆健康状况中会增加，包括那些涉及疼痛的。这项研究系统地回顾了骨盆健康状况下盆底肌张力增加的证据。
方法：电子数据库(PubMed，CINAHL,和Embase)被搜索到2021年5月31日。搜索策略包括骨盆和/或地板的变体，肌肉，和语气使用关键字和医学主题词(MeSH)术语。
方法：如果研究调查了盆底肌肉的张力增加，并报告了具有任何骨盆健康状况的人的盆底肌肉的活性或机械性能的测量，包括疼痛,肠,泌尿生殖系统,或者性功能障碍。包括任何设计的研究，除了系统和叙述性的评论。研究的参考清单，reviews,和书籍章节进行了搜索以进行其他研究。
方法：使用标准化表格提取数据，包括测量工具和结果测量。使用改良的ROBINS-I（非随机研究中的偏倚风险-干预）工具分析偏倚风险，并分配分数以确定研究是否提供了“令人信服”的解释(与无条件对照组相比，有效度量，没有应用程序问题)。
结果：总计，共纳入151项研究，报告8种不同的工具(肌电图，测力计,测压,数字触诊,排粪造影,超声，磁共振成像，其他)。最常见的骨盆健康状况是骨盆疼痛（n=16），其次是肠道和泌尿生殖系统。大多数研究（57％）是横断面的。很少包括健康对照组进行比较（27％）。未经验证的方法或以排除令人信服的解释的方式应用的方法很常见(94%)。在提供令人信服证据的15种测量工具中，与对照组相比，10在骨盆健康状况（所有疼痛）中表现出更大的张力，5没有差异。
结论：尽管有大量文献，很少有研究提供令人信服的证据，证明骨盆健康状况下骨盆底肌肉的张力/过度活动增加。解释受到设计和测量问题的阻碍。术语往往不准确。很少有研究调查男性，变性人,和儿科组。
方法：电子数据库(PubMed，CINAHL,和Embase)被搜索到2021年5月31日。搜索策略包括骨盆和/或地板的变体，肌肉，和语气使用关键字和医学主题词(MeSH)术语。
方法：如果研究调查了盆底肌肉的张力增加，并报告了具有任何骨盆健康状况的人的盆底肌肉的活性或机械性能的测量，包括疼痛,肠,泌尿生殖系统,或者性功能障碍。包括任何设计的研究，除了系统和叙述性的评论。研究的参考清单，reviews,和书籍章节进行了搜索以进行其他研究。
方法：使用标准化表格提取数据，包括测量工具和结果测量。使用改良的ROBINS-I（非随机研究中的偏倚风险-干预）工具分析偏倚风险，并分配分数以确定研究是否提供了“令人信服”的解释(与无条件对照组相比，有效度量，没有应用程序问题)。
结果：总计，共纳入151项研究，报告8种不同的工具(肌电图，测力计,测压,数字触诊,排粪造影,超声，磁共振成像，其他)。最常见的骨盆健康状况是骨盆疼痛（n=16），其次是肠道和泌尿生殖系统。大多数研究（57％）是横断面的。很少包括健康对照组进行比较（27％）。未经验证的方法或以排除令人信服的解释的方式应用的方法很常见(94%)。在提供令人信服证据的15种测量工具中，与对照组相比，10在骨盆健康状况（所有疼痛）中表现出更大的张力，5没有差异。
结论：尽管有大量文献，很少有研究提供令人信服的证据，证明骨盆健康状况下骨盆底肌肉的张力/过度活动增加。解释受到设计和测量问题的阻碍。术语往往不准确。很少有研究调查男性，变性人,和儿科组。
