Clinical Evaluation of Pelvic Floor Muscles Versus Instrumental Assessment with Myotonometry: A Diagnostic Validity Study

Abstract

Pelvic floor evaluation is essential for assessing its mechanical and elastic properties to guide treatment decisions. The lack of objective instrumental tools creates challenges in both clinical practice and research. This study aimed to evaluate the diagnostic validity of subjective palpation for classifying pelvic floor muscle tone in comparison to biomechanical parameters obtained with myotonometry in healthy young women. A secondary aim was to explore the consistency of measurements between a novice and an experienced examiner. An observational study was conducted in the laboratories of the Universidad Europea de Madrid. Forty-nine healthy women (mean age 24.4 ± 7.23 years) were recruited. Each participant underwent pelvic floor assessment by palpation and myotonometry, performed independently by one novice and one experienced examiner. ROC analysis showed that tone and dynamic stiffness were reliable markers for identifying hypertonicity in subjective palpation. Significant differences were found across hypotonic, normotonic, and hypertonic classifications for both the novice (F = 24.581, p < 0.001, η2p = 0.517) and experienced (F = 28.219, p < 0.001, η2p = 0.551) examiners. Myotonometry measurements demonstrated significant alignment with palpation-based classifications of perineal body tone. Minimal differences between novice and experienced examiners suggest that myotonometry can provide consistent results regardless of experience.