Best Verbal Instruction to Obtain Voluntary Pelvic Floor Muscle Contraction
Best Verbal Instruction to Obtain Voluntary Pelvic Floor Muscle Contraction
The purpose of this study is to determine the best verbal instruction to obtain a PFMC and to
 evaluate the understanding and acceptability of the proposed instructions.
Pelvic floor muscles contraction (PFMC) is usually recommended for evaluation and treatment
 of pelvic floor disorders.

 In clinical practice, many patients fail to achieve a voluntary PFMC and only about one-third
 of women perform an ideal PFMC after brief written or verbal instruction. When no PFMC is
 elicited, it might be explained by an anatomical or neurological issue but also by a lack of
 understanding of the instructions and / or poor knowledge of the anatomy. Pelvic floor
 muscles (PFM) evaluation may depends on the method used to elicit and assess the contraction
 including verbal instructions. There is no current gold standard methodology for quantifying
 PFM strength and the verbal instructions used to elicit the PFMC are rarely reported in the
 studies. There is few specific works about the instructions. One recent study report that the
 pattern of urethral movement is influenced by the instructions used to teach activation of
 the PFM in men. Another study showed that some specific instructions are most effective in
 eliciting a correct PFMC in women.

 Thus, an appropriate verbal instruction in terms of understanding, social and cultural
 acceptability, taking into account the anatomical knowledge of the patients, would probably
 allow a better evaluation of the PFM and even a better efficacy of pelvic floor training.

 The purpose of this study is to determine the best verbal instruction to obtain a PFMC and to
 evaluate the understanding and acceptability of the proposed instructions.

 This is a prospective observational study lead in two phases in the Neurourology Department
 of a University Hospital.

 Phase 1: survey carry out the health professionals. Members of the scientific committees of
 national academic societies in neuro-urology, pelvi-perineology and pelvic-floor
 neurophysiology would be invited to answer a questionnaire by mail. It will include open
 questions about the most frequently verbal instructions used to elicit a PFMC. These
 instructions will be collected, analysed and selected for the second phase.

 Phase 2: structured interviews with patients and with non-health professional subjects.

 Patients and non-health professionals subjects will be invited to answer a 3-parts
 questionnaire based on the gender: (i) demographic, social and medical data; (ii) evaluation
 of the anatomical knowledge of the perineum with a picture of the perineum and a sagittal
 section of the pelvic area of the corresponding sex. In the third part (iii), the
 participants will assess the instructions selected in the first phase according to their
 understanding and their acceptability (good, intermediate, poor). They finally will have to
 choose the best instruction i.e. which seems to be the more suitable to obtain a PFMC.

 Ethics: a local ethics committee approved this study. Since it is an observational study, the
 participant will have a newsletter.
Inclusion Criteria:

 -  Follow in neuro-urology

 -  Lower urinary tract symptoms

 Exclusion Criteria:

 -  Can't speak French