{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:24:58Z","timestamp":1792470298112,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T00:00:00Z","timestamp":1658016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the validity of shear wave elastography (SWE) as a measure of stiffness of the puborectalis muscle by examining: (1) the relationship between puborectalis muscle stiffness and pelvic floor muscle (PFM) activation at different intensities; and (2) the relationship between puborectalis stiffness and pelvic floor morphometry during contractions at different intensities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Fifteen healthy asymptomatic women performed 6\u2010s isometric PFM contractions at different intensities (0, 10%, 20%, 30%, 50%, 75%, and 100% of maximal voluntary contraction) guided by intravaginal electromyography (EMG). Stiffness of the puborectalis muscle was measured using SWE by calculating the average shear modulus in regions of interest that contained puborectalis muscle fibers parallel to the transducer. Pelvic floor morphometry was assessed in the mid\u2010sagittal plane using transperineal B\u2010mode ultrasound imaging. Shear modulus, EMG (root mean square amplitude) and pelvic floor morphometry parameters were normalized to the value recorded during maximal voluntary contraction. To assess the relationship between stiffness and pelvic floor activation\/morphometry, coefficient of determination (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ) was calculated for each participant and a group average was computed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Shear modulus and EMG were highly correlated (average\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      ; left 0.90\u2009\u00b1\u20090.08, right 0.87\u2009\u00b1\u20090.15). Shear modulus also strongly correlated with bladder neck position (\n                      <jats:italic>x<\/jats:italic>\n                      \u2010axis horizontal coordinates relative to the pubic symphysis), anorectal rectal angle and position, levator plate angle, and antero\u2010posterior diameter of the levator hiatus (average\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      : range 0.62\u20130.78).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings support the validity of SWE to assess puborectalis muscle stiffness in females. Stiffness measures were strongly associated with PFM EMG and pelvic floor morphometry and may be used to indirectly assess the level of activation of the puborectalis muscle without the use of more invasive techniques. By overcoming limitations of current assessment tools, this promising noninvasive and real\u2010time technique could enable important breakthrough in the pathophysiology and management of pelvic floor disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.25010","type":"journal-article","created":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T03:20:04Z","timestamp":1658028004000},"page":"1620-1628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Validation of shear wave elastography as a noninvasive measure of pelvic floor muscle stiffness"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7171-1411","authenticated-orcid":false,"given":"M\u00e9lanie","family":"Morin","sequence":"first","affiliation":[{"name":"School of Rehabilitation, Faculty of Medicine and Health Sciences Universit\u00e9 de Sherbrooke and Research Center of the Centre Hospitalier de l'Universit\u00e9 de Sherbrooke (CHUS)  Sherbrooke Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sauro E.","family":"Salomoni","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, Center for Clinical Research Excellence in Spinal Pain, Injury and Health The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5444-477X","authenticated-orcid":false,"given":"Ryan E.","family":"Stafford","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, Center for Clinical Research Excellence in Spinal Pain, Injury and Health The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne M.","family":"Hall","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, Center for Clinical Research Excellence in Spinal Pain, Injury and Health The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1206-9107","authenticated-orcid":false,"given":"Paul W.","family":"Hodges","sequence":"additional","affiliation":[{"name":"School of Health and Rehabilitation Sciences, Center for Clinical Research Excellence in Spinal Pain, Injury and Health The University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181fd2356"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0b013e3181ed3e31"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2017.02.012"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20069"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12367"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-011-1652-4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-017-2843-y"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/bcr2787"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0766"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0029261"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23275"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13688"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-018-3693-4"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15232"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7750"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2015.02.005"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.08.105"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20618"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24658"},{"key":"e_1_2_10_21_1","volume-title":"Foundations of Clinical Research. 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