{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:20:50Z","timestamp":1789446050634,"version":"build-2803163510"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2017,4,1]],"date-time":"2017-04-01T00:00:00Z","timestamp":1491004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2017,4,1]],"date-time":"2017-04-01T00:00:00Z","timestamp":1491004800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pelvic floor muscle (PFM) dysfunctions are reported to be involved in provoked vestibulodynia (PVD). Although heightened PFM tone has been suggested, the relative contribution of active and passive components of tone remains misunderstood. Likewise, alterations in PFM contractility have been scarcely studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare PFM tone, including the relative contribution of its active and passive components, and muscular contractility in women with PVD and asymptomatic controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-six asymptomatic women and 56 women with PVD participated in the study. The PVD diagnosis was confirmed by a gynecologist based on a standardized examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>PFM function was evaluated using a dynamometric speculum combined with surface electromyography (EMG). PFM general tone was evaluated in static conditions at different vaginal apertures and during repeated dynamic cyclic stretching. The active contribution of tone was characterized using the ratio between EMG in a static position and during stretching and the proportion of women presenting PFM activation during stretching. Contribution of the passive component was evaluated using resting forces, stiffness, and hysteresis in women sustaining a negligible EMG signal during stretching. PFM contractility, such as strength, speed of contraction, coordination, and endurance, also was assessed during voluntary isometric efforts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Greater PFM resting forces and stiffness were found in women with PVD compared with controls, indicating an increased general tone. An increased active component also was found in women with PVD because they presented a superior EMG ratio, and a larger proportion of them presented PFM activation during stretching. Higher passive properties also were found in women with PVD. Women with PVD also showed decreased strength, speed of contraction, coordination, and endurance compared with controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications<\/jats:title>\n                    <jats:p>Findings provide further evidence of the contribution of PFM alterations in the etiology of PVD. These alterations should be assessed to provide patient-centered targeted treatment options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strengths and Limitations<\/jats:title>\n                    <jats:p>The use of a validated tool investigating PFM alterations constitutes a strength of this study. However, the study design does not allow the determination of the sequence of events in which these muscle alterations occurred\u2014before or after the onset of PVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings support the involvement of active and passive components of PFM tone and an altered PFM contractility in women with PVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.jsxm.2017.02.012","type":"journal-article","created":{"date-parts":[[2017,3,30]],"date-time":"2017-03-30T12:34:11Z","timestamp":1490877251000},"page":"592-600","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":94,"title":["Heightened Pelvic Floor Muscle Tone and Altered Contractility in Women with Provoked Vestibulodynia"],"prefix":"10.1093","volume":"14","author":[{"given":"M\u00e9lanie","family":"Morin","sequence":"first","affiliation":[{"name":"School of Rehabilitation \u00a0 \u00a0 \u00a0 , Sherbrooke, QC , Canada"},{"name":"Faculty of Medicine and Health Sciences \u00a0 \u00a0 \u00a0 , Sherbrooke, QC , Canada"},{"name":"Universit\u00e9 de Sherbrooke; Research Center \u00a0 \u00a0 \u00a0 , Sherbrooke, QC , Canada"},{"name":"Centre hospitalier de l\u2019Universit\u00e9 de Sherbrooke \u00a0 \u00a0 \u00a0 , Sherbrooke, QC , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yitzchak M.","family":"Binik","sequence":"additional","affiliation":[{"name":"Department of Psychology \u00a0 , Montr\u00e9al, QC , Canada"},{"name":"McGill University \u00a0 , Montr\u00e9al, QC , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Bourbonnais","sequence":"additional","affiliation":[{"name":"School of Rehabilitation \u00a0 \u00a0 , Montr\u00e9al, QC , Canada"},{"name":"Faculty of Medicine \u00a0 \u00a0 , Montr\u00e9al, QC , Canada"},{"name":"Universit\u00e9 de Montr\u00e9al; Institute of Rehabilitation Gingras-Lindsay of Montreal; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) \u00a0 \u00a0 , Montr\u00e9al, QC , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Khalif\u00e9","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u00a0 , Montr\u00e9al, QC , Canada"},{"name":"Jewish General Hospital \u00a0 , Montr\u00e9al, QC , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Ouellet","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology \u00a0 , Montr\u00e9al, QC , Canada"},{"name":"Universit\u00e9 de Montr\u00e9al and CHUM \u00a0 , Montr\u00e9al, QC , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Bergeron","sequence":"additional","affiliation":[{"name":"Department of Psychology \u00a0 , Montr\u00e9al, QC , Canada"},{"name":"Universit\u00e9 de Montr\u00e9al \u00a0 , Montr\u00e9al, QC , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,4,1]]},"reference":[{"key":"2023011111052761700_bib1","doi-asserted-by":"crossref","first-page":"40.e1","DOI":"10.1016\/j.ajog.2013.09.033","article-title":"Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions","volume":"210","author":"Harlow","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"2023011111052761700_bib2","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1097\/AOG.0000000000001359","article-title":"2015 ISSVD, ISSWSH and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia","volume":"127","author":"Bornstein","year":"2016","journal-title":"Obstet Gynecol"},{"key":"2023011111052761700_bib3","first-page":"291","article-title":"Vulvodynia: definition, prevalence, impact, and pathophysiological factors","volume":"13","author":"Pukall","year":"2016","journal-title":"J\u00a0Sex Med"},{"key":"2023011111052761700_bib4","first-page":"3227","article-title":"Moving beyond the diagnosis of vestibulodynia\u2014a holiday wish list","volume":"6","author":"Goldstein","year":"2009","journal-title":"J\u00a0Sex Med"},{"key":"2023011111052761700_bib5","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/j.pain.2011.01.035","article-title":"Genital pain in women: beyond interference with intercourse","volume":"152","author":"Bergeron","year":"2011","journal-title":"Pain"},{"key":"2023011111052761700_bib6","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1097\/01.ogx.0000219814.40759.38","article-title":"A\u00a0conceptual model for the pathophysiology of vulvar vestibulitis syndrome","volume":"61","author":"Zolnoun","year":"2006","journal-title":"Obstet Gynecol Surv"},{"key":"2023011111052761700_bib7","first-page":"776","article-title":"Morphometry of the pelvic floor muscles in women with and without provoked vestibulodynia using 4D ultrasound","volume":"11","author":"Morin","year":"2014","journal-title":"J\u00a0Sex Med"},{"key":"2023011111052761700_bib8","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/01443610400023106","article-title":"Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome","volume":"26","author":"Reissing","year":"2005","journal-title":"J\u00a0Psychosom Obstet Gynaecol"},{"key":"2023011111052761700_bib9","first-page":"1003","article-title":"Pelvic floor muscle assessment outcomes in women with and without provoked vestibulodynia and the impact of a physical therapy program","volume":"7","author":"Gentilcore-Saulnier","year":"2010","journal-title":"J\u00a0Sex Med"},{"key":"2023011111052761700_bib10","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/B:ASEB.0000007458.32852.c8","article-title":"Vaginal spasm, pain, and behavior: an empirical investigation of the diagnosis of vaginismus","volume":"33","author":"Reissing","year":"2004","journal-title":"Arch Sex Behav"},{"key":"2023011111052761700_bib11","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1007\/s00192-015-2660-6","article-title":"Pelvic floor muscle function in women with provoked vestibulodynia and asymptomatic controls","volume":"26","author":"Naess","year":"2015","journal-title":"Int Urogynecol J"},{"key":"2023011111052761700_bib12","first-page":"157","article-title":"Establishing the diagnosis of vulvar vestibulitis","volume":"42","author":"White","year":"1997","journal-title":"J\u00a0Reprod Med"},{"key":"2023011111052761700_bib13","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.clinph.2008.10.156","article-title":"Central nervous system abnormalities in vaginismus","volume":"120","author":"Frasson","year":"2009","journal-title":"Clin Neurophysiol"},{"key":"2023011111052761700_bib14","first-page":"959","article-title":"Electromyographic comparisons of the pelvic floor in women with dysesthetic vulvodynia and asymptomatic women","volume":"43","author":"Glazer","year":"1998","journal-title":"J\u00a0Reprod Med"},{"key":"2023011111052761700_bib15","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1080\/01674820400017921","article-title":"Surface electromyography diagnostics in women with partial vaginismus with or without vulvar vestibulitis and in asymptomatic women","volume":"25","author":"Engman","year":"2004","journal-title":"J\u00a0Psychosom Obstet Gynaecol"},{"key":"2023011111052761700_bib16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0304-3959(97)00102-4","article-title":"Understanding and measurement of muscle tone as related to clinical muscle pain","volume":"75","author":"Simons","year":"1998","journal-title":"Pain"},{"key":"2023011111052761700_bib17","first-page":"883","article-title":"Vaginal palpation of pelvic floor muscle strength: Inter-test reproducibility and comparison between palpation and vaginal squeeze pressure","volume":"80","author":"Bo","year":"2001","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2023011111052761700_bib18","first-page":"2178","article-title":"Active and passive components of pelvic floor muscle tone in women with provoked vestibulodynia: a perspective based on a review of the literature","volume":"12","author":"Thibault-Gagnon","year":"2015","journal-title":"J\u00a0Sex Med"},{"key":"2023011111052761700_bib19","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jneumeth.2009.05.027","article-title":"The reliability of surface EMG recorded from the pelvic floor muscles","volume":"182","author":"Auchincloss","year":"2009","journal-title":"J\u00a0Neurosci Methods"},{"issue":"96","key":"2023011111052761700_bib20","first-page":"1486","article-title":"The extraction of neural strategies from the surface EMG","volume":"2004","author":"Farina","year":"1985","journal-title":"J\u00a0Appl Phys"},{"key":"2023011111052761700_bib21","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/S0268-0033(00)00061-9","article-title":"Passive extensibility of skeletal muscle: review of the literature with clinical implications","volume":"16","author":"Gajdosik","year":"2001","journal-title":"Clin Biomech"},{"key":"2023011111052761700_bib22","first-page":"85","article-title":"Surface electromyographic amplitude normalization methods: a review","volume-title":"Electromyography: new developments, procedures and applications","author":"Sousa","year":"2012"},{"key":"2023011111052761700_bib23","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1002\/nau.20603","article-title":"Reliability of dynamometric passive properties of the pelvic floor muscles in postmenopausal women with stress urinary incontinence","volume":"27","author":"Morin","year":"2008","journal-title":"Neurourol Urodyn"},{"key":"2023011111052761700_bib24","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.jelekin.2009.10.004","article-title":"Application of a new method in the study of pelvic floor muscle passive properties in continent women","volume":"20","author":"Morin","year":"2010","journal-title":"J\u00a0Electromyogr Kinesiol"},{"key":"2023011111052761700_bib25","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S0304-3959(00)00449-8","article-title":"A\u00a0randomized comparison of group cognitive-behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis","volume":"91","author":"Bergeron","year":"2001","journal-title":"Pain"},{"key":"2023011111052761700_bib26","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/S0002-9378(96)70243-0","article-title":"The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction","volume":"175","author":"Bump","year":"1996","journal-title":"Am J Obstet Gynecol"},{"key":"2023011111052761700_bib27","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1002\/nau.20334","article-title":"Reliability of speed of contraction and endurance dynamometric measurements of the pelvic floor musculature in stress incontinent parous women","volume":"26","author":"Morin","year":"2007","journal-title":"Neurourol Urodyn"},{"key":"2023011111052761700_bib28","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1002\/nau.10175","article-title":"Reliability of dynamometric measurements of the pelvic floor musculature","volume":"23","author":"Dumoulin","year":"2004","journal-title":"Neurourol Urodyn"},{"key":"2023011111052761700_bib29","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.jelekin.2016.01.009","article-title":"The impact of state of bladder fullness on tonic and phasic activation of the pelvic floor muscles in women","volume":"27","author":"McLean","year":"2016","journal-title":"J\u00a0Electromyogr Kinesiol"},{"key":"2023011111052761700_bib30","doi-asserted-by":"crossref","first-page":"244","DOI":"10.2519\/jospt.1997.26.5.244","article-title":"Viscoelastic behavior of plantar flexor muscle-tendon unit at rest","volume":"26","author":"Lamontagne","year":"1997","journal-title":"J\u00a0Orthop Sports Phys Ther"},{"key":"2023011111052761700_bib31","article-title":"Statistical power analysis for the behavioral sciences","author":"Cohen","year":"1988","edition":"2nd ed."},{"key":"2023011111052761700_bib32","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s00421-005-0091-7","article-title":"Influence of a low-level contractile response from the soleus, gastrocnemius and tibialis anterior muscles on viscoelastic stress-relaxation of aged human calf muscle-tendon units","volume":"96","author":"Gajdosik","year":"2006","journal-title":"Eur J Appl Physiol"},{"key":"2023011111052761700_bib33","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/01274882-200630010-00004","article-title":"Physical therapy treatment for vulvar vestibulitis: a case report","volume":"30","author":"Downey","year":"2006","journal-title":"J\u00a0Womens Health Phys Therap"},{"key":"2023011111052761700_bib34","first-page":"283","article-title":"Treatment of vulvar vestibulitis syndrome with electromyographic biofeedback of pelvic floor musculature","volume":"40","author":"Glazer","year":"1995","journal-title":"J\u00a0Reprod Med"},{"key":"2023011111052761700_bib35","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s10484-008-9049-y","article-title":"Vulvodynia: a psychophysiological profile based on electromyographic assessment","volume":"33","author":"Jantos","year":"2008","journal-title":"Appl Psychophysiol Biofeedback"},{"key":"2023011111052761700_bib36","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1177\/036354659702500522","article-title":"The effect of strength and flexibility training on skeletal muscle electromyographic activity, stiffness, and viscoelastic stress relaxation response","volume":"25","author":"Klinge","year":"1997","journal-title":"Am J Sports Med"},{"key":"2023011111052761700_bib37","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1600-0838.1998.tb00171.x","article-title":"Passive properties of human skeletal muscle during stretch maneuvers. A review","volume":"8","author":"Magnusson","year":"1998","journal-title":"Scand J Med Sci Sports"},{"key":"2023011111052761700_bib38","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1007\/s00192-008-0682-z","article-title":"The quantification of levator muscle resting tone by digital assessment","volume":"19","author":"Dietz","year":"2008","journal-title":"Int Urogynecol J"},{"key":"2023011111052761700_bib39","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.jbmt.2008.05.007","article-title":"Human resting muscle tone (hrmt): narrative introduction and modern concepts","volume":"12","author":"Masi","year":"2008","journal-title":"J\u00a0Bodyw Mov Ther"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609517301182?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609517301182?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/14\/4\/592\/48526238\/jsm_14_4_592.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/14\/4\/592\/48526238\/jsm_14_4_592.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T09:47:34Z","timestamp":1673430454000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/14\/4\/592\/6973622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,1]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2017,4,1]]},"published-print":{"date-parts":[[2017,4,1]]}},"URL":"https:\/\/doi.org\/10.1016\/j.jsxm.2017.02.012","relation":{},"ISSN":["1743-6109","1743-6095"],"issn-type":[{"value":"1743-6109","type":"electronic"},{"value":"1743-6095","type":"print"}],"subject":[],"published-other":{"date-parts":[[2017,4]]},"published":{"date-parts":[[2017,4,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Heightened Pelvic Floor Muscle Tone and Altered Contractility in Women With Provoked Vestibulodynia","name":"articletitle","label":"Article Title"},{"value":"The Journal of Sexual Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jsxm.2017.02.012","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}