Reviewer's report
Title:Normal reference values of strength in pelvic floor muscle of women: a
descriptive study
Version:2Date:25 July 2014
Reviewer: Carmen Suárez
Reviewer's report:
In relation to the review of the article entitled "Normal reference values of
strength in pelvic floor muscle of women: a descriptive study", It is important to
highlight its relevance so as to know aspects relating to SUI.
However, it is important to comment on some points that would improve it for
publication:
- Firstly, regarding the title, the population under study is not included since the
study is focused on women with SUI.
- Regarding the abstract, if we focus on MeSH, the keywords Normal reference
values and scoring measures, are not included.
- On page 4 line 1, instead of Training for the SUI, Pelvic floor muscle training
For SUI should be changed.
- Insofar as the aims, the first and foremost objective does not respond to the title
of the study, which is based on normal reference values of the strength of the
pelvic floor muscles, and as the objective the description of clinical, functional
and quality of life aspects are aimed at; however, they do collect the study
population, women with SUI here.
- In terms of methodology, the fact is that a descriptive study involves a good
description of sampling followed by the team to select the 218 women, which
does not appear within.
o As for the Ethical clearance, specify in which University it was given.
o In the section outcomes reported by the patient, in the semi-structured
interview, although it has been prepared by them, Have they been based on any
previous one as there are questionnaires for this purpose? It is focused on
urinary incontinence but they collected data on fecal incontinence, but not on
other aspects of pelvic floor dysfunction, why?
o Following this section, the authors use non-specific questionnaires to measure
quality of life, but there are validated SUI specific questionnaires in spanish, Why
do the authors not use them?
o In relation to section outcomes Informed by the clinician, in Manual muscle
testing, the study of Ferreira et al (reference 22) provides a fair interobserver
reliability, so it would have been interesting if the authors would had reviewed it
in their study.
o In this section, relating to perineometer, reference 24 should go after the name
of Isherwood and Rane.
- In the Results section in the second paragraph, line 12, the authors discuss
gynecological screening, At what time were these data collected?
o In the results concerning the manual test, both The right and left sides, provide
values of 7.64 and 7.35 respectively, Where are the data extracted from, taking
into account that the Oxford scale is from 0 to 5?
o And in this section, the authors speak of quartile 4, Is it about the data located
beyond the 75th percentile? Only quartile 1,2 and 3 are used.
o In the correlation analysis, the tables are wrong, Table 3 should be 4 and
viceversa.
- In the Discussion section, in the first paragraph, the authors mention the
contribution of their study, but they should highlight that it has been performed in
women with SUI.
o In the second paragraph of the discussion, when the authors mention the
studies with references 25 and 22, Was the study population of these authors
women with SUI or without dysfuntion?
- In the Conclusion section, in the first paragraph, line 24, the sample of women
with SUI must be referenced. And maybe, the non-significance between values
of muscle strength and quality of life could be improved or changed, using
specific questionnaires for SUI.
- Regarding Tables, in Table 1, the data for the SF-12 PCS and SF-12 MCS are
collected, What do these acronyms (PCS and MCS) mean? They have not been
explained previously or in the legend.
o In Table 2.1, What measure have they used in the mean weight in the first,
second and third labor?
o Why is the sample in Tables 2.1 and 2.2 (n=212) different from Table
2.3(n=218)? Were Data completed mistakenly?
o In Table 2.2, Which could be the reason For these findings about 89 women
suffering losses of urine, and 100 women having losses during strain or stress?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interests