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Biomedical subjects

M C Dougherty

Publications and source records attributed to M C Dougherty.

35 records · Page 2Linked to original sources
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Dynamic characteristics of the circumvaginal muscles during pregnancy and the postpartum.

Weakened circumvaginal muscles (CVM) may occur after childbirth and may be associated with obstetric factors such as perineal outcome, episiotomy, length of second stage labor, baby weight, and pushing technique. Pressures developed by the CVM during pregnancy and postpartum were obtained to test the hypothesis that significantly lower pressures would be developed by the CVM in the early postpartum than during pregnancy. The sample consisted of 29 pregnant women who planned to deliver at a birth center. A follow-up study was performed approximately one year after delivery to determine if improvement of the CVM occurred over time. The results supported the hypothesis and indicated that restitution of the CVM occurred after the early postpartum period.

Adult↗
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On writing.

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Writing↗
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Reading for writing.

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Attitude of Health Personnel↗
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The dynamic characteristics of the circumvaginal muscles.

Circumvaginal muscle (CVM) maximum pressure was studied as related to the postpartal period, parity, type of birth, episiotomy, age, breastfeeding, physical activity, body mass, stress urinary incontinence, and orgasm in a sample of 98 healthy postpartal and nonpostpartal women. Circumvaginal muscle pressure tracings were obtained from these women using a pressure-sensitive, intravaginal balloon device. Correlations between circumvaginal muscle maximum pressures and episiotomy, age, breastfeeding, physical activity, body mass, stress urinary incontinence, and orgasm were either not significant or only weakly significant. However, Duncan's multiple range test showed differences in the maximum pressures between groups (nulliparous, parity greater than 0, cesarean delivery, and vaginal delivery) and indicated that vaginal birth has a marked weakening effect on the circumvaginal muscles.

Adult↗
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Continence for women: evidence-based practice.

Approximately 20% of women ages 25-64 years experience urinary incontinence. The symptoms increase during perimenopause, when 31% of women report that they experience incontinent episodes at least once per month. Bladder training and pelvic muscle exercise are the recommended initial treatment and can be taught effectively in the ambulatory care setting. Bladder training enables women to accommodate greater volumes of urine and extend between-voiding intervals. Pelvic muscle exercise increases muscle strength and reduces unwanted urine leakage. Accumulated research results provide evidence-based guidelines for nursing practice. The Association of Women's Health, Obstetric, and Neonatal Nurses has identified continence for women as the focus of its third research utilization project. This article presents the rationale, evidence base, and educational strategies compiled by the Research Utilization 3 Nurse Scientist Team. Nurses can enable women to incorporate these noninvasive techniques into self-care.

Adult↗
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Using a relational database to support nursing research.

Designing, implementing, and maintaining a relational database for a complex, longitudinal clinical research project can be the key to the success of a research project. Related issues of data entry, accuracy, confidentiality, security, data analysis, and evaluation of research activities are among the considerations that must be addressed. Our experience with designing a system that was effective and user-friendly to manage the data collected during a 6-year, National Institutes of Health-funded, nursing research project is highlighted. Nurses and other healthcare providers may find our experience with a relational database helpful and applicable to similar clinical research projects.

Clinical Nursing Research↗
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Variation in intravaginal pressure measurements.

The wide variation in intravaginal pressure measurements of the circumvaginal muscles (CVM) was studied in five subjects under well-controlled conditions. Previous research and clinical observations have indicated that fluctuations in the measurement of intravaginal pressure may be associated with time of day, day of testing, and existing stress factors. Subjects were assessed four times per day, on four consecutive days, for a total of 16 assessments. At each of the 16 conditions for a given subject, 10 CVM contractions lasting 12 seconds each were recorded and the variables, maximum pressure (MP10), peak maximum pressure (PMP), and abdominal pressure were analyzed. The within-subject variance was 15.5 (SD = 3.9); the between-subject variance was 132.4 (SD = 11.5). The effects of day, time, and stressor were analyzed by ANOVA specifically designed for variance estimates; no significant differences were found. The clinical observations that led to the study were not supported when systematically investigated. However, consistent data collection procedures appeared to reduce within-subject variance.

Adult↗
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Development and testing of the circumvaginal muscles rating scale.

The purpose of this research was to develop an instrument for clinical assessment of the circumvaginal muscles (CVM), to test the reliability of the instrument, and to correlate sample characteristics with this instrument. The 9-point CVM Rating Scale is based on four components: pressure, duration, muscle ribbing, and position of the examiner's finger during examination. Reliability of the CVM Rating Scale was ascertained by use of interrater and test-retest reliability. Interrater reliability was tested on two separate occasions, N = 10, rho = 0.6, p less than .04; N = 10, rho = 0.7, p less than .05. A test-retest sequence was conducted 10 days apart, N = 10, rho = 0.9, p less than .003. Results from these tests indicated that the CVM Rating Scale is a reliable instrument for assessing CVM. A convenience sample of 30 women, aged 18-37, in good general health was tested, using the CVM Rating Scale. Women with a history of pelvic floor reconstructive surgery were excluded. A significant positive correlation between self-reported orgasm and the CVM Rating Scale total scores was found, chi 2 = 7.5, p less than .02. No significant correlations were found between age, race, parity, episiotomy, or self-reported Kegel exercises and the CVM Rating Scale total scores. The scale is a cost-effective, time-efficient, systematic assessment, accessible in clinical settings.

Adolescent↗
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An instrument to assess the dynamic characteristics of the circumvaginal musculature.

This report describes an intravaginal balloon device (IVBD) and an improved method for measuring the dynamic characteristics of circumvaginal muscle (CVM) contractions. The IVBD measurement system may be used in research on women's health problems related to the pelvic floor musculature. The system is independent of examiner judgment and variability, and measurement conditions are carefully controlled. In an initial trial using the device with 20 volunteers, aged 22 to 58 years, the maximal pressure developed during strong CVM contractions was measured with the subjects supine. Subjects were asked to repeat the contraction while they contracted abdominal muscles. The length of time a submaximal contraction could be held was also measured. Test-retest reliability, determined by repeating each experiment, revealed significant correlations in maximal pressure attained, r = .85, p less than .03. A t test demonstrated no significant difference between the variables with and without the use of abdominal muscles, indicating the contraction of abdominal muscles did not affect intravaginal pressure when assessed with the IVBD. A weak correlation between length of time a submaximal contraction could be held and age of subject was found, r = -.44, p less than .06, but no pressure variable was correlated with age or parity, a possible effect of the small sample in this study.

Adult↗
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The circumvaginal musculature: correlation between pressure and physical assessment.

This study assessed two recently developed techniques to assess the circumvaginal musculature (CVM), the CVM Rating Scale and the pressure sensitive intravaginal balloon device (IVBD), and correlated results of the two methods. Thirty women volunteers, aged 20 to 42, were studied. CVM Rating Scale total scores and IVBD maximal contraction variables were measured for resting pressure, rate of rise, maximal pressure, rate of return, and time that a submaximal contraction could be sustained (endurance contraction). Age, parity, self-reported orgasm, self-reported Kegel exercises, and self-reported physical exercise were separately correlated with CVM Rating Scale total scores and IVBD maximal pressure results. A positive significant correlation was found between the CVM Rating Scale total scores and the IVBD maximal contraction results for the variables rate of rise, r = .50, p less than .01, maximum pressure, r = .82, p less than .01, and rate of return, r = .44, p less than .01. Self-reported orgasm had a positive significant correlation to the CVM Rating Scale total scores, rho = .34, p less than .05, and to the IVBD maximal pressure results, r = .52, p less than .01. A positive correlation was found between self-reported physical exercise and the CVM Rating Scale total scores, rho = .31, p less than .05. IBVD maximal pressure results were negatively correlated with age, r = -.34, p less than .05, and parity, r = -.34, p less than .05.

Adult↗
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Pelvic muscles during rest: responses to pelvic muscle exercise.

The purpose of the research was to study pelvic muscle changes in the resting phase between voluntary contractions (during pelvic muscle assessment) and in response to pelvic muscle exercise (PME) through secondary analysis of data. The sample consisted of healthy women (N = 38) aged 35 to 54. Analysis of variance showed a significant difference in resting pressure within each assessment (F = 2.92, p < .04). A significant difference in resting pressures within subjects was found (F = 3.54, p < .02). Within-subject variance suggests exercises performed without a warmup may result in incomplete relaxation prior to contraction. Significant change between baseline and Level 1 of the graded PME program suggests slow relaxation of untrained muscles. Increases in resting pressure at Levels 3 and 4 may be a more accurate reflection of muscle hypertrophy. The results of this research indicate that care should be taken in establishing the point from which changes during contractions are measured. It is recommended that the resting pressure be used. Exercise continued for more than 3 or 4 weeks accounts for nearly all strength gains and explains the increases in resting pressure at PME Levels 3 and 4.

Adult↗