Table 4. GRADE evidence profile for cross-sectional studies: women without pelvic floor dysfunction versus women with pelvic floor dysfunction*.
| No. of participants (studies) | Quality assessment | Summary of findings | Certainty in estimates | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Study event rates MD (SD) | Mean difference(95% CI) | Anticipated absolute effects | OR Quality of evidence | ||||||||
| Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Women without PFD | Women with PFD | Risk in women without PFD* | Risk in women with PFD* | |||
| Cocontraction activity of transversus abdominis muscles when the PFMs contract | |||||||||||
| 52 (2) | Serious limitationa | Nonserious limitationb | Serious limitationd | Serious limitatione | Undetectable | 2.5 (0.4)** | 2.1 (0.3)** | −0.61 (−1.42 to 0.20) | The mean rate of coactivity of the transversus abdominis muscles was 2.5. | The mean rate of coactivity of the transversus abdominis muscles in the exposed group was on average 0.61 lower (1.42 lower to 0.20 higher). | ⊕⊕OO LOW |
| Sensitivity analysis of cocontraction activity of transversus abdominis muscles when the PFMs contract | |||||||||||
| 32 (1) | Serious limitationa | Serious limitationc | Serious limitationd | Nonserious limitatione | Undetectable | 2.5 (0.4)** | 2.1 (0.3)** | −1.02(−1.90 to -0.14) | The mean rate of coactivity of the transversus abdominis muscles was 2.5. | The mean rate of coactivity of the transversus abdominis muscles in the exposed group was on average 1.02 lower (1.9 lower to 0.14 lower). | ⊕OOO VERY LOW |
| Cocontraction activity of the rectus abdominis muscle when the PFMs contract | |||||||||||
| 128 (3) | Serious limitationa | Serious limitationc | Serious limitationd | Serious limitatione | Undetectable | 6 (4)*** | 8 (5)*** | −2.05 (−6.51 to 2.42) | The mean rate of coactivity of the rectus abdominis muscle was 6. | The mean rate of coactivity of the rectus abdominis in the exposed group was on average 2.05 lower (6.51 lower to 2.42 higher). | ⊕OOO VERY LOW |
| Sensitivity analysis of the cocontraction activity of the rectus abdominis muscle when the PFMs contract | |||||||||||
| 56 (2) | Serious limitationa | Serious limitationc | Serious limitationd | Nonserious limitatione | Undetectable | 6 (4)*** | 8 (5)*** | 0.89 (-0.03 to 1.82) | The mean rate of coactivity of the rectus abdominis muscle was 6. | The mean rate of coactivity of the rectus abdominis in the exposed group was on average 0.89 higher (0.03 higher to 1.82 higher). | ⊕⊕OO LOW |
| Cocontraction activity of the obliquus internus abdominis muscle when the PFMs contract | |||||||||||
| 118 (3) | Serious limitationa | Serious limitationc | Serious limitationd | Serious limitatione | Undetectable | 23 (3)**** | 18 (2)**** | −0.47 (−2.38 to 1.44) | The mean rate of coactivity of the obliquus internus muscle was 0.23 | The mean rate of coactivity of the obliquus internus in the exposed group was on average 0.47 lower (2.38 lower to 1.44 higher). | ⊕OOO VERY LOW |
| Sensitivity analysis of the cocontraction activity of the obliquus internus abdominis muscle when the PFM contracts | |||||||||||
| 26 (1) | Serious limitationa | Serious limitationc | Serious limitationd | Nonserious limitatione | Undetectable | 26 (18)*** | 57 (34)*** | 1.10 (0.27 to 1.94) | The mean rate of coactivity of the obliquus internus muscle was 26. | The mean rate of coactivity of the obliquus internus in the exposed group was on average 1.10 higher (0.27 higher to 1.94 higher). | ⊕⊕OO LOW |
| Cocontraction activity of the obliquus externus abdominis muscles when the PFM contracts | |||||||||||
| 98 (2) | Serious limitationa | Serious limitationc | Serious limitationd | Serious limitatione | Undetectable | 30 (5)**** | 21 (4)**** | 0.01 (−4.00 to 4.03) | The mean rate of coactivity of the obliquus externus muscle was 30. | The mean rate of coactivity of the obliquus externus in the exposed group was on average 0.01 higher (4.00 lower to 4.03 higher). | ⊕OOO VERY LOW |
| Sensitivity analysis of the cocontraction activity of the obliquus externus abdominis muscle when the PFMs contract | |||||||||||
| 26 (1) | Serious limitationa | Serious limitationc | Serious limitationd | Nonserious limitatione | Undetectable | 9 (4)*** | 37 (18)*** | 2.08 (1.10 to 3.06) | The mean rate of coactivity of the obliquus externus muscle was 9. | The mean rate of coactivity of the obliquus externus in the exposed group was on average 2.08 higher (1.10 higher to 3.06 higher). | ⊕⊕OO LOW |
Abbreviations: MD: mean difference; SD: standard deviation; PFD: pelvic floor dysfunction; CI: Confidence interval.
*
Cross-sectional studies started from high quality evidence because of the nature of the clinical question.
**
The estimated risk control was taken from the mean estimated control risk from the Tajiri (2011) study (35).
***
The estimated risk control was taken from the mean estimated control risk from the Thompson (2006b) study (37).
****
The estimated risk control was taken from the mean estimated control risk from the Madill (2009) study (30).
a
Issues related to exposure and outcome assessments, follow-up period and cointerventions.
b
There may not be considerable heterogeneity (I2 <50%).
c
There is considerable heterogeneity (I2>75%).
d
Included studies with only one PFD.
e
95% Confidence interval for absolute effects include clinically important significance and no significance.