Aims: Evaluate the intra-and inter-rater reliability of maximal voluntary contraction (MVC) of pelvic floor muscle (PFM) assessment by unidigital and bidigital vaginal palpation. As a secondary aim, evaluate the construct validity of vaginal palpation and a manometer.Methods: A total of 120 women were recruited and allocated into three groups according to age (group 1 [G1]: 18-35; G2: 36-59; G3: ≥60 years). Examiner A conducted an interview and examiners B and C performed evaluations of PFM function using both unidigital and bidigital vaginal palpation. Seven to 10 days later, examiner B repeated both types of vaginal palpation and measured the MVC pressure with a Peritron. Reliability was analyzed using Cohenʼs linear weighted Kappa (κ w ). The construct validity was calculated using the Spearmanʼs correlation (r s ).Results: Intra-rater reliability of unidigital and bidigital palpation was κ w = 0.75 and κ w = 0.58 in G1, κ w = 0.59 and κ w = 0.73 in G2, and κ w = 0.79 and κ w = 0.86 in G3, respectively. Inter-rater reliability of unidigital and bidigital palpation was κ w = 0.52 and κ w = 0.48 in G1, κ w = 0.47 and κ w = 0.52 in G2, and κ w = 0.50 and κ w = 0.64 in G3, respectively. Spearmanʼs correlation coefficients were significant at r s = 0.79 and r s = 0.80 for unidigital and bidigital vaginal palpation, respectively.Conclusions: Unidigital or bidigital vaginal palpation were indicated to evaluate G1 and G2 but bidigital palpation was more reliable in G3 when two examiners performed the evaluation. For the assessment conducted by one examiner, unidigital palpation was more reliable in G1 while bidigital palpation was more reliable in G2 and G3. Both unidigital and bidigital palpation have high measures of validity. K E Y W O R D S manometry, outcome and process assessment, palpation, pelvic floor, reproducibility of results, strength This study was conducted at Federal University of São Carlos.

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O objetivo deste estudo foi avaliar a satisfação de puérperas após intervenção fisioterapêutica em educação em saúde. Estudo transversal e observacional que contou com a participação de 63 puérperas internadas em alojamento conjunto de uma maternidade. Foram realizadas atividades de educação em saúde abordando modificações e adaptações do puerpério, utilizando materiais de apoio de baixo custo, linguagem simples e exercícios preventivos. As mulheres também receberam uma cartilha educativa elaborada pelos pesquisadores. Posteriormente, foi realizada a avaliação da satisfação da puérpera em relação ao atendimento fisioterapêutico. A maioria das puérperas apresentou-se muito satisfeitas (55,5%) e satisfeitas (44,4%) com o atendimento. O esclarecimento de dúvidas foi melhor que esperado (39,6%) e como esperado (47,6%). A maioria das participantes sanou dúvidas (93,6%), afirmou que participaria novamente da atividade e recomendaria a assistência para outras mulheres (93,6%). Estratégias fisioterapêuticas de educação em saúde são satisfatórias para mulheres do puerpério imediato.

Introduction Pelvic floor muscle training (PFMT) exercises and neuromuscular electrical stimulation (NMES) are described as conservative interventions to prevent or treat female stress urinary incontinence (SUI). However, it has not been described yet the effect of PFMT associated to intravaginal NMES which evaluated the cost-effectiveness and cost-utility of treating. Aims To evaluate the effects of intravaginal NMES associated with the PFMT protocol on urinary loss and quality of life in women with SUI and to evaluate the cost-effectiveness and cost-utility and pelvic floor muscle in women with SUI. Methods Randomized controlled trial study with economic evaluation. Inclusion criteria are woman (biological), aged ≥ 18 years old and with a report of SUI ≥ once/week. Exclusion criteria are presence of vaginal or urinary infection, virginity, being in the gestational or puerperium period, or neurological disease. Participants will undergo physical therapy assessment and intervention: anamnesis, pelvic floor muscle assessment by vaginal palpation and manometry (PeritronTM), questionnaires (Short-Form 6 Dimensions—Brazil (SF-6D), King's Health Questionnaire (KHQ) and King´s Health Questionnaire for Scoring Algorithm), health costs, and voiding diary. Participants will be randomly allocated into 3 groups: CG (control group), IG 1 (intervention group 1, PFMT), and IG2 (intervention group 2, PFMT + NMES). The statistical analysis will be performed by intention to treat, and multivariate analysis of mixed effects will be used to compare outcomes. Effect size measurements will be calculated and will be provided by Cohen’s d test. A significance level of 5% will be adopted. Additionally, the incremental cost-effectiveness and incremental cost-utility ratios will be used. Discussion This protocol can corroborate with the literature in order to identify the effect of techniques, based on the possibility of confirming the hypothesis that the NMES associated with PFMT performed concurrently will be the best treatment option; considering the effectiveness, cost-effectiveness, and cost-utility analysis, it will be used as an option for optimization of the treatment of SUI. Trial registration Brazilian Registry of Clinical Trials (ReBEC) ID: RBR-6gtzg4. Registered on September 3, 2019.