Inter‐ and intrarater reliability of unidigital and bidigital vaginal palpation to evaluation of maximal voluntary contraction of pelvic floor muscles considering risk factors and dysfunctions

Abstract

Aims: To evaluate inter-and intrarater reliability of unidigital and bidigital vaginal palpation of pelvic floor muscle (PFM) maximal voluntary contraction (MVC) according to PFM risk factors and dysfunctions. Methods: A total of 187 women were recruited and evaluated by two examiners. Both performed the evaluation of MVC with unidigital and bidigital palpation, graded by Modified Oxford Scale. After 7-10 days, one examiner repeated the assessment. To analyze reliability by Cohenʼs linear Kappa (κw), participants were allocated into different groups according to: body mass index (BMI), menopause, parity, type of delivery and PFM dysfunctions, as pelvic organ prolapse (POP), constipation, urgency, urgency urinary incontinence, pelvic pain, and stress urinary incontinence. Results: Inter-rater reliability of unidigital palpation was considered fair (κw = 0.21-0.40) to moderate (κw = 0.41-0.60) according to BMI, postmenopausal status, parity, type of delivery, and PFM dysfunctions. Inter-rater reliability of bidigital palpation varied from none (κw = 0.00-0.20) to moderate for all risk factors and PFM dysfunctions. Intra-rater reliability of unidigital palpation was considered fair only for women with POP (κw = 0.37) and moderate to substantial (κw = 0.61-0.80) to all other variables. Intra-rater reliability of bidigital palpation ranged from moderate to almost perfect (κw = 0.81-1.00). Conclusions: When performing vaginal palpation, physiotherapists must consider the way that is performing the evaluation, as some PFM risk factors and dysfunctions could influence the inter-and intrarater reliability of unidigital and bidigital palpation.

Nuances of the Valsalva manoeuvre and bracing with regard to resistance training performance and its effects on the pelvic floor

“…Following functional analysis, assessment of the PFMs and visualization of the presence of POP can be completed, and this is often done in supine (Madhu et al 2018;da Silva et al 2021). For PFM strength assessments, individuals rest with their hips flexed and abducted.…”

“…The strength of the pelvic floor is evaluated with digital palpation (i.e. the index finger, or index and middle fingers) (da Silva et al 2021). This assessment method is cost-effective and commonly used in physiotherapy practice (Deegan et al 2018).…”

Do Dynamometric Variables of the Pelvic Floor Muscles Differ between Women with and without Stress Urinary Incontinence? A Blind, Cross-sectional Study

“…Moreover, divergent opinions are found in the literature regarding the reliability of these methods [5,7,8]. Thus, measurements obtained using electromyography, perineometry, dynamometry and different imaging methods (ultrasound, magnetic resonance and urodynamic analysis) have been used to determine and quantify the function of these muscles in a more precise manner [9].…”