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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
Author(s) -
Silva Jordana B.,
Oliveira Sato Tatiana,
Rocha Ana P. R.,
Driusso Patricia
Publication year - 2021
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.24566
Subject(s) - palpation , medicine , pelvic floor , urinary incontinence , intra rater reliability , pelvic floor dysfunction , physical therapy , surgery , confidence interval
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.