Department of Physical Therapy, Women's Health Research Laboratory, São Carlos, São Paulo, Brazil.
Department of Physical Therapy, Preventive Physical Therapy and Ergonomics Laboratory, São Carlos, São Paulo, Brazil.
Neurourol Urodyn. 2021 Jan;40(1):348-357. doi: 10.1002/nau.24566. Epub 2020 Nov 5.
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.
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 Cohen's 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.
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).
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.
根据盆底肌（PFM）功能障碍和风险因素，评估单指和双指触诊 PFM 最大自主收缩（MVC）的组内和组间信度。
共招募了 187 名女性，由两名检查者进行评估。两位检查者均使用改良 Oxford 量表对 MVC 进行单指和双指触诊评估。7-10 天后，其中一位检查者重复评估。为了通过 Cohen 线性 Kappa（κw）分析可靠性，根据 BMI、绝经、产次、分娩类型和 PFM 功能障碍（如盆腔器官脱垂（POP）、便秘、尿急、急迫性尿失禁、盆腔痛和压力性尿失禁）将参与者分配到不同的组中。
根据 BMI、绝经状态、产次、分娩类型和 PFM 功能障碍，单指触诊的组间信度被认为是适度（κw=0.41-0.60）到中度（κw=0.21-0.40）。双指触诊的组间信度在所有风险因素和 PFM 功能障碍中均从无（κw=0.00-0.20）到中度不等。单指触诊的组内信度仅在患有 POP 的女性中被认为是适度（κw=0.37），而在所有其他变量中则为中度到高度（κw=0.61-0.80）。双指触诊的组内信度范围从中度到几乎完美（κw=0.81-1.00）。
当进行阴道触诊时，物理治疗师必须考虑评估的方式，因为一些 PFM 风险因素和功能障碍可能会影响单指和双指触诊的组内和组间信度。
