Are visual inspection and digital palpation reliable methods to assess ability to perform a pelvic floor muscle contraction? An intra‐rater study

Abstract

Aims: To investigate the intrarater reliability of visual inspection and digital palpation to classify women's ability to perform a voluntary pelvic floor muscle (PFM) contraction and the association between the two methods. Methods: This was a test-retest clinical study including 44 women. The ability to perform a PFM voluntary contraction was evaluated two times in all participants using visual inspection and digital palpation. All analyzed participants were assessed with a 7-day interval between the two assessments and by the same examiner. Kappa's agreement coefficient was used to estimate the intrarater reliability, and Fisher's exact test was used to analyze association between the two methods. Results: This study found a substantial intrarater reliability of visual inspection (k = 0.73; p < .001) and digital palpation (k = 0.74; p < .001). A significant association between visual inspection and digital palpation was found at both time points (p < .001). Conclusion: Both visual inspection and digital palpation have substantial intrarater reliability and visual inspection can be recommended when vaginal palpation is not tolerated.

Exploring pelvic floor muscle function in men with and without pelvic floor symptoms: A population‐based study

“…We identified differences in muscle function by thorough pelvic floor musculature assessment that prevented undesirable activity in other muscles, with the same well‐experienced pelvic floor physical therapist performing all assessments. 24 As such, inter‐rater reliability issues were not present, but intra‐rater reliability might limit the outcomes of our study. We are unaware of previous studies on the inter‐rater and intrarater reliability in male pelvic floor assessment, reflecting a lack of studies on the male pelvic floor.…”

“…Furthermore, we included men of all ages with and without PFS, and we used validated questionnaires with clear cut‐off values. We identified differences in muscle function by thorough pelvic floor musculature assessment that prevented undesirable activity in other muscles, with the same well‐experienced pelvic floor physical therapist performing all assessments 24 . As such, inter‐rater reliability issues were not present, but intra‐rater reliability might limit the outcomes of our study.…”

Comparing male and female pelvic floor muscle function by the number and type of pelvic floor symptoms

“…Third, the unequal distribution of PFS between sexes might have influenced our results by the over‐representation of certain groups. Fourth, although the same experienced female pelvic floor physical therapist performed all assessments in this study to prevent interobserver variation, we acknowledge the lack of previous studies on inter‐rater and intrarater reliability in male PFM assessment 24 . While our reliance on one assessor for PFM assessments might have introduced systematic errors, it will also have prevented differences in outcomes of PFM function due to different assessors.…”

“…Fourth, although the same experienced female pelvic floor physical therapist performed all assessments in this study to prevent interobserver variation, we acknowledge the lack of previous studies on inter-rater and intrarater reliability in male PFM assessment. 24 While our reliance on one assessor for PFM assessments might have introduced systematic errors, it will also have prevented differences in outcomes of PFM function due to different assessors. Fifth, bias may have resulted from enquiring about PFM function and by virtue of participants having complaints.…”