Abstract
BackgroundThe aim of this study was to compare pelvic floor muscle (PFM) strength using transvaginal digital palpation in healthy continent women in different age groups, and to compare the inter- and intra-rater reliability of examiners performing anterior and posterior vaginal assessments.MethodsWe prospectively studied 150 healthy multiparous women. They were distributed into four different groups, according to age range: G1 (n = 37), 30–40 years-old; G2 (n = 39), 41–50 years-old; G3 (n = 39), 51–60 years-old; and G4 (n = 35), older than 60 years-old. PFM strength was evaluated using transvaginal digital palpation in the anterior and posterior areas, by 3 different examiners, and graded using a 5-point Amaro’s scale.ResultsThere was no statistical difference among the different age ranges, for each grade of PFM strength. There was good intra-rater concordance between anterior and posterior PFM assessment, being 64.7%, 63.3%, and 66.7% for examiners A, B, and C, respectively. The intra-rater concordance level was good for each examiner. However, the inter-rater reliability for two examiners varied from moderate to good.ConclusionsAge has no effect on PFM strength profiles, in multiparous continent women. There is good concordance between anterior and posterior vaginal PFM strength assessments, but only moderate to good inter-rater reliability of the measurements between two examiners.
Highlights
The aim of this study was to compare pelvic floor muscle (PFM) strength using transvaginal digital palpation in healthy continent women in different age groups, and to compare the inter- and intra-rater reliability of examiners performing anterior and posterior vaginal assessments
It has been demonstrated that the weakness of the PFM is significantly higher in incontinent women [3,4] and that this weakness is worse in women with urge urinary incontinence [5]
According to the International Classifications of Impairments, Disabilities and Handicaps (ICIDH), a nonfunctioning PFM occurs when there is a reduction in force generation and incorrect timing or coordination of muscle contraction [6]
Summary
The aim of this study was to compare pelvic floor muscle (PFM) strength using transvaginal digital palpation in healthy continent women in different age groups, and to compare the inter- and intra-rater reliability of examiners performing anterior and posterior vaginal assessments. Urinary incontinence (UI) in women is common and prevalence increases with age [1,2]. Damage to the pelvic floor muscle (PFM) can decrease the muscle strength and could result in urinary and fecal incontinence [2]. The vaginal palpation is currently used by most physical therapists to assess PFM contraction. There has been no systematic research to determine the best method of vaginal palpation to evaluate the pelvic floor contraction [6], and different score systems have been described
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