title: Reliability of pelvic floor muscle strength assessment using different test positions and tools.
abstract: OBJECTIVE
  The aims of this study were to determine the intra-therapist reliability for digital muscle testing and vaginal manometry on maximum voluntary contraction strength and endurance. In addition, we assessed how reliability varied with different tools and different testing positions.
  
  
  METHODS
  Subjects included 20 female physiotherapists. The modified Oxford scale was used for the digital muscle testing, and the Peritron perineometer was used for the vaginal resting pressure and vaginal squeeze pressure assessments. Strength and endurance testing were performed. The highest of the maximum voluntary contraction scores was used in strength analysis, and a fatigue index value was calculated from the endurance repetitions. Bent-knee lying, supine, sitting, and standing positions were used. The time interval for between-session reliability was 2-6 weeks.
  
  
  RESULTS
  Kappa values for the between-session reliability of digital muscle testing were 0.69, 0.69, 0.86, and 0.79 for the four test positions, respectively. Intra-class correlation coefficient (ICC) values for squeeze pressure readings for the four positions were 0.95, 0.91, 0.96, and 0.92 for maximum voluntary contraction, and 0.05, 0.42, 0.13, and 0.35 for endurance testing. ICC values for resting pressure were 0.74, 0.77, 0.47, and 0.29.
  
  
  CONCLUSIONS
  Reliability of digital muscle testing was very good in sitting and good in the other three positions. vaginal resting pressure demonstrated very good reliability in all four positions for maximum voluntary contraction, but was unreliable for endurance testing. Vaginal resting pressure was not reliable in upright positions. Both measurement tools are reliable in certain positions, with manometry demonstrating higher reliability coefficients.
authors.affiliation: Rehabilitation Sciences Research Centre, School of Physiotherapy, The University of Melbourne, Parkville, Australia.
authors.forename: Helena C
authors.initials: HC
authors.lastname: Frawley
authors.affiliation: Rehabilitation Sciences Research Centre, School of Physiotherapy, The University of Melbourne, Parkville, Australia.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Galea
authors.affiliation: Rehabilitation Sciences Research Centre, School of Physiotherapy, The University of Melbourne, Parkville, Australia.
authors.forename: Bev A
authors.initials: BA
authors.lastname: Phillips
authors.affiliation: Rehabilitation Sciences Research Centre, School of Physiotherapy, The University of Melbourne, Parkville, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Sherburn
authors.affiliation: Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D008365:Manometry / Q000295:instrumentation* / Q000379:methods*; D008875:Middle Aged; D010173:Palpation / Q000379:methods*; D017773:Pelvic Floor / Q000502:physiology*; D011187:Posture; D015203:Reproducibility of Results