title: Validating a clinical measure of levator hiatus size.
abstract: OBJECTIVE
  We evaluate the interrater reliability of levator hiatus (LH) size and correlate size to other measures of muscle function.
  
  
  METHODS
  Participants were examined independently by 2 examiners. During maximal contraction of the levator ani, the muscle was assessed by using Brink's scale. The LH was measured in the transverse and sagittal dimensions by digital palpation. The paired t test was used to compare continuous variables and Spearman's coefficient was used for correlations.
  
  
  RESULTS
  The mean LH transverse was 4.5 cm and the mean LH sagittal was 3 cm. The inter-rater correlation for the LH transverse measurement was 0.6 (P < .01) and 0.8 (P < .01) for the LH sagittal measurement. The correlations between the LH size and Brink's scale were moderate (correlation coefficient -0.4 to -0.5, P < .01). Eighty-three percent of measurements were within 1 cm.
  
  
  CONCLUSIONS
  This technique for clinical measurement of levator hiatus size shows good interrater reliability.
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: Sarah Hamilton
authors.initials: SH
authors.lastname: Boyles
authors.forename: S Renee
authors.initials: SR
authors.lastname: Edwards
authors.forename: W Thomas
authors.initials: WT
authors.lastname: Gregory
authors.forename: Mary Anna
authors.initials: MA
authors.lastname: Denman
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D001837:Body Weights and Measures; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D015588:Observer Variation; D017773:Pelvic Floor / Q000033:anatomy & histology* / Q000502:physiology*; D015203:Reproducibility of Results; D014636:Valsalva Maneuver / Q000502:physiology