title: Inter-rater reliability study of the modified Oxford Grading Scale and the Peritron manometer.
abstract: OBJECTIVE
  To evaluate the inter-rater reliability of the modified Oxford Grading Scale and the Peritron manometer.
  
  
  METHODS
  All participants were evaluated twice, first by one examiner and 30 days later by a second examiner. Measurements of vaginal squeeze pressure were compared with the results from the palpation test.
  
  
  METHODS
  Nineteen women with a mean age of 23.7 years (range 21 to 28 years).
  
  
  RESULTS
  Inter-rater reliability for vaginal palpation was fair (κ=0.33, 95% confidence interval 0.09 to 0.57). Using the Peritron manometer, the difference between examiners was less than 10cmH(2)O in 11 of the 19 (58%) cases. The palpation test did not differentiate between weak, moderate, good and strong muscle contractions. This study found fair inter-rater reliability for the modified Oxford Grading Scale and moderate inter-rater reliability for the Peritron manometer.
  
  
  CONCLUSIONS
  The inter-rater reliability of vaginal squeeze pressure measurement using the Peritron manometer is acceptable and can be used in re-evaluations performed by different examiners in clinical practice. However, for research purposes, the ideal situation would be for a single examiner to assess and re-assess the subject. Vaginal palpation is important in the clinical assessment of correctness of a pelvic floor muscle contraction, but this study does not support the use of the modified Oxford Grading Scale as a reliable and valid method to measure and differentiate pelvic floor muscle strength.
authors.affiliation: Faculty of Medicine of Ribeirão Preto, Department of Biomechanics, Medicine and Rehabilitation of Locomotor System, Course of Physiotherapy, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, 14049-900, Ribeirão Preto, SP, Brazil. cristine@fmrp.usp.br
authors.forename: Cristine Homsi Jorge
authors.initials: CH
authors.lastname: Ferreira
authors.forename: Patrícia Brentegani
authors.initials: PB
authors.lastname: Barbosa
authors.forename: Flaviane
authors.initials: F
authors.lastname: de Oliveira Souza
authors.forename: Flávia Ignácio
authors.initials: FI
authors.lastname: Antônio
authors.forename: Maíra Menezes
authors.initials: MM
authors.lastname: Franco
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008365:Manometry / Q000295:instrumentation / Q000592:standards / Q000706:statistics & numerical data; D015588:Observer Variation; D010173:Palpation; D017773:Pelvic Floor / Q000502:physiology*; D026741:Physical Therapy Modalities; D011312:Pressure; D012016:Reference Values; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000534:rehabilitation*; D014621:Vagina / Q000502:physiology*; D055815:Young Adult