title: Reliability of pelvic floor muscle strength assessment in healthy continent women.
abstract: BACKGROUND
  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.
  
  
  METHODS
  We 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.
  
  
  RESULTS
  There 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.
  
  
  CONCLUSIONS
  Age 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.
authors.affiliation: Department of Urology, Medical School of Botucatu, São Paulo State University, Botucatu, Brazil. urologia@fmb.unesp.br.
authors.forename: Dulcegleika V B
authors.initials: DV
authors.lastname: Sartori
authors.affiliation: Coordinator of Pelvic Floor Rehabilitation Service, Medical School of Botucat, São Paulo State University, Botucatu, Brazil. orsigam@yahoo.com.br.
authors.forename: Monica O
authors.initials: MO
authors.lastname: Gameiro
authors.affiliation: Department of Urology, Medical School of Botucatu, São Paulo State University, Botucatu, Brazil. hamilto@fmb.unesp.br.
authors.forename: Hamilto A
authors.initials: HA
authors.lastname: Yamamoto
authors.affiliation: Department of Urology, Medical School of Botucatu, São Paulo State University, Botucatu, Brazil. kawano@fmb.unesp.br.
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Kawano
authors.affiliation: Department of Urology, Medical School of Botucatu, São Paulo State University, Botucatu, Brazil. rodrigo.guerra@fmb.unesp.br.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Guerra
authors.affiliation: Department of Biostatistics, Medical School of Botucatu, São Paulo State University, Botucatu, Brazil. padovani@ibb.unesp.br.
authors.forename: Carlos R
authors.initials: CR
authors.lastname: Padovani
authors.affiliation: Department of Urology, Medical School of Botucatu, São Paulo State University, Botucatu, Brazil. jamaro@fmb.unesp.br.|Department of Urology, School of Medicine, São Paulo State University (UNESP), Campus de Rubião Júnior, s/n, 18618-970, Botucatu, SP, Brazil. jamaro@fmb.unesp.br.
authors.forename: João L
authors.initials: JL
authors.lastname: Amaro
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D020073:Gravidity; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength; D010173:Palpation; D010298:Parity; D017773:Pelvic Floor / Q000502:physiology*; D010808:Physical Examination; D011446:Prospective Studies; D015203:Reproducibility of Results; D014549:Urinary Incontinence / Q000503:physiopathology