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Reliability of the PERFECT scheme assessed by unidigital and bidigital vaginal palpation

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Abstract

Introduction and hypothesis

The aim of the present study was to evaluate the inter- and intra-rater reliability of the PERFECT scheme assessed by uni- and bidigital vaginal palpation in young nulligravid women.

Methods

Forty healthy women [median age 22 (19–34) years] were evaluated by unidigital vaginal palpation by both Examiners A and C, while the other 40 participants [median age 23.5 (19–35) years] were assessed by Examiners B and C by bidigital vaginal palpation. Inter- and intra-rater reliability of all items of the PERFECT scheme were evaluated: P = power (Modified Oxford Scale); E = endurance; R = repetitions; F = fast contractions. Cohenʼs linear weighted kappa (κw) was used to assess the reliability of the power, while the intraclass correlation coefficient (ICC) was applied for the other items. A priori sample size calculation found that 40 participants would be adequate.

Results

Inter-rater reliability of unidigital palpation was considered fair for power (κw = 0.34) and poor for other items (ICC < 0.50); bidigital inter-rater reliability was considered moderate (power: κw = 0.57; endurance: ICC = 0.53; fast contractions: ICC = 0.65, respectively) and low (repetitions: ICC = 0.27). Intra-rater reliability was substantial for power (κw = 0.73 and 0.62), moderate for fast contractions (ICC = 0.63 and 0.51) and poor for repetitions (ICC < 0.50), respectively, for uni- and bidigital palpation. Endurance showed poor (ICC < 0.50) and moderate (ICC = 0.61) reliability for uni- and bidigital palpation.

Conclusions

The PERFECT scheme carried out by bidigital vaginal palpation presents higher reliability when two examiners carry out the physical examination. When one examiner is responsible for PFM assessment, both types of palpation are recommended for evaluation of power and fast contraction; endurance should be evaluated using bidigital palpation. Examiners should be careful during the assessment of repetition of sustained contractions because inter- and intra-reliabilities for both types of palpation were classified as poor.

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Funding

This study was funded by in part by Coordenação de Aperfeçoamento Pessoal de Ensino Superior (CAPES) and The São Paulo Research Foundation (FAPESP), process number 2019/10077–7.

Author information

Authors and Affiliations

  1. Physical Therapy Department, Women’s Health Research Laboratory, Rodovia Washington Luís, km 235, Monjolinho, São Carlos, SP, 13565-905, Brazil

    Jordana Barbosa da Silva, Jéssica Gabriela de Godoi Fernandes, Bruna Raquel Caracciolo, Sara Campana Zanello & Patricia Driusso

  2. Physical Therapy Department, Preventive Physical Therapy and Ergonomics Laboratory, São Carlos, Rodovia Washington Luís, km 235, Monjolinho, São Carlos, SP, 13565-905, Brazil

    Tatiana de Oliveira Sato

Authors
  1. Jordana Barbosa da Silva
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  2. Jéssica Gabriela de Godoi Fernandes
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  3. Bruna Raquel Caracciolo
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  4. Sara Campana Zanello
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  5. Tatiana de Oliveira Sato
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  6. Patricia Driusso
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Contributions

JBS:

(1) Substantial contributions to conception and design;

(2) Drafting and revising the article critically for important intellectual content;

(3) Final approval of the version to be published.

JGGF:

(1) Drafting and revising the article critically for important intellectual content;

(2) Final approval of the version to be published.

BRC:

(1) Drafting and revising the article critically for important intellectual content;

(2) Final approval of the version to be published.

SCC:

(1) Drafting and revising the article critically for important intellectual content;

(2) Final approval of the version to be published.

TOS:

(1) Substantial contributions to conception and design;

(2) Drafting and revising the article critically for important intellectual content;

(3) Final approval of the version to be published.

PD:

(1) Substantial contributions to conception and design;

(2) Drafting and revising the article critically for important intellectual content;

(3) Final approval of the version to be published.

Corresponding author

Correspondence to Jordana Barbosa da Silva.

Ethics declarations

Ethical approval

This study was approved by the Ethics and Research Committee of the Federal University of São Carlos (CAAE: 51999415.9.0000.5504).

Conflict of interest

The authors declare that there is no conflict of interest.

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da Silva, J.B., de Godoi Fernandes, J.G., Caracciolo, B.R. et al. Reliability of the PERFECT scheme assessed by unidigital and bidigital vaginal palpation. Int Urogynecol J 32, 3199–3207 (2021). https://doi.org/10.1007/s00192-020-04629-2

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  • DOI: https://doi.org/10.1007/s00192-020-04629-2

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