Are visual inspection and digital palpation reliable methods to assess ability to perform a pelvic floor muscle contraction? An intra-rater study

Aims To investigate the intrarater reliability of visual inspection and digital palpation to classify women's ability to perform a voluntary pelvic floor muscle (PFM) contraction and the association between the two methods. Methods This was a test-retest clinical study including 44 women. The ability to perform a PFM voluntary contraction was evaluated two times in all participants using visual inspection and digital palpation. All analyzed participants were assessed with a 7-day interval between the two assessments and by the same examiner. Kappa's agreement coefficient was used to estimate the intrarater reliability, and Fisher's exact test was used to analyze association between the two methods. Results This study found a substantial intrarater reliability of visual inspection (k = 0.73; p < .001) and digital palpation (k = 0.74; p < .001). A significant association between visual inspection and digital palpation was found at both time points (p < .001). Conclusion Both visual inspection and digital palpation have substantial intrarater reliability and visual inspection can be recommended when vaginal palpation is not tolerated.