Reprodutibilidade inter e intra-examinador do esquema perfect por meio da palpação vaginal bidigital

Abstract

Introduction: The evaluation of the pelvic floor musculature (MAP) is important because through this it is possible to verify possible dysfunctions of the floor musculature pelvic floor (DMAP) that can have repercussions in urinary and fecal incontinence, prolapse of pelvic organs and sexual dysfunction Therefore, one of the methods of evaluating the MAP's function is through bidigital palpation using the PERFECT scheme. Objective: To evaluate the inter and intra-examiner reproducibility of the PERFECT scheme for evaluation of the pelvic floor musculature by means of bidigital vaginal palpation. Materials and methods: This is a test-retest reproducibility study. Were 41 women were evaluated, with a mean age of 23.7 years old (with standard deviation 3.9). A researcher carried out the participants' anamnesis and randomization of the order of the examiners who underwent bidigital vaginal palpation and graduation of the MAP function through the PERFECT scheme (P = ”power”, voluntary contraction maximum (CVM); E = "endurance", maximum sustained contraction (CSM); R = ”repetition”, repetitions of CSM contractions; F = ”fast”, repetitions of fast contractions ”; ECT = ”every contraction timed”, monitoring contractions). It was adopted a time of ten-minute rest between assessments. One of the examiners repeated the assessment 7-10 days from the first meeting. The reproducibility of the data was analyzed using of the kappa coefficient test for ordinal data, and intraclass correlation coefficient (ICC) for numerical data. Results: Inter-examiner reproducibility was considered moderate for the items “P” (k = 0.57), “E” (ICC = 0.53) and “F” (ICC = 0.65) and low for item “R” (ICC = 0.27). Intra-examiner reproducibility was substantial for the item “P” (k = 0.62), moderate for items “E” (ICC = 0.62) and “F” (ICC = 0.55) and low for item item “R” (ICC = 0.26). Conclusion: CVM reproducibility was greater when performed by just one researcher. However, the assessment of sustained contraction and repetitions of fast and slow contractions shows equal reproducibility in the evaluations performed by one researcher at two different times, or by two researchers at one same evaluation day.