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Development of a Pelvic Floor Muscle Coordination Scale

Objective:The purpose of this study was to examine the interrater reliability and criterion-related validity of a scale developed to quantify pelvic floor muscle (PFM) coordination through observational assessment. Study Design:Descriptive study. Background:Observation of muscle coordination is a common part of a PFM examination; however, no instrument is currently available to facilitate a clinician's objective documentation of PFM coordination. We developed a 5-item scale, the Pelvic Floor Muscle Coordination Scale (PFMCS), to quantify a woman's PFM coordination. Methods and Measures:Twenty women with varying symptoms of pelvic floor disorders including urinary symptoms, colorectal distress, and(or pelvic organ prolapse participated in the study. Subjects completed the 20-item Pelvic Floor Distress Inventory (PFDI-20), which served as the criterion standard. Five investigators administered the PFMCS with standardized verbal cueing preceding performance of 5 activities. Intraclass correlation coefficients were used to examine interrater reliability. Quadratic regression analysis was used to assess validity. Results:The PFMCS total score intraclass correlation coefficient was 0.792. Interrater reliability of the subscales varied from good to moderate. Scores on the PFMCS were associated with the Pelvic Organ Prolapse Distress Inventory (R2 [SUPERSCRIPT EQUALS SIGN] 0.355, P [SUPERSCRIPT EQUALS SIGN] .024) and the Urinary Distress Inventory (R2 [SUPERSCRIPT EQUALS SIGN] 0.304, P [SUPERSCRIPT EQUALS SIGN] .046) subscales of the PFDI-20. Conclusion:The PFMCS is a promising observational scale for facilitating visual inspection of PFM coordination. The scale demonstrated good reliability and scores were correlated with 2 subscales of the PFDI-20 questionnaire.