Category: Cancer Rehabilitation; Measurement
Objective : To evaluate the inter-rater and intra-rater reliability of bladder wall thickness, urethral length and pelvic floor muscle (PFM) function using ultrasound imaging (USI).
Design : Clinimetrics.
Setting : Tertiary oncology referral center.
Participants (or Animals, Specimens, Cadavers) : Convenience sample of 20 women who have received radiotherapy for a cancer in the pelvic area.
Interventions : Not applicable.
Main Outcome Measure(s) : Methods and procedures: using a 3-7MHz curved-array transducer in dorsal lithotomy position, 2D transperineal USI assessments were carried out independently by two trained raters (R1;R2) with different level of experience. R1 (a resident in radiology) performed 2 assessments, each separated by a 30-minute interval, while R2 (a trained research physiotherapist; SB) performed a single assessment on the same day. After complete bladder voiding, 3 images of 5 variables were collected: bladder wall thickness (BWT); levator plate length at rest (LPR), during a maximal voluntary contraction of the PFM (MVC) and during a maximal Valsalva manoeuvre (MVM); and urethral length (UL). Reliability was analysed using intra-class correlation coefficients and 95% confidence intervals (ICC[CI]).
Results : Between-raters reliability was very good for LPR: 0.820[0.548, 0,929], MVC: 0.790[0.460, 0.917], MVM: 0.793[0.491, 0.917] and UL: 0.751[0.362, 0.902]. It was low for BWT: 0.035[-1.640, 0.629]. Intra-rater reliability was very good for LPR: 0.973 [0.934, 0.989], MVC: 0.953[0.882, 0.981], MVM: 0.835[0.586, 0.935], and UL: 0.957[0.891, 0.983], but it was low for BWT: 0.323[-0.429, 0.710].
Conclusions : USI can be used by trained assessors for the evaluation of the PFM function, as well as urethral length. It is not recommended for the assessment of BWT.
Stephanie Bernard– Doctoral candidate, Université Laval, Quebec, Quebec
Anne-Gabrielle Frenette– Resident, CHU de Québec-Université Laval, Quebec, Quebec
Evelyne Gentilcore-Saulnier– Resident, CHU de Québec-Université Laval, Quebec, Quebec
Marie-Anne Froment– Radiooncologist, CHU de Québec-Université Laval, Quebec, Quebec
Patricia Noël– Radiologist, CHU de Québec-Université Laval, Quebec, Quebec
Linda McLean– Full Professor, University of Ottawa, Ottawa, Ontario
Hélène Moffet– Full Professor, Université Laval, Quebec, Quebec