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, QuebecAnne-Gabrielle Frenette
– Resident, CHU de Québec-Université Laval, Quebec, QuebecEvelyne Gentilcore-Saulnier
– Resident, CHU de Québec-Université Laval, Quebec, QuebecMarie-Anne Froment
– Radiooncologist, CHU de Québec-Université Laval, Quebec, QuebecPatricia Noël
– Radiologist, CHU de Québec-Université Laval, Quebec, QuebecLinda McLean
– Full Professor, University of Ottawa, Ottawa, OntarioHélène Moffet
– Full Professor, Université Laval, Quebec, Quebec