ArticleBMJ open2021
Clinical assessment of pelvic floor and abdominal muscles 3 months post partum: an inter-rater reliability study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The AfterBabyBodyStudy- Testing Manual Examination Methods and Exercise Effects on Muscular Recovery After Pregnancy
Combined Effects Of Stability Oriented Breathing Exercises and Kegel's Exercises On Inter-recti Distance, Lumbopelvic Pain and Strength In Postpartum Women
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Precision medicine exploration of postpartum rectus abdominis muscle separation: from basic research to clinical practice.BMC surgery · 2025Pooled it
- Patients' experiences of participating in physiotherapeutic telerehabilitation for postpartum pelvic floor dysfunction; a qualitative study.BMC musculoskeletal disorders · 2026Article
- Pelvic Floor Muscle Strength and Bothersome Urinary Incontinence After Pregnancy: A Cohort Study.International urogynecology journal · 2025Article
- Postpartum depression in Northeastern China: a cross-sectional study 6 weeks after giving birth.Frontiers in public health · 2025Article
- The Impact of Exercising on Pelvic Symptom Severity, Pelvic Floor Muscle Strength, and Diastasis Recti Abdominis After Pregnancy: A Longitudinal Prospective Cohort Study.Physical therapy · 2024Article
- Assessment of Involuntary PFM Contractions in Comparison with Existing Literature and IUGA/ICS Terminology Reports.International urogynecology journal · 2024Article
- The "Mother Load" and Return to Sport: A Case Report of Returning to Professional Netball Following Cesarean Section.International journal of sports physical therapy · 2023Article
- Can Clinical Postpartum Muscle Assessment Help Predict the Severity of Postpartum Pelvic Girdle Pain? A Prospective Cohort Study.Physical therapy · 2022Article
- Prevalence and factors associated with postpartum pelvic girdle pain among women in Poland: a prospective, observational study.BMC musculoskeletal disorders · 2022Observational
- The Association between Postpartum Pelvic Girdle Pain and Pelvic Floor Muscle Function, Diastasis Recti and Psychological Factors-A Matched Case-Control Study.International journal of environmental research and public health · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEvaluation of the inter-rater reliability of clinical assessment methods for pelvic floor muscles and diastasis recti abdominis post partum.
designA multicentre inter-rater reliability study.
settingThree primary care rehabilitation centres in Sweden.
participantsA total of 222 participants were recruited via advertising at Swedish maternity care units and social media. Eligibility for participation included female gender, ≥18 years, at maximum 3 months after childbirth. Exclusion criteria were chronic pelvic girdle pain and/or low back pain and/or pelvic floor tear grade III/IV. At each centre, 2 physiotherapists, with training and experience in pelvic floor assessment, assessed the 222 women according to a standardised protocol in random order. OUTCOME MEASURES: Inter-rater reliability of the assessment of pelvic floor muscle function (involuntary and voluntary contraction and voluntary relaxation) and diastasis recti abdominis (width, depth and bulging).
resultsVaginal palpation of maximal voluntary contraction revealed a kappa value of 0.69 (95% CI 0.62 to 0.76). Assessments of involuntary contraction and voluntary relaxation yielded inconsistent results, with slight-to-moderate weighted kappa values ranging from 0.10 to 0.51. After 2 months of training in applying this method, diastasis recti abdominis width measured at the umbilicus by calliper yielded an intraclass correlation coefficient value of 0.83 (95% CI 0.76 to 0.87). Assessments of diastasis recti abdominis depth and bulging showed moderate kappa values, with reservation for some inconsistency between the centres.
conclusionsVaginal palpation of pelvic floor muscle strength is a reliable method for the postpartum muscle assessment. Additional research is needed to identify reliable assessment method for other pelvic floor muscle functions like involuntary contraction and voluntary relaxation. With some training, a calliper is a reliable instrument for measuring the postpartum diastasis recti abdominis width. This study provides novel thoughts about how to measure diastasis recti abdominis depth and bulging. TRIAL REGISTRATION NUMBER: NCT03703804.
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Registered trials
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