Feasibility, inter- and intra-rater reliability of physiotherapists measuring prolapse using the pelvic organ prolapse quantification system

Introduction and hypothesis There is no agreed assessment tool for physiotherapists treating pelvic organ prolapse. This study hypothesised that pelvic organ prolapse quantification (POP-Q) assessment was a feasible measure for use by physiotherapists and tested inter- and intra-rater agreement. Methods Six physiotherapists and two gynaecologists participated. Women were recruited from uro/gynaecology clinics. Two POP-Q examinations were performed at the first clinic (gynaecologist, physiotherapist 1) and 1 week later (physiotherapist 1, physiotherapist 2). The examination was timed and women completed a short questionnaire. Using weighted kappa, agreement of POP-Q stage was assessed. Results Forty-five women were recruited (median age 59, range 32-87 years). Agreement between gynaecologist and physiotherapist was substantial (weighted kappa=0.63). Weighted kappa was 0.67 for inter-rater agreement between two different physiotherapists and 0.71 for intra-rater reliability for the same physiotherapist. Examination time was significantly shorter (difference 53±73 s, p<0.001) for gynaecologists. Participants found the examination acceptable. Conclusions POP-Q is a feasible and reliable outcome measure for physiotherapists to use.