Reliability of Different Clinical Techniques for Assessing Foot Posture.

OBJECTIVE: The aim was to determine the interrater and intrarater reliability of navicular drop (NDP), navicular drift (NDT), and the Foot Posture Index-6 (FPI-6), and test-retest reliability of the static arch index (SAI) and dynamic arch index (DAI). METHODS: Sixty healthy individuals were assessed for intrarater and test-retest reliability. From 60 participants, 30 individuals were assessed for interrater reliability. A digital caliper was used to measure NDP and NDT. Electronic pedography was used to calculate SAI and DAI. The FPI-6 was also performed. All assessments were performed on the dominant foot. The NDP, NDT, SAI, and DAI were repeated 3 times. The NDP and NDT were analyzed separately using both first measurement and the average, but the SAI and DAI were analyzed using only the average. The NDP, NDT, and FPI-6 were conducted by 2 raters to determine interrater reliability and were repeated by a single rater after 5 days from initial assessment to determine intrarater reliability. The SAI and DAI were also repeated after 5 days to determine test-retest reliability. RESULTS: Intrarater intraclass correlation coefficients (ICCs) were 0.934 and 0.970 for NDP, 0.724 and 0.850 for NDT, and 0.945 for FPI. Interrater ICCs were 0.712 and 0.811 for NDP, 0.592 and 0.797 for NDT, and 0.575 for FPI. Test-retest ICCs of the SAI and DAI were 0.850 and 0.876, respectively. CONCLUSION: Navicular drop is relatively more reliable than other traditional techniques. Also, the FPI-6 has excellent intrarater reliability, but only moderate interrater reliability. The results can provide clinicians and researchers with a reliable way to implement foot posture assessment.

Pelvic floor muscle function and symptoms of dysfunctions in midwifes and nurses of reproductive age with and without pelvic floor dysfunction.

OBJECTIVES: This study aims to compare pelvic floor muscle (PFM) functions in midwifes and nurses of reproductive age with and without pelvic floor dysfunction (PFD) and investigate the relationship between PFM function and the number, type and symptoms of PFDs. MATERIALS AND METHODS: 82 midwifes and nurses of reproductive age with (n = 51) and without PFD (n = 31) participated in the study. PFM function was assessed by digital palpation using PERFECT scale. Gynecological examination, ultrasonography, disease-specific questionnaires, questions and tests were used to assess symptoms of PFD. PFD was assessed in terms of risk factors, urinary incontinence, fecal incontinence, pelvic organ prolapse (POP), pelvic pain and sexual dysfunctions. RESULTS: Power parameter of PERFECT scheme was significantly lower in subjects with PFD compared to Non-PFD group (p = 0.002). 41% of the subjects with Power 5 PFM strength in PFD group were diagnosed as stage 1 POP, 5.8% as stage 2 POP, 15.7% of urge incontinence, 23.3% of stress incontinence and 10.5% of mixed incontinence. Both urinary incontinence and POP were detected in 15.7% of them. Among all subjects, incontinence symptoms decreased whereas POP and sexual function did not change as PFM increased. PFM strength was negatively correlated with the number of PFD (p = 0.002, r = -0.34). The type of dysfunction did not correlate with PFM strength (p > 0.05). CONCLUSION: PFM strength only affects of urinary incontinence sypmtoms among all PFDs in midwifes and nurses of reproductive age. PFM strength may not be the main factor in the occurrence of PFDs as pelvic floor does not consist solely of muscle structure. However, it strongly affects the number of dysfunctions. Therefore, PFM training should be performed to prevent the occurrence of extra dysfunctions in addition to the existing ones even if it does not alter the symptoms.