Electromyographic analysis of maximal voluntary contraction of female pelvic floor muscles: Intrarater and interrater reliability study.

AIMS To investigate the intrarater and interrater reliability of the surface electromyography (sEMG) of female pelvic floor muscles (PFM) by visual determination of the onset-offset during maximal voluntary contraction (MVC). METHODS Intrarater and interrater reliability study. Three MVC, recorded for 5 s (s) each and separated by intervals of 60 s, were requested. Two independent raters visually determined the onset and offset of each MVC. The agreement between raters on the quality of the signals was analyzed both qualitatively (visual inspection) and quantitatively (signal-to-noise ratio, SNR). The reliability of integral and median frequency (MDF) of sEMG signals during MVC was analyzed using intraclass correlation coefficient (ICC) models (ICC2,1 , ICC2,3 ) and repeated measures analysis of variance. RESULTS A total of 58 women (mean age of 54 years) and two independent raters participated in the analyses. Of the total, 22 (37.9%) were considered of high quality by both raters and the SNR ranged 34.3-22.2 decibels (dB). The agreement of qualitative visual evaluation of the sEMG signal was fair (Cohen's κ = 0.306 [0.148; 0.463]). Intrarater and interrater reliability were excellent for the average of the three MVC, both for integral (ICC2,3  = 0.884 [0.821; 0.925]; ω2  = -0.006, p = 0.558) and MDF (ICC2,3  = 0.998 [0.998; 0.999]; ω2  = -0.009, p = 0.992). CONCLUSION Qualitative visual analysis of the sEMG signal presents fair interrater agreement and reflects the SNR. Visual determination of the onset and offset of the MVC of PFM using the standard interface of the sEMG software has excellent reliability for determination of muscle activation variables.