Verbal instruction to obtain voluntary pelvic floor muscle contraction: Acceptability, and understanding.

Summary Purpose The aim of this study was to describe verbal instructions used to obtain a voluntary pelvic floor muscle contraction and to evaluate their understanding and acceptability. Methods This prospective study led in two phases. A questionnaire was submitted to experts to collect the most frequently used instructions to obtain a PFMC. Then a questionnaire was submitted to subjects in order to: estimate the pelvic floor anatomical knowledge; estimate understanding and acceptability of these instructions; select the best instruction. Results First phase: 46 experts proposed 356 instructions. Forty-four percent were functional instructions (“hold a gas”), 40% anatomical (“squeeze your anus”) and 16% allied both. Fifteen instructions for the women and 11 for the men were selected. Second phase: 33 subjects completed the questionnaire. More than 75% had correct answers for anatomical knowledge. The instructions judged by the subjects as the most adapted to obtain a PFMC were: “contract the anus”, “do as if you wanted to hold a strong desire to void”. The items including “perineum” or “vagina” were less understood. Conclusions The more understandable and acceptable instruction to assess the PFMC is the association of two simple instructions: one anatomical and one functional. Level of evidence 4.