Comprehensive pelvic muscle assessment: Developing and testing a dual e-Learning and simulation-based training program

The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: The Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium launched the RISE FOR HEALTH (RISE) national study of women's bladder health which includes annual surveys and an in-person visit. For the in-person exam, a standardized, replicable approach to conducting a pelvic muscle (PM) assessment was necessary. The process used to develop the training, the products, and group testing results from the education and training are described. Methods: A comprehensive pelvic muscle assessment (CPMA) program was informed by literature view and expert opinion. Training materials were prepared for use on an electronicLearning (e-Learning) platform. An in-person hands-on simulation and certification session was then designed. It included a performance checklist assessment for use by Clinical Trainers, who in collaboration with a gynecology teaching assistant, provided an audit and feedback process to determine Trainee competency. Results: Five discrete components for CPMA training were developed as e-Learning modules. These were: (1) overview of all the clinical measures and PM anatomy and examination assessments, (2) visual assessment for pronounced pelvic organ prolapse, (3) palpatory assessment of the pubovisceral muscle to estimate muscle integrity, (4) digital vaginal assessment to estimate strength, duration, symmetry during PM contraction, and (5) pressure palpation of both myofascial structures and PMs to assess for self-report of pain. Seventeen Trainees completed the full CPMA training, all successfully meeting the a priori certification required pass rate of 85% on checklist assessment. Conclusions: The RISE CPMA training program was successfully conducted to assure standardization of the PM assessment across the PLUS multicenter research sites. This approach can be used by researchers and healthcare professionals who desire a standardized approach to assess competency when performing this CPMA in the clinical or research setting.

Original languageEnglish (US)
Pages (from-to)1036-1054
Number of pages19
JournalNeurourology and Urodynamics
Issue number5
StatePublished - Jun 2023

Bibliographical note

Funding Information:
The authors would like to acknowledge the following: RISE research coordinators for their invaluable contributions: UCSD: Kyle Herrala, Elia Smith, and Dulce Rodriguez‐Ponciano; UMICH: Sarah Hortsch and Ruta Misiunas; UPenn: Emily Gus; WASHU: Ratna Pakpahan; Loyola: Mary Tulke; UIC: Elise Levin; Yale: Leslie Burke‐Hovey; NU: Melissa Marquez and Sophia Kallas; UAB: Hannah Burns; Emory: Taressa Sergent; Meg Tolbert, CRNP for assistance as a PM Clinical Trainer; Diane K. Newman, Melanie Meister, Jerry L. Lowder, and Sarah Hortsch for a voice over for PM e‐Learning modules; and Vanika Chary and K. D. Bohara for implementation of the PM training. They would also like to thank the collegial research work of the Prevention of Lower Urinary Tract Symptoms Research Consortium members. This work was supported by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health by cooperative agreements (U24 DK106786, U01 DK106853, U01 DK126045, U01 DK106858, U01 DK106898, U01 DK106893, U01 DK106827, U01 DK106908, U01 DK106892). and the National Institute on Aging, National Institutes of Health Office of Research on Women's Health.

Publisher Copyright:
© 2023 Wiley Periodicals LLC.


  • comprehensive pelvic muscle assessment
  • pelvic examination
  • pelvic floor myofascial pain
  • pelvic muscle strength
  • pelvic organ prolapse
  • pubovisceral (pubococcygeus) muscle
  • women's health

PubMed: MeSH publication types

  • Multicenter Study
  • Journal Article
  • Research Support, N.I.H., Extramural


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