Table 1.

Digital pelvic floor muscle assessment items, definitions of normal function, and pelvic floor muscle assessment outcome codes for heatmaps

	EAS		PRM
Item	Description	Normal function (heatmap)	Description	Normal function (heatmap)
Tone	Normal	0 = normal tone	Normal	0 = normal tone
	Decreased	1 = decreased/increased tone	Decreased	1 = decreased/increased tone
	Increased		Increased
Voluntary contraction	Yes, circular closing and contraction in cephalad ventral direction	0 = yes	Yes, in cephalad‐ventral direction	0 = yes
	Straining	0.5 = straining	Straining	0.5 = straining
	No, no movement	1 = no, no movement	No, no movement	1 = no, no movement
Voluntary relaxation (after contraction)	Yes: relaxation felt after instruction; normal finding	0 = complete (delayed) relaxation	Yes: relaxation felt after instruction: normal finding	0 = complete relaxation
	Partial or delayed relaxation	0.5 = partial or delayed relaxation	Partial relaxation	0.5 = partial relaxation
	No: Absent = nonrelaxation PFM	1 = no relaxation	No: Absent = nonrelaxation PFM	1 = no relaxation
Strength: maximum voluntary contraction	Strong	0 = strong/normal (moderate)	Strong	0 = strong/normal (moderate)
	Normal (moderate)	0.5 = weak	Normal (moderate)	0.5 = weak
	Weak	1 = absent	Weak	1 = absent
	Absent		Absent
Repeatability of contraction (Frequency of maximum voluntary contraction (1 s)	10 times	0 = 7–10 times	10 times	0 = 7–10 times
	7–9 times	0.33 = 4–6 times	7–9 times	0.33 = 4–6 times
	4–6 times	0.66 =1–3 times	4–6 times	0.66 = 1–3 times
	1–3 times	1 = 0 times	1–3 times	1 = 0 times
	0 times		0 times
Endurance	7–10 s	0 = 7–10 s	7–10 s	0 = 7–10 s
	3–7 s	0.33 = 3–6.99 s	3–7 s	0.33 = 3–6.99 s
	1–3 s	0.66 = 1–2.99 s	1–3 s	0.66 = 1–2.99 s
	0–1 s	1 = 0–0.99 s	0–1 s	1 = 0‐0.99 s
Anorectal angle			Yes, increased at contraction	0 = yes
			No, no increase at contraction	1 = no
Sphincter closed	Yes, closed	0 = yes
(at rest)	No, not closed	1 = no

Note: Description is based on Frawley et al. ⁵

Normal function is shown in bold and the endurance item is the mean average of three endurance contractions (10 s each). 

Abbreviations: EAS, external anal sphincter; PFM, pelvic floor musculature; PRM, puborectal muscle.