Assessment Tool: Oxford Grading Scale
The Oxford Grading Scale standardises the assessment of pelvic floor muscle strength. The clinician performs a digital internal examination while the patient attempts a voluntary pelvic floor contraction. Document the grade, hold duration in seconds, and number of repeats achieved. Reassess after 6–8 weeks of pelvic floor rehabilitation to evaluate treatment response.
Oxford Grading Scale — Pelvic Floor Muscle Strength
A validated 6-point ordinal scale used by nurses and continence specialists to assess the strength and endurance of pelvic floor muscles during voluntary contraction. Assessed by digital internal examination. Grade 0 = no contraction; Grade 5 = strong contraction with sustained lift against resistance.
Grade reference
0–1
Absent / very weak — immediate referral
2–3
Weak–moderate — Kegel exercise program
4–5
Good–strong — maintenance exercises
Result
Oxford Grade: —/5
Functional status:
Repeat assessment after 6–8 weeks of pelvic floor rehabilitation to evaluate response. A gain of 1–2 Oxford grades or a meaningful increase in hold duration indicates clinically meaningful improvement. Document findings for continuity of care.