Physiotherapy interventions for pelvic floor dysfunctions in stroke survivors - a scoping review of literature.

Abstract

Background: Pelvic floor dysfunction (PFD) are common following stroke. Physiotherapy interventions such as pelvic floor muscle training (PFMT) seems to be effective in the general population with PFD, but its usefulness in stroke patients has rarely been addressed.

Objectives: We aimed to explore existing physiotherapy interventions and their influence in managing PFD in men and women stroke survivors.

Methods: Eight major databases were searched from inception to date using appropriate keywords and search strings. We included experimental studies comparing physiotherapy to control interventions/alternate treatments. PFD were grouped under urinary incontinence (UI), bowel dysfunction (BD), and sexual dysfunctions (SD) based on the studies. Two reviewers independently screened the title and abstract, to determine the included studies and the third author resolved disputes.

Results: Fourteen studies were identified of which ten focused on the management of UI, one on BD, and three on the management of SD. PFMT was predominantly used to manage UI independently or combined with other forms of treatment such as timed voiding, intermittent catheterization, acupuncture, and drug therapy. BD was managed using anal sphincter strengthening exercises, PFMT, and bowel training. Management of SD for both men and women included comfortable and safe sexual position training, stretching, and PFMT. Studies found significant improvement in terms of symptoms of bladder and bowel incontinence, number of incontinence episodes and muscle strength on digital palpation of the pelvic floor muscles.

Conclusion: Physiotherapy interventions including PFMT may help in managing the symptoms and improving the quality of life of stroke survivors with PFD.