Pub Date : 2022-10-01DOI: 10.1097/JWH.0000000000000248
Shana McMeans, Emily Gantt, S. Rhodes, S. Wood, Kate Divine, Lisa W. McVey
Background: The World Health Organization supports and recognizes the benefits of breastfeeding, at least 6 months or more, for both a mother and her baby. A common cause for cessation of breastfeeding is the development of mastitis typically caused by a clogged milk duct. Literature is limited on physical therapy's role in reducing clogged milk ducts and subsequent mastitis. Study Design: A case report Case Description: This case describes a 33-year-old woman who was referred to physical therapy following unsuccessful treatment for breastfeeding complications that included daily bilateral clogged milk ducts and mastitis. The patient participated in a comprehensive physical therapy approach consisting of patient education, moist heat, therapeutic ultrasound, manual techniques, and cryotherapy. Outcomes: A retrospective review of 5 physical therapy visits over 3 weeks was completed. The patient reported no recurrence of mastitis and the ability to manage and decrease the recurrence of clogged milk ducts. The patient's number of daily clogged milk ducts and reported success with breastfeeding improved. At 6 months post-discharge, the patient reported she was able to continue breastfeeding and had no recurrence of mastitis. Discussion: Physical therapists may have a potential role in treating clogged milk ducts and subsequent mastitis in postpartum women where there is a lack of availability of lactation resources. A video abstract is available (see Supplemental Digital Content 1, available at: http://links.lww.com/JWHPT/A84).
{"title":"The Role of Physical Therapy in Reducing the Recurrence of Clogged Milk Ducts and Subsequent Mastitis","authors":"Shana McMeans, Emily Gantt, S. Rhodes, S. Wood, Kate Divine, Lisa W. McVey","doi":"10.1097/JWH.0000000000000248","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000248","url":null,"abstract":"Background: The World Health Organization supports and recognizes the benefits of breastfeeding, at least 6 months or more, for both a mother and her baby. A common cause for cessation of breastfeeding is the development of mastitis typically caused by a clogged milk duct. Literature is limited on physical therapy's role in reducing clogged milk ducts and subsequent mastitis. Study Design: A case report Case Description: This case describes a 33-year-old woman who was referred to physical therapy following unsuccessful treatment for breastfeeding complications that included daily bilateral clogged milk ducts and mastitis. The patient participated in a comprehensive physical therapy approach consisting of patient education, moist heat, therapeutic ultrasound, manual techniques, and cryotherapy. Outcomes: A retrospective review of 5 physical therapy visits over 3 weeks was completed. The patient reported no recurrence of mastitis and the ability to manage and decrease the recurrence of clogged milk ducts. The patient's number of daily clogged milk ducts and reported success with breastfeeding improved. At 6 months post-discharge, the patient reported she was able to continue breastfeeding and had no recurrence of mastitis. Discussion: Physical therapists may have a potential role in treating clogged milk ducts and subsequent mastitis in postpartum women where there is a lack of availability of lactation resources. A video abstract is available (see Supplemental Digital Content 1, available at: http://links.lww.com/JWHPT/A84).","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48275227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1097/jwh.0000000000000255
C. Chiarello
{"title":"Embracing Change","authors":"C. Chiarello","doi":"10.1097/jwh.0000000000000255","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000255","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41430545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-27DOI: 10.1097/JWH.0000000000000246
A. Danna-dos-Santos, V. S. Cardoso, A. T. Magalhães, P. Driusso, A. Degani
Background: Changes to segmental inertial properties, abdominal growth, and increased circulating relaxin are some of the numerous contributing factors to higher risks of falling during pregnancy. These factors emerge in different phases of pregnancy, have a cumulative effect, and vary across women. For these reasons, determining each factor's role in the development of higher fall risk is challenging and yet crucial in uncovering their clinical importance. Objectives: To investigate the independent effect of additional abdominal weight on balance control in nonpregnant women. Study Design: A longitudinal study. Methods: Ten healthy women were submitted to computerized posturography while an additional abdominal weight (7% of body mass) was applied for 24 hours. Postural behavior was recorded from 4 experimental conditions: before placement of the additional weight (Baseline), immediately after placement of the abdominal weight (T1), 24 hours after continuous application of the abdominal weight (T2), and immediately after abdominal weight removal (T3). Variables of interest were extracted from the participant's body sway dynamics and included the center of pressure (COP) migration area, range, root mean square (RMS), mean velocity, median frequency (F50), and signal sample entropy (SEnt). Results: At T3, significant increases were found for the COP migration area, mediolateral range, and mediolateral RMS (P values range: .005-.013). Also at T3, significant decreases were found for mediolateral F50 and SEnt (P values range: .001-.038). Conclusion: Modifications in balance behavior were observed when the abdominal weight was removed after 24 hours of application. Significant changes occurred in the mediolateral body sway amplitude and regularity suggesting the presence of mediolateral instability.
{"title":"Simulation of Pregnancy-Related Abdominal Mass Results in Nonimmediate Changes in Postural Control: An Exploratory Study","authors":"A. Danna-dos-Santos, V. S. Cardoso, A. T. Magalhães, P. Driusso, A. Degani","doi":"10.1097/JWH.0000000000000246","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000246","url":null,"abstract":"Background: Changes to segmental inertial properties, abdominal growth, and increased circulating relaxin are some of the numerous contributing factors to higher risks of falling during pregnancy. These factors emerge in different phases of pregnancy, have a cumulative effect, and vary across women. For these reasons, determining each factor's role in the development of higher fall risk is challenging and yet crucial in uncovering their clinical importance. Objectives: To investigate the independent effect of additional abdominal weight on balance control in nonpregnant women. Study Design: A longitudinal study. Methods: Ten healthy women were submitted to computerized posturography while an additional abdominal weight (7% of body mass) was applied for 24 hours. Postural behavior was recorded from 4 experimental conditions: before placement of the additional weight (Baseline), immediately after placement of the abdominal weight (T1), 24 hours after continuous application of the abdominal weight (T2), and immediately after abdominal weight removal (T3). Variables of interest were extracted from the participant's body sway dynamics and included the center of pressure (COP) migration area, range, root mean square (RMS), mean velocity, median frequency (F50), and signal sample entropy (SEnt). Results: At T3, significant increases were found for the COP migration area, mediolateral range, and mediolateral RMS (P values range: .005-.013). Also at T3, significant decreases were found for mediolateral F50 and SEnt (P values range: .001-.038). Conclusion: Modifications in balance behavior were observed when the abdominal weight was removed after 24 hours of application. Significant changes occurred in the mediolateral body sway amplitude and regularity suggesting the presence of mediolateral instability.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61633783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1097/jwh.0000000000000247
C. Chiarello
{"title":"Clinician's Dilemma: You're Not Alone!","authors":"C. Chiarello","doi":"10.1097/jwh.0000000000000247","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000247","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46216013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-19DOI: 10.1097/JWH.0000000000000244
Jennifer A. LaCross, D. Borello-France, G. Marchetti, Rose L. Turner, S. George
Background: Functional constipation, diagnosed by physicians utilizing the Rome criteria, is a nonpathologic bowel condition resulting in difficulty with defecation. Adults with functional constipation experience infrequent defecation and may strain and/or use manual maneuvers to produce a bowel movement. Physical therapy should be offered as part of conservative intervention. The goals of this guideline were to describe the available evidence and create a reference document of evidence for physical therapists managing adults with functional constipation symptoms. Methods: A systematic search of the literature was performed for articles published between 1990 and 2019 related to physical therapy interventions for adult functional constipation. A summary of details including benefits, risks, harms, and costs related to each intervention category is provided. Results: Strong evidence suggests that physical therapists should offer biofeedback interventions to their patients with functional constipation, including either electromyographic, rectal balloon catheter, or anorectal manometry biofeedback. Moderate evidence supports the use of manual therapy, whereas weak evidence was found to support the use of electrical stimulation to manage adult functional constipation. Finally, although we were not able to grade the evidence for the use of patient education and therapeutic exercise in the physical therapy management of functional constipation, we did provide a summary of these interventions in the literature. Discussion/Conclusions: Our findings suggest that physical therapists can confidently include biofeedback interventions into the plan of care for adults with functional constipation, as they are supported by strong evidence. Manual therapy also provided a degree of evidence suitable to recommend its use.
{"title":"Physical Therapy Management of Functional Constipation in Adults: A 2021 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association's Academy of Pelvic Health Physical Therapy","authors":"Jennifer A. LaCross, D. Borello-France, G. Marchetti, Rose L. Turner, S. George","doi":"10.1097/JWH.0000000000000244","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000244","url":null,"abstract":"Background: Functional constipation, diagnosed by physicians utilizing the Rome criteria, is a nonpathologic bowel condition resulting in difficulty with defecation. Adults with functional constipation experience infrequent defecation and may strain and/or use manual maneuvers to produce a bowel movement. Physical therapy should be offered as part of conservative intervention. The goals of this guideline were to describe the available evidence and create a reference document of evidence for physical therapists managing adults with functional constipation symptoms. Methods: A systematic search of the literature was performed for articles published between 1990 and 2019 related to physical therapy interventions for adult functional constipation. A summary of details including benefits, risks, harms, and costs related to each intervention category is provided. Results: Strong evidence suggests that physical therapists should offer biofeedback interventions to their patients with functional constipation, including either electromyographic, rectal balloon catheter, or anorectal manometry biofeedback. Moderate evidence supports the use of manual therapy, whereas weak evidence was found to support the use of electrical stimulation to manage adult functional constipation. Finally, although we were not able to grade the evidence for the use of patient education and therapeutic exercise in the physical therapy management of functional constipation, we did provide a summary of these interventions in the literature. Discussion/Conclusions: Our findings suggest that physical therapists can confidently include biofeedback interventions into the plan of care for adults with functional constipation, as they are supported by strong evidence. Manual therapy also provided a degree of evidence suitable to recommend its use.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49537676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-04DOI: 10.1097/JWH.0000000000000245
Jennifer A. LaCross, D. Borello-France, G. Marchetti, Rose L. Turner, S. George
Background: Functional constipation, diagnosed by physicians utilizing the Rome criteria, is a nonpathologic bowel condition resulting in difficulty with defecation. Adults with functional constipation experience infrequent defecation and may strain and/or use manual maneuvers to produce a bowel movement. Physical therapy should be offered as part of conservative intervention. The goals of this guideline were to describe the available evidence and create a reference document of evidence for physical therapists managing adults with functional constipation symptoms. Methods: A systematic search of the literature was performed for articles published between 1990 and 2019 related to physical therapy interventions for adult functional constipation. A summary of details including benefits, risks, harms, and costs related to each intervention category is provided. Results: Strong evidence suggests that physical therapists should offer biofeedback interventions to their patients with functional constipation, including either electromyographic, rectal balloon catheter, or anorectal manometry biofeedback. Moderate evidence supports the use of manual therapy, whereas weak evidence was found to support the use of electrical stimulation to manage adult functional constipation. Finally, although we were not able to grade the evidence for the use of patient education and therapeutic exercise in the physical therapy management of functional constipation, we did provide a summary of these interventions in the literature. Discussion/Conclusions: Our findings suggest that physical therapists can confidently include biofeedback interventions into the plan of care for adults with functional constipation, as they are supported by strong evidence. Manual therapy also provided a degree of evidence suitable to recommend its use.
{"title":"Physical Therapy Management of Functional Constipation in Adults Executive Summary: A 2021 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association's Academy of Pelvic Health Physical Therapy","authors":"Jennifer A. LaCross, D. Borello-France, G. Marchetti, Rose L. Turner, S. George","doi":"10.1097/JWH.0000000000000245","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000245","url":null,"abstract":"Background: Functional constipation, diagnosed by physicians utilizing the Rome criteria, is a nonpathologic bowel condition resulting in difficulty with defecation. Adults with functional constipation experience infrequent defecation and may strain and/or use manual maneuvers to produce a bowel movement. Physical therapy should be offered as part of conservative intervention. The goals of this guideline were to describe the available evidence and create a reference document of evidence for physical therapists managing adults with functional constipation symptoms. Methods: A systematic search of the literature was performed for articles published between 1990 and 2019 related to physical therapy interventions for adult functional constipation. A summary of details including benefits, risks, harms, and costs related to each intervention category is provided. Results: Strong evidence suggests that physical therapists should offer biofeedback interventions to their patients with functional constipation, including either electromyographic, rectal balloon catheter, or anorectal manometry biofeedback. Moderate evidence supports the use of manual therapy, whereas weak evidence was found to support the use of electrical stimulation to manage adult functional constipation. Finally, although we were not able to grade the evidence for the use of patient education and therapeutic exercise in the physical therapy management of functional constipation, we did provide a summary of these interventions in the literature. Discussion/Conclusions: Our findings suggest that physical therapists can confidently include biofeedback interventions into the plan of care for adults with functional constipation, as they are supported by strong evidence. Manual therapy also provided a degree of evidence suitable to recommend its use.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46571980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-13DOI: 10.1097/JWH.0000000000000242
A. Rudavsky, Lauren J Hickox, Megan Frame, Daisy Philtron, M. Massery
Background: Postpartum women are at an increased risk of falls. Maintaining standing balance is multifactorial, involving abdominal wall/pelvic floor muscle responsivity, quick generation of intra-abdominal pressure, and glottis position. Objective: To identify whether using voicing tasks improves balance in postpartum women. Study Design: Research report. Methods: Eleven postpartum women and 10 age-matched nulliparous controls stood on a force plate when balance was perturbed to the front or back of their bodies while performing 6 different breathing and voicing tasks. Tasks modified glottis position and lung volume. Primary outcome measure was maximal displacement of center of pressure immediately following perturbation. Results: When comparing the 2 groups' responses, postpartum women showed worse balance during the “Ah” sound and “normal exhale without breath hold” (P = .049 and P = .031, respectively). When comparing all responses to each task, participants in both groups showed no significantly different response to any tasks when they were perturbed anteriorly. The nulliparous group also had no significantly different responses when perturbed posteriorly. Postpartum women showed a significant difference in response to “normal exhale without breath hold” compared with “counting” (P = .01), with better balance for “counting.” Conclusion: Postpartum women showed improved balance during the “counting” task, which incorporates the glottis into the balance mechanism. Tasks that did not incorporate the glottis (exhalation) and relied more on the abdominal wall/pelvic floor produced worse balance in postpartum women. For recently postpartum women, counting may be a helpful strategy to improve balance and reduce fall risk.
{"title":"Certain Voicing Tasks Improve Balance in Postpartum Women Compared With Nulliparous Women","authors":"A. Rudavsky, Lauren J Hickox, Megan Frame, Daisy Philtron, M. Massery","doi":"10.1097/JWH.0000000000000242","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000242","url":null,"abstract":"Background: Postpartum women are at an increased risk of falls. Maintaining standing balance is multifactorial, involving abdominal wall/pelvic floor muscle responsivity, quick generation of intra-abdominal pressure, and glottis position. Objective: To identify whether using voicing tasks improves balance in postpartum women. Study Design: Research report. Methods: Eleven postpartum women and 10 age-matched nulliparous controls stood on a force plate when balance was perturbed to the front or back of their bodies while performing 6 different breathing and voicing tasks. Tasks modified glottis position and lung volume. Primary outcome measure was maximal displacement of center of pressure immediately following perturbation. Results: When comparing the 2 groups' responses, postpartum women showed worse balance during the “Ah” sound and “normal exhale without breath hold” (P = .049 and P = .031, respectively). When comparing all responses to each task, participants in both groups showed no significantly different response to any tasks when they were perturbed anteriorly. The nulliparous group also had no significantly different responses when perturbed posteriorly. Postpartum women showed a significant difference in response to “normal exhale without breath hold” compared with “counting” (P = .01), with better balance for “counting.” Conclusion: Postpartum women showed improved balance during the “counting” task, which incorporates the glottis into the balance mechanism. Tasks that did not incorporate the glottis (exhalation) and relied more on the abdominal wall/pelvic floor produced worse balance in postpartum women. For recently postpartum women, counting may be a helpful strategy to improve balance and reduce fall risk.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41667077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-07DOI: 10.1097/jwh.0000000000000241
Lauren Knepper
{"title":"Multifaceted Physical Therapy Approach in Male Adolescent With Coccydynia: A Case Report","authors":"Lauren Knepper","doi":"10.1097/jwh.0000000000000241","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000241","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44487951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1097/jwh.0000000000000224
Stefanie N Foster, Theresa M Spitznagle, Lori J Tuttle, Jerry L Lowder, Siobhan Sutcliffe, Karen Steger-May, Chiara Ghetti, Jinli Wang, Taylor Burlis, Melanie R Meister, Michael J Mueller, Marcie Harris-Hayes
Background: Women with urgency/frequency predominant lower urinary tract symptoms (UF-LUTS) may have elevated pelvic floor muscle (PFM) position at rest and limited mobility with PFM contraction and bearing down, but this has not been quantified.
Objectives: To compare PFM position and mobility using transperineal ultrasound (TPUS) at rest, maximal PFM contraction (perineal elevation), and bearing down (perineal descent) in women with and without UF-LUTS. We hypothesized that women with UF-LUTS would demonstrate elevated resting position and decreased excursion of pelvic landmarks during contraction and bearing down as compared to women without UF-LUTS.
Study design: Case-control study.
Methods: Women with UF-LUTS were matched 1:1 on age, body mass index and vaginal parity to women without UF-LUTS. TPUS videos were obtained during 3 conditions: rest, PFM contraction, and bearing down. Levator plate angle (LPA) and puborectalis length (PR length), were measured for each condition. Paired t-tests or Wilcoxon signed rank tests compared LPA and PR length between cases and controls.
Results: 21 case-control pairs (42 women): Women with UF-LUTS demonstrated greater LPA at rest (66.8 ± 13.2 degrees vs 54.9 ± 9.8 degrees; P=0.006), and less PR lengthening from rest to bearing down (0.2 ± 3.1 mm vs 2.1 ± 2.9 mm; P=.03).
Conclusion: Women with UF-LUTS demonstrated more elevated (cranioventral) position of the PFM at rest and less PR muscle lengthening with bearing down. These findings highlight the importance of a comprehensive PFM examination and possible treatment for women with UF-LUTS to include PFM position and mobility.
背景:患有急迫性/频率性下尿路症状(UF-LUTS)的女性可能在休息时骨盆底肌(PFM)位置升高，并且PFM收缩和压下时活动受限，但这尚未被量化。目的:利用经会阴超声(TPUS)比较有和没有UF-LUTS的女性在静息、最大PFM收缩(会阴抬高)和压下(会阴下降)时PFM的位置和活动度。我们假设，与没有UF-LUTS的女性相比，患有UF-LUTS的女性在收缩和压迫期间会表现出静止位置升高和骨盆标志偏移减少。研究设计:病例对照研究。方法:将患有UF-LUTS的女性在年龄、体重指数和阴道胎次方面与未患有UF-LUTS的女性进行1:1的匹配。在休息、PFM收缩和压下3种情况下获得tpu视频。分别测量两组患者的提肛板角(LPA)和耻骨直肠肌长度(PR)。配对t检验或Wilcoxon符号秩检验比较病例和对照组之间的LPA和PR长度。结果:21对病例对照(42名女性):患有UF-LUTS的女性在休息时表现出更大的LPA(66.8±13.2度vs 54.9±9.8度;P=0.006)，从静止到压下的PR长度较小(0.2±3.1 mm vs 2.1±2.9 mm;P = 03)。结论:患有UF-LUTS的女性在休息时PFM的位置升高(颅腹侧)，并且在压下时PR肌延长较少。这些发现强调了全面的PFM检查的重要性，以及对女性UF-LUTS的可能治疗，包括PFM的位置和活动。
{"title":"Pelvic Floor Mobility measured by Transperineal Ultrasound Imaging in Women with and without Urgency and Frequency Predominant Lower Urinary Tract Symptoms.","authors":"Stefanie N Foster, Theresa M Spitznagle, Lori J Tuttle, Jerry L Lowder, Siobhan Sutcliffe, Karen Steger-May, Chiara Ghetti, Jinli Wang, Taylor Burlis, Melanie R Meister, Michael J Mueller, Marcie Harris-Hayes","doi":"10.1097/jwh.0000000000000224","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000224","url":null,"abstract":"<p><strong>Background: </strong>Women with urgency/frequency predominant lower urinary tract symptoms (UF-LUTS) may have elevated pelvic floor muscle (PFM) position at rest and limited mobility with PFM contraction and bearing down, but this has not been quantified.</p><p><strong>Objectives: </strong>To compare PFM position and mobility using transperineal ultrasound (TPUS) at rest, maximal PFM contraction (perineal elevation), and bearing down (perineal descent) in women with and without UF-LUTS. We hypothesized that women with UF-LUTS would demonstrate elevated resting position and decreased excursion of pelvic landmarks during contraction and bearing down as compared to women without UF-LUTS.</p><p><strong>Study design: </strong>Case-control study.</p><p><strong>Methods: </strong>Women with UF-LUTS were matched 1:1 on age, body mass index and vaginal parity to women without UF-LUTS. TPUS videos were obtained during 3 conditions: rest, PFM contraction, and bearing down. Levator plate angle (LPA) and puborectalis length (PR length), were measured for each condition. Paired t-tests or Wilcoxon signed rank tests compared LPA and PR length between cases and controls.</p><p><strong>Results: </strong>21 case-control pairs (42 women): Women with UF-LUTS demonstrated greater LPA at rest (66.8 ± 13.2 degrees vs 54.9 ± 9.8 degrees; P=0.006), and less PR lengthening from rest to bearing down (0.2 ± 3.1 mm vs 2.1 ± 2.9 mm; P=.03).</p><p><strong>Conclusion: </strong>Women with UF-LUTS demonstrated more elevated (cranioventral) position of the PFM at rest and less PR muscle lengthening with bearing down. These findings highlight the importance of a comprehensive PFM examination and possible treatment for women with UF-LUTS to include PFM position and mobility.</p>","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216208/pdf/nihms-1743063.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9227260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1097/jwh.0000000000000243
C. Chiarello
{"title":"A Useful Professional Tool","authors":"C. Chiarello","doi":"10.1097/jwh.0000000000000243","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000243","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41915650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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