Pub Date : 2021-01-01DOI: 10.1097/JWH.0000000000000197
C. Chiarello
{"title":"Teach Your Clients Well","authors":"C. Chiarello","doi":"10.1097/JWH.0000000000000197","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000197","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61633733","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 : 2021-01-01DOI: 10.1097/jwh.0000000000000193
S. Clinton, R. Stephenson, Jeffrey J. Miller
{"title":"Book Reviews","authors":"S. Clinton, R. Stephenson, Jeffrey J. Miller","doi":"10.1097/jwh.0000000000000193","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000193","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41707854","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 : 2020-12-24DOI: 10.1097/JWH.0000000000000190
M. Fischer, J. Boissonnault, J. Colquitt
Background: Literature exists for both management of lumbopelvic pain during pregnancy and physical therapy medical screening for cancer. However, little has been written on spinal cord tumors masked by pregnancy-related thoracic or lumbopelvic pain. This case presents management of a client with pregnancy-related back pain complaints and also highlights how a spinal tumor can mimic many common pregnancy symptoms. Case Description: This case describes the physical therapy (PT) management of a pregnant client presenting with thoracic and lumbopelvic pain. Initially, treatment focused on core and pelvic girdle strengthening along with postural retraining and stretching. The client attended a total of 5 PT visits after which point progressive neurological symptoms developed. Medical examination, including imaging, revealed arachnoid cysts secondary to an ependymoma, a rare spinal tumor. Outcomes: The client delivered a viable preterm infant and passed away 2 months after her initial diagnosis secondary to the malignancy. Discussion: This case describes how systemic disease may present as pregnancy-related musculoskeletal dysfunction. Recognition of non–mechanical-based symptom complaints may assist in the detection of occult pathology. There are, however, rare occurrences when red flag signs appear only in the final stages of the disease with irreversible tumor expansion and metastases, ultimately leading to death. Informed Consent: This case is unique as the individual under discussion is deceased and therefore unable to provide consent.
{"title":"A Case Report of Ependymoma in a Pregnant Client With Thoracic and Lumbopelvic Pain","authors":"M. Fischer, J. Boissonnault, J. Colquitt","doi":"10.1097/JWH.0000000000000190","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000190","url":null,"abstract":"Background: Literature exists for both management of lumbopelvic pain during pregnancy and physical therapy medical screening for cancer. However, little has been written on spinal cord tumors masked by pregnancy-related thoracic or lumbopelvic pain. This case presents management of a client with pregnancy-related back pain complaints and also highlights how a spinal tumor can mimic many common pregnancy symptoms. Case Description: This case describes the physical therapy (PT) management of a pregnant client presenting with thoracic and lumbopelvic pain. Initially, treatment focused on core and pelvic girdle strengthening along with postural retraining and stretching. The client attended a total of 5 PT visits after which point progressive neurological symptoms developed. Medical examination, including imaging, revealed arachnoid cysts secondary to an ependymoma, a rare spinal tumor. Outcomes: The client delivered a viable preterm infant and passed away 2 months after her initial diagnosis secondary to the malignancy. Discussion: This case describes how systemic disease may present as pregnancy-related musculoskeletal dysfunction. Recognition of non–mechanical-based symptom complaints may assist in the detection of occult pathology. There are, however, rare occurrences when red flag signs appear only in the final stages of the disease with irreversible tumor expansion and metastases, ultimately leading to death. Informed Consent: This case is unique as the individual under discussion is deceased and therefore unable to provide consent.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"34 - 40"},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46270771","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 : 2020-11-23DOI: 10.1097/JWH.0000000000000188
A. Tremback-Ball, Kaitlin Fulton, Nicole Giampietro, M. Gibbons, Arielle Kneller, Hayley Zelinka
Background: Gender-specific aspects of physiology influence multiple systems including the cardiovascular, respiratory, neuromuscular, and musculoskeletal systems. Studies have shown that female athletes are 2 to 10 times more susceptible to ligamentous injury than men. Studies contributed these findings to varying anatomical structure between men and women, hormonal changes throughout the menstrual cycle, and some athletes taking oral contraceptives. A female athlete may be just as fit as her male counterpart, yet it is recognized that the menstrual cycle has unique physiological and psychological effects on athletic performance. Fluctuations in sex hormones and symptoms of the menstrual cycle may impact one's ability to train and compete. Objectives: To analyze the effect of the menstrual cycle on athletic performance in NCAA Division III collegiate athletes. Study Design: Prospective, nonexperimental, descriptive study. Methods: Participants were recruited from NCAA Division III universities in Pennsylvania. Data were collected on participants' demographics, menstrual cycle history, use of birth control, premenstrual symptoms, and athletic performance. Athletic performance was examined and compared during the follicular and luteal phases and during nonmenstruating and menstruating days. Results: Eight athletes were included in the analysis. No trends were observed when comparing athletic performance during the follicular and luteal phases. When examining nonmenstruating and menstruating days, most average race times slowed or increased. Conclusion: Incorporating menstrual cycle tracking into a plan of care can help therapists determine best exercises based on phase of cycle. Therapists can also educate patients at risk of injury, modifying training plans and expectations on performance.
{"title":"Effect of the Menstrual Cycle on Athletic Performance in NCAA Division III Collegiate Athletes","authors":"A. Tremback-Ball, Kaitlin Fulton, Nicole Giampietro, M. Gibbons, Arielle Kneller, Hayley Zelinka","doi":"10.1097/JWH.0000000000000188","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000188","url":null,"abstract":"Background: Gender-specific aspects of physiology influence multiple systems including the cardiovascular, respiratory, neuromuscular, and musculoskeletal systems. Studies have shown that female athletes are 2 to 10 times more susceptible to ligamentous injury than men. Studies contributed these findings to varying anatomical structure between men and women, hormonal changes throughout the menstrual cycle, and some athletes taking oral contraceptives. A female athlete may be just as fit as her male counterpart, yet it is recognized that the menstrual cycle has unique physiological and psychological effects on athletic performance. Fluctuations in sex hormones and symptoms of the menstrual cycle may impact one's ability to train and compete. Objectives: To analyze the effect of the menstrual cycle on athletic performance in NCAA Division III collegiate athletes. Study Design: Prospective, nonexperimental, descriptive study. Methods: Participants were recruited from NCAA Division III universities in Pennsylvania. Data were collected on participants' demographics, menstrual cycle history, use of birth control, premenstrual symptoms, and athletic performance. Athletic performance was examined and compared during the follicular and luteal phases and during nonmenstruating and menstruating days. Results: Eight athletes were included in the analysis. No trends were observed when comparing athletic performance during the follicular and luteal phases. When examining nonmenstruating and menstruating days, most average race times slowed or increased. Conclusion: Incorporating menstrual cycle tracking into a plan of care can help therapists determine best exercises based on phase of cycle. Therapists can also educate patients at risk of injury, modifying training plans and expectations on performance.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"20 - 26"},"PeriodicalIF":0.0,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49297573","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 : 2020-11-13DOI: 10.1097/JWH.0000000000000187
J. Stone, Katie Skibiski, Sarah K. Hwang, C. Barnes
Supplemental Digital Content is Available in the Text. Background: Cesarean section represents the most commonly performed inpatient surgical procedure in the United States. The few studies currently available regarding the role of physical therapy in postoperative recovery only look at the first few days or weeks postpartum. The goal of this pilot randomized controlled trial was to assess the impact of physical therapy post-cesarean delivery and to serve as a potential basis for future research. Objective: To evaluate the short- and long-term impact of an individualized, comprehensive physical therapy program on post-cesarean delivery recovery. Study Design: Unblinded randomized controlled trial. Methods: The intervention group went through an individualized 6-week physical therapy program, which included in-clinic treatment and home exercises in addition to usual postoperative care. Outcome measures used were a visual pain rating scale, Oswestry Disability Index, patient satisfaction questionnaire, and self-rated exercise confidence scale. Results: Seventy-two participants were included in final analysis. Satisfaction was significantly higher at 14 weeks (P = .048) and 6 months (P = .047) in the intervention group. Pain rating was significantly lower at 14 weeks (P = .049) in the intervention group. A significant change was found between baseline and 14-week/6-month follow up for Oswestry (P < .0001), patient satisfaction (P = .024), and self-efficacy with exercise (P = .034) in the intervention group. A significant main effect for self-efficacy with exercise (P = .025) in the intervention group was found at all time points compared with standard of care. Significant differences between variables were found for the Oswestry intervention group [8-14 weeks (P = .003), 8 weeks to 6 months (P = .001), and 8 weeks to 1 year (P = .007)] and the standard of care group [8 weeks to 6 months (P = .001) and 8 weeks to 1 year (P = .006)]. Conclusions: Participants who received physical therapy had significantly improved outcomes compared with the standard of care group. This suggests that physical therapy may be a helpful adjunct to cesarean delivery recovery, although larger studies should be done for definitive conclusions.
{"title":"Physical Therapy in Addition to Standard of Care Improves Patient Satisfaction and Recovery Post-cesarean Section","authors":"J. Stone, Katie Skibiski, Sarah K. Hwang, C. Barnes","doi":"10.1097/JWH.0000000000000187","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000187","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Cesarean section represents the most commonly performed inpatient surgical procedure in the United States. The few studies currently available regarding the role of physical therapy in postoperative recovery only look at the first few days or weeks postpartum. The goal of this pilot randomized controlled trial was to assess the impact of physical therapy post-cesarean delivery and to serve as a potential basis for future research. Objective: To evaluate the short- and long-term impact of an individualized, comprehensive physical therapy program on post-cesarean delivery recovery. Study Design: Unblinded randomized controlled trial. Methods: The intervention group went through an individualized 6-week physical therapy program, which included in-clinic treatment and home exercises in addition to usual postoperative care. Outcome measures used were a visual pain rating scale, Oswestry Disability Index, patient satisfaction questionnaire, and self-rated exercise confidence scale. Results: Seventy-two participants were included in final analysis. Satisfaction was significantly higher at 14 weeks (P = .048) and 6 months (P = .047) in the intervention group. Pain rating was significantly lower at 14 weeks (P = .049) in the intervention group. A significant change was found between baseline and 14-week/6-month follow up for Oswestry (P < .0001), patient satisfaction (P = .024), and self-efficacy with exercise (P = .034) in the intervention group. A significant main effect for self-efficacy with exercise (P = .025) in the intervention group was found at all time points compared with standard of care. Significant differences between variables were found for the Oswestry intervention group [8-14 weeks (P = .003), 8 weeks to 6 months (P = .001), and 8 weeks to 1 year (P = .007)] and the standard of care group [8 weeks to 6 months (P = .001) and 8 weeks to 1 year (P = .006)]. Conclusions: Participants who received physical therapy had significantly improved outcomes compared with the standard of care group. This suggests that physical therapy may be a helpful adjunct to cesarean delivery recovery, although larger studies should be done for definitive conclusions.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"10 - 19"},"PeriodicalIF":0.0,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45411441","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 : 2020-11-13DOI: 10.1097/JWH.0000000000000189
Kate Divine, Lisa W. McVey
Supplemental Digital Content is Available in the Text. Background: Pelvic floor dysfunction is linked to urinary incontinence (UI) and urinary tract infections (UTIs). Recurrent UTIs can affect an individual's quality of life, especially emotionally. Literature examining the conservative management of recurrent UTI is mostly in the pediatric and neurologic populations, not the general adult population. Therefore, the purpose of this case report is to describe the physical therapy (PT) management of a patient with a 10-year history of uncomplicated UTIs and UI. Case Description: This case describes the management for a 50-year-old woman referred to PT for UI, UTIs, urinary urgency/frequency, and pelvic pain. PT interventions included bladder retraining, surface electromyography biofeedback, electrical stimulation, therapeutic exercises, patient education, and a progressive home exercise program. Outcomes: Following 6 PT sessions over a 6-week period, the patient reported decreased urinary symptoms and resolution of UI. The Urinary Impact Questionnaire (UIQ) improved by 18% and the Focus on Therapeutic Outcomes Pelvic Floor Dysfunction Questionnaire (FOTO PFDI) improved by 8%. The patient reported no recurrence of UTIs at 3 months post-discharge. Discussion: A PT program designed to improve pelvic floor strength and coordination may have contributed to a decrease in UTI frequency and elimination of UI within a 3-month time frame. PT could provide a conservative treatment option for uncomplicated recurrent UTI and UI to improve the social/emotional impacts of symptoms and reduce antibiotic use. Future studies are needed to see the long-term effects of PT on UTI frequency. Informed Consent: This study was approved and exempt from a local intuitional review board. A video abstract for this article is available at: http://links.lww.com/JWHPT/A39.
{"title":"Physical Therapy Management in Recurrent Urinary Tract Infections: A Case Report","authors":"Kate Divine, Lisa W. McVey","doi":"10.1097/JWH.0000000000000189","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000189","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Pelvic floor dysfunction is linked to urinary incontinence (UI) and urinary tract infections (UTIs). Recurrent UTIs can affect an individual's quality of life, especially emotionally. Literature examining the conservative management of recurrent UTI is mostly in the pediatric and neurologic populations, not the general adult population. Therefore, the purpose of this case report is to describe the physical therapy (PT) management of a patient with a 10-year history of uncomplicated UTIs and UI. Case Description: This case describes the management for a 50-year-old woman referred to PT for UI, UTIs, urinary urgency/frequency, and pelvic pain. PT interventions included bladder retraining, surface electromyography biofeedback, electrical stimulation, therapeutic exercises, patient education, and a progressive home exercise program. Outcomes: Following 6 PT sessions over a 6-week period, the patient reported decreased urinary symptoms and resolution of UI. The Urinary Impact Questionnaire (UIQ) improved by 18% and the Focus on Therapeutic Outcomes Pelvic Floor Dysfunction Questionnaire (FOTO PFDI) improved by 8%. The patient reported no recurrence of UTIs at 3 months post-discharge. Discussion: A PT program designed to improve pelvic floor strength and coordination may have contributed to a decrease in UTI frequency and elimination of UI within a 3-month time frame. PT could provide a conservative treatment option for uncomplicated recurrent UTI and UI to improve the social/emotional impacts of symptoms and reduce antibiotic use. Future studies are needed to see the long-term effects of PT on UTI frequency. Informed Consent: This study was approved and exempt from a local intuitional review board. A video abstract for this article is available at: http://links.lww.com/JWHPT/A39.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"27 - 33"},"PeriodicalIF":0.0,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46322569","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 : 2020-10-01Epub Date: 2020-10-14DOI: 10.1097/JWH.0000000000000180
Carina Siracusa, Amelia Gray
Background: Much of the research and clinical commentary on COVID-19 have been focused on respiratory function. Pelvic floor therapists understand that both respiratory dysfunction and hospitalization can have an impact on pelvic floor function. This clinical commentary provides context as to how the long-term effects of COVID-19 could affect the pelvic floor as well as some generalized treatment considerations.
Discussion: The respiratory diaphragm has an impact on the ability of the pelvic floor to contract and relax in a manner that will allow for both continence and elimination. COVID-19 survivors often have disability in this muscle of respiration that can lead to implications for both overactive and underactive pelvic floor. Commonly, this population is hospitalized for long periods of time, which can have long-term consequences on both bladder and bowel functioning including, but not limited to, incontinence, urinary retention, and constipation. Pelvic floor therapists must be prepared to adjust both their evaluation and treatment methods in consideration of this novel treatment population.
Conclusions: Because of the pervasive nature of this virus, pelvic floor physical therapists should be a part of the rehabilitation team treating these patients once they have become medically stable.Video abstract with sound available at http://links.lww.com/JWHPT/A36.
{"title":"Pelvic Floor Considerations in COVID-19.","authors":"Carina Siracusa, Amelia Gray","doi":"10.1097/JWH.0000000000000180","DOIUrl":"10.1097/JWH.0000000000000180","url":null,"abstract":"<p><strong>Background: </strong>Much of the research and clinical commentary on COVID-19 have been focused on respiratory function. Pelvic floor therapists understand that both respiratory dysfunction and hospitalization can have an impact on pelvic floor function. This clinical commentary provides context as to how the long-term effects of COVID-19 could affect the pelvic floor as well as some generalized treatment considerations.</p><p><strong>Discussion: </strong>The respiratory diaphragm has an impact on the ability of the pelvic floor to contract and relax in a manner that will allow for both continence and elimination. COVID-19 survivors often have disability in this muscle of respiration that can lead to implications for both overactive and underactive pelvic floor. Commonly, this population is hospitalized for long periods of time, which can have long-term consequences on both bladder and bowel functioning including, but not limited to, incontinence, urinary retention, and constipation. Pelvic floor therapists must be prepared to adjust both their evaluation and treatment methods in consideration of this novel treatment population.</p><p><strong>Conclusions: </strong>Because of the pervasive nature of this virus, pelvic floor physical therapists should be a part of the rehabilitation team treating these patients once they have become medically stable.<b>Video abstract with sound available at</b> http://links.lww.com/JWHPT/A36.</p>","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"44 4","pages":"144-151"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641036/pdf/jwhpt-44-144.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39121980","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 : 2020-09-16DOI: 10.1097/JWH.0000000000000164
U. Nweke, A. Ezeukwu, Chidinma Peace Mbanasor, C. Ojukwu, I. Sunday‐Adeoye, E. Anekwu, B. Daniyan, E. N. Yakubu
Background: Obstetric fistula is a major maternal health issue with its attendant physical, psychosocial, and economic correlates. The morbidity worsens with physical challenges associated with neurological and musculoskeletal injury in the patient. Objectives: The major objective of this study was to examine selected clinical characteristics and determinants of obstetric palsy among patients with obstetric fistula. Study Design: Descriptive retrospective study. Methods: Medical records of 452 patients who were treated for obstetric fistula at the National Obstetric Fistula Centre, Abakaliki, from January 2014 to May 2018 were retrieved and analyzed for clinical characteristics and clinical determinants using the SPSS for Windows (SPSS version 20). Results: Results revealed that 23.5% of the subjects neither registered for nor attended antenatal care in a health facility. While 50.9% of the subjects had lived with fistula for less than a year, 31.4% lived with obstetric fistula between 1 and 9 years. Labor lasting for 2 days or more was reported by 46.7%. Vaginal births were reported by 34.1%. Intracervical fistula was the most frequently encountered fistula. Maternal obstetric paralysis of one or both lower limbs was found in 31.4% of the subjects. Results of a binary logistic regression model also reveals that antenatal care, duration of labor, mode of delivery, and circumferential fistula were significant determinants of obstetric palsy among patients with obstetric fistula. Conclusion: There is need to increase public enlightenment and make antenatal care and delivery readily available to reduce obstetric fistula and maternal obstetric palsy. Therapists' awareness of these determinants also aids in clinical diagnosis, prognosis, and prevention.
背景:产科瘘是一个主要的孕产妇健康问题，伴随着身体、社会心理和经济相关因素。发病率随着患者神经和肌肉骨骼损伤相关的身体挑战而恶化。目的:本研究的主要目的是检查产科瘘患者中产科瘫痪的临床特征和决定因素。研究设计:描述性回顾性研究。方法:检索2014年1月至2018年5月在Abakaliki国家产科瘘中心接受产科瘘治疗的452例患者的医疗记录，并使用SPSS for Windows (SPSS version 20)分析临床特征和临床决定因素。结果:结果显示，23.5%的受试者既没有登记也没有参加过卫生机构的产前护理。50.9%的患者患产科瘘的时间少于1年，31.4%的患者患产科瘘的时间为1 - 9年。分娩持续2天及以上的占46.7%。顺产占34.1%。宫颈内瘘是最常见的瘘管。31.4%的受试者出现单侧或双侧下肢瘫痪。二元logistic回归模型的结果还显示，产前护理、分娩时间、分娩方式和围瘘是产科瘘患者产科瘫痪的重要决定因素。结论:应加强公众教育，提高产前保健和分娩的便利性，以减少产科瘘和产妇产科瘫痪。治疗师对这些决定因素的认识也有助于临床诊断、预后和预防。
{"title":"Selected Clinical Characteristics and Determinants of Obstetric Palsy Among Patients With Obstetric Fistula","authors":"U. Nweke, A. Ezeukwu, Chidinma Peace Mbanasor, C. Ojukwu, I. Sunday‐Adeoye, E. Anekwu, B. Daniyan, E. N. Yakubu","doi":"10.1097/JWH.0000000000000164","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000164","url":null,"abstract":"Background: Obstetric fistula is a major maternal health issue with its attendant physical, psychosocial, and economic correlates. The morbidity worsens with physical challenges associated with neurological and musculoskeletal injury in the patient. Objectives: The major objective of this study was to examine selected clinical characteristics and determinants of obstetric palsy among patients with obstetric fistula. Study Design: Descriptive retrospective study. Methods: Medical records of 452 patients who were treated for obstetric fistula at the National Obstetric Fistula Centre, Abakaliki, from January 2014 to May 2018 were retrieved and analyzed for clinical characteristics and clinical determinants using the SPSS for Windows (SPSS version 20). Results: Results revealed that 23.5% of the subjects neither registered for nor attended antenatal care in a health facility. While 50.9% of the subjects had lived with fistula for less than a year, 31.4% lived with obstetric fistula between 1 and 9 years. Labor lasting for 2 days or more was reported by 46.7%. Vaginal births were reported by 34.1%. Intracervical fistula was the most frequently encountered fistula. Maternal obstetric paralysis of one or both lower limbs was found in 31.4% of the subjects. Results of a binary logistic regression model also reveals that antenatal care, duration of labor, mode of delivery, and circumferential fistula were significant determinants of obstetric palsy among patients with obstetric fistula. Conclusion: There is need to increase public enlightenment and make antenatal care and delivery readily available to reduce obstetric fistula and maternal obstetric palsy. Therapists' awareness of these determinants also aids in clinical diagnosis, prognosis, and prevention.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"44 1","pages":"152 - 159"},"PeriodicalIF":0.0,"publicationDate":"2020-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45403897","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 : 2020-09-02DOI: 10.1097/JWH.0000000000000178
Erin H. Hartigan, J. McAuley, Michael A. Lawrence
Supplemental Digital Content is Available in the Text. Background: Women with stress urinary incontinence (SUI) use different hip biomechanics during gait than women without SUI. Objective: To compare hip angles, moments, and temporal-spatial parameters during gait between women with and without SUI from a control to full-bladder condition. Study Design: Case-control study with a repeated-measures design. Methods: Hip angles and moments (net forces) of 19 women with SUI and 23 women without SUI were analyzed during the weight acceptance phase of the gait. Mixed-model analyses of variance were used to compare between groups (SUI, without SUI), conditions (control, full bladder), and limbs (dominant [D], nondominant [ND]). Significance: P < .05. Results: Women with SUI were older (P < .001), more active (P = .022), produced more offspring (P < .001), used lesser adduction (P = .035; D-limb only), and minimum (P = .01) and peak flexion angles (P = .01), compared with women without SUI. Hip angles (internal rotation [IR]: ND > D, P < .001; external rotation [ER]: D > ND, P = .001), and moments (IR: ND < D, P = .001) differed between limbs. For ER moments, post hoc testing revealed that ND > D were found for women without SUI (P < .001, both conditions) and women with SUI during the control condition only (P = .001). From the control to full-bladder condition, ER angles decreased (P = .012), abduction moments increased (without SUI only; P = .027), extension moments increased (P = .003; D-limb only), step time increased (P = .006), and cadence decreased (P = .007). Conclusions: Women with SUI did not use different hip moments but used different hip positions during gait compared with women without SUI. Women with and without SUI altered force generation differently in response to bladder stress. A Video Abstract for this article is available at http://links.lww.com/JWHPT/A41.
{"title":"Women With and Without Self-reported Stress Urinary Incontinence Walk Differently Before and After 16-Ounce Water Consumption","authors":"Erin H. Hartigan, J. McAuley, Michael A. Lawrence","doi":"10.1097/JWH.0000000000000178","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000178","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Women with stress urinary incontinence (SUI) use different hip biomechanics during gait than women without SUI. Objective: To compare hip angles, moments, and temporal-spatial parameters during gait between women with and without SUI from a control to full-bladder condition. Study Design: Case-control study with a repeated-measures design. Methods: Hip angles and moments (net forces) of 19 women with SUI and 23 women without SUI were analyzed during the weight acceptance phase of the gait. Mixed-model analyses of variance were used to compare between groups (SUI, without SUI), conditions (control, full bladder), and limbs (dominant [D], nondominant [ND]). Significance: P < .05. Results: Women with SUI were older (P < .001), more active (P = .022), produced more offspring (P < .001), used lesser adduction (P = .035; D-limb only), and minimum (P = .01) and peak flexion angles (P = .01), compared with women without SUI. Hip angles (internal rotation [IR]: ND > D, P < .001; external rotation [ER]: D > ND, P = .001), and moments (IR: ND < D, P = .001) differed between limbs. For ER moments, post hoc testing revealed that ND > D were found for women without SUI (P < .001, both conditions) and women with SUI during the control condition only (P = .001). From the control to full-bladder condition, ER angles decreased (P = .012), abduction moments increased (without SUI only; P = .027), extension moments increased (P = .003; D-limb only), step time increased (P = .006), and cadence decreased (P = .007). Conclusions: Women with SUI did not use different hip moments but used different hip positions during gait compared with women without SUI. Women with and without SUI altered force generation differently in response to bladder stress. A Video Abstract for this article is available at http://links.lww.com/JWHPT/A41.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"44 1","pages":"182 - 192"},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41492147","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 : 2020-08-20DOI: 10.1097/JWH.0000000000000179
Donald Kasitinon, B. Kelly, T. Price, A. Chhabra, K. Scott
Background: Pudendal neuropathy is an underrecognized cause of pelvic pain that can be difficult to diagnose and treat. Cycling has been the traditional etiology associated with exercise-induced pudendal neuropathy, but with changing aesthetic and societal norms emphasizing a strong physique, there has been increasing anecdotal evidence of squat-based exercises causing the condition. Study Design: Case series. A retrospective medical record review was performed to look at all patients with pudendal nerve injuries who presented to a physical medicine and rehabilitation pelvic floor rehabilitation clinic over a 1-year period. Case Description: There were 15 cases of pudendal neuropathy thought to be due to squat-based exercises. Here, we present 4 of these patients (1 male and 3 females) who had good follow-up and compliance with treatment recommendations, along with their respective outcomes. Outcomes: This is the first case series to present a number of patients with pelvic pain due to pudendal neuropathies presumably derived from squat-related exercise. All 4 of these patients had good outcomes utilizing a multidisciplinary approach to management. Discussion: It is important for both physicians and physical therapists to learn to recognize pudendal neuropathy as a cause of pelvic pain and to counsel patients effectively to help them avoid pudendal nerve injury during exercise.
{"title":"Pudendal Nerve Injuries in Sports and Exercise: A Case Series of Pudendal Neuropathies From Squats","authors":"Donald Kasitinon, B. Kelly, T. Price, A. Chhabra, K. Scott","doi":"10.1097/JWH.0000000000000179","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000179","url":null,"abstract":"Background: Pudendal neuropathy is an underrecognized cause of pelvic pain that can be difficult to diagnose and treat. Cycling has been the traditional etiology associated with exercise-induced pudendal neuropathy, but with changing aesthetic and societal norms emphasizing a strong physique, there has been increasing anecdotal evidence of squat-based exercises causing the condition. Study Design: Case series. A retrospective medical record review was performed to look at all patients with pudendal nerve injuries who presented to a physical medicine and rehabilitation pelvic floor rehabilitation clinic over a 1-year period. Case Description: There were 15 cases of pudendal neuropathy thought to be due to squat-based exercises. Here, we present 4 of these patients (1 male and 3 females) who had good follow-up and compliance with treatment recommendations, along with their respective outcomes. Outcomes: This is the first case series to present a number of patients with pelvic pain due to pudendal neuropathies presumably derived from squat-related exercise. All 4 of these patients had good outcomes utilizing a multidisciplinary approach to management. Discussion: It is important for both physicians and physical therapists to learn to recognize pudendal neuropathy as a cause of pelvic pain and to counsel patients effectively to help them avoid pudendal nerve injury during exercise.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"3 - 9"},"PeriodicalIF":0.0,"publicationDate":"2020-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47538180","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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