Pub Date : 2020-02-18DOI: 10.1097/JWH.0000000000000198
J. Guan, Claire Hamnett, S. Jakučionis, F. Hameed, C. Chiarello
Supplemental Digital Content is Available in the Text. Introduction: Pregnancy-related pelvic girdle pain (PRPGP) is a type of low back pain located between the posterior iliac crest and the gluteal fold that is exacerbated with load transfer activities and may be due to inadequate muscle activation and laxity. PRPGP affects a high percentage of pregnant women and can continue to persist postpartum. Objectives: The purpose of this study was to determine the feasibility for women with PRPGP to perform exercises designed to target core musculature throughout their pregnancy. Exercise and education (EE) was compared with education alone (EA). Study Design: This pilot study is a longitudinal, 2-group, repeated-measure, time series design. Methods: Women with PRPGP were randomly assigned to the EE group or the EA group. Pain and function were measured with the Numeric Pain Rating Scale and the Pelvic Girdle Questionnaire (PGQ), respectively, beginning at 20 to 28 weeks' gestation for 5 total sessions. Results: There was a significant main effect of session for group, as both EE and EA demonstrated a decrease in current pain (P = .019), worst pain (P = .007), and an increase in the PGQ (P = .0001) over time. There was no statistical difference between the groups. Best pain was not significant (P = .174). Conclusions: Women with PRPGP improved in pain and function from their second trimester to 6 weeks postpartum regardless of group assignment. This suggests that this population may benefit from additional education and a targeted exercise program for core musculature. Future research is needed to confirm these findings. (see the Video, Supplemental Digital Content 1, which is the video abstract, available at: http://links.lww.com/JWHPT/A42).
{"title":"Can an Outpatient Exercise Program for Pregnancy-Related Pelvic Girdle Pain Improve Pain and Function Versus Education? A Feasibility Study","authors":"J. Guan, Claire Hamnett, S. Jakučionis, F. Hameed, C. Chiarello","doi":"10.1097/JWH.0000000000000198","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000198","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Introduction: Pregnancy-related pelvic girdle pain (PRPGP) is a type of low back pain located between the posterior iliac crest and the gluteal fold that is exacerbated with load transfer activities and may be due to inadequate muscle activation and laxity. PRPGP affects a high percentage of pregnant women and can continue to persist postpartum. Objectives: The purpose of this study was to determine the feasibility for women with PRPGP to perform exercises designed to target core musculature throughout their pregnancy. Exercise and education (EE) was compared with education alone (EA). Study Design: This pilot study is a longitudinal, 2-group, repeated-measure, time series design. Methods: Women with PRPGP were randomly assigned to the EE group or the EA group. Pain and function were measured with the Numeric Pain Rating Scale and the Pelvic Girdle Questionnaire (PGQ), respectively, beginning at 20 to 28 weeks' gestation for 5 total sessions. Results: There was a significant main effect of session for group, as both EE and EA demonstrated a decrease in current pain (P = .019), worst pain (P = .007), and an increase in the PGQ (P = .0001) over time. There was no statistical difference between the groups. Best pain was not significant (P = .174). Conclusions: Women with PRPGP improved in pain and function from their second trimester to 6 weeks postpartum regardless of group assignment. This suggests that this population may benefit from additional education and a targeted exercise program for core musculature. Future research is needed to confirm these findings. (see the Video, Supplemental Digital Content 1, which is the video abstract, available at: http://links.lww.com/JWHPT/A42).","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"68 - 75"},"PeriodicalIF":0.0,"publicationDate":"2020-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45479244","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 : 2020-02-18DOI: 10.1097/JWH.0000000000000196
S. Bernard, Alice Pellichero, L. McLean, H. Moffet
Background: Responsive patient-reported outcome measures (PROMs) are able to detect change induced by a treatment. It is unknown whether PROMs on urinary incontinence (UI) are responsive in a conservative management setting. Objective: To systematically review the responsiveness of recommended PROMs (grade A) for the assessment of health-related quality of life in women receiving conservative treatment for UI. Study Design: Systematic review. Methods: A literature search was conducted on MEDLINE, EMBASE, and CINAHL. Selection criteria included women with UI undergoing conservative treatment, grade A-recommended PROM measuring the impact of UI on health-related quality of life, at least 1 responsiveness index, and original results. Two reviewers independently performed screening, data extraction, and methodological quality assessment using COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN). A descriptive analysis was conducted. Results: Five studies, including 5 PROMs, were retained (n = 672 participants). Participants had mixed UI (n = 3 studies) or stress UI (n = 2 studies). Flaws in methodological quality were identified (n = 1 study) for the assessment of responsiveness (COSMIN Box I) and (n = 3 studies) for interpretability (Box J). Highest internal responsiveness was found for the International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form (ICIQ-UI SF) (standardized response mean: 2.07, effect size = 2.12) and highest external responsiveness was found for the Protection Amount Frequency Adjustment Body Image Questionnaire (PRAFAB-Q) (area under the curve: 0.96). Conclusion: Four questionnaires presented at least 1 high responsiveness index (Urinary Incontinence Specific Quality of Life Instrument [I-QOL], PRAFAB-Q, ICIQ-UI SF, and International Consultation on Incontinence Questionnaire—Lower Urinary Tract Symptoms Quality of Life Modules [ICIQ-LUTSqol]). While the ICIQ-UI presented the highest overall responsiveness index, the PRAFAB-Q, an informative and brief questionnaire for clinical use, had the highest index with the highest methodological quality. There is a need to further confirm responsiveness of PROMs in this population and context.
{"title":"Responsiveness of Health-Related Quality of Life Patient-Reported Outcome Measures in Women Receiving Conservative Treatment for Urinary Incontinence: A Systematic Review","authors":"S. Bernard, Alice Pellichero, L. McLean, H. Moffet","doi":"10.1097/JWH.0000000000000196","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000196","url":null,"abstract":"Background: Responsive patient-reported outcome measures (PROMs) are able to detect change induced by a treatment. It is unknown whether PROMs on urinary incontinence (UI) are responsive in a conservative management setting. Objective: To systematically review the responsiveness of recommended PROMs (grade A) for the assessment of health-related quality of life in women receiving conservative treatment for UI. Study Design: Systematic review. Methods: A literature search was conducted on MEDLINE, EMBASE, and CINAHL. Selection criteria included women with UI undergoing conservative treatment, grade A-recommended PROM measuring the impact of UI on health-related quality of life, at least 1 responsiveness index, and original results. Two reviewers independently performed screening, data extraction, and methodological quality assessment using COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN). A descriptive analysis was conducted. Results: Five studies, including 5 PROMs, were retained (n = 672 participants). Participants had mixed UI (n = 3 studies) or stress UI (n = 2 studies). Flaws in methodological quality were identified (n = 1 study) for the assessment of responsiveness (COSMIN Box I) and (n = 3 studies) for interpretability (Box J). Highest internal responsiveness was found for the International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form (ICIQ-UI SF) (standardized response mean: 2.07, effect size = 2.12) and highest external responsiveness was found for the Protection Amount Frequency Adjustment Body Image Questionnaire (PRAFAB-Q) (area under the curve: 0.96). Conclusion: Four questionnaires presented at least 1 high responsiveness index (Urinary Incontinence Specific Quality of Life Instrument [I-QOL], PRAFAB-Q, ICIQ-UI SF, and International Consultation on Incontinence Questionnaire—Lower Urinary Tract Symptoms Quality of Life Modules [ICIQ-LUTSqol]). While the ICIQ-UI presented the highest overall responsiveness index, the PRAFAB-Q, an informative and brief questionnaire for clinical use, had the highest index with the highest methodological quality. There is a need to further confirm responsiveness of PROMs in this population and context.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"57 - 67"},"PeriodicalIF":0.0,"publicationDate":"2020-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48303614","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 : 2020-01-01DOI: 10.1097/JWH.0000000000000148
Rebecca Reisch
Background: Overactive bladder (OAB) is a common condition with a negative impact on quality of life. Physical therapists utilize multiple treatments for OAB, including behavioral training such as pelvic floor muscle training and urgency control strategies. Objectives: The purposes of this narrative literature review were to describe the rationale and theory for behavioral training techniques for OAB, review published evidence for these techniques, and discuss additional questions provoked by the review as well as future research directions. Study Design: Narrative literature review. Methods: A 2018 review of PubMed, CINAHL, the Cochrane database, and the Trip database yielded 12 articles appropriate for evidence analysis. Review of Literature: Pelvic floor muscle training for OAB has been studied by multiple authors. Most outcomes are favorable, but there is inadequate evidence to support any specific training protocol. Similarly, modalities to aid pelvic floor muscle training and/or reduce urinary urgency generally have positive results but published studies are difficult to compare and ideal treatment parameters are unclear. Cognitive strategies as a component of treatment for OAB, while commonly used clinically, are understudied at this time. Overall, while there is evidence to support behavioral training, the currently available literature on this subject leaves many unanswered questions. Conclusion: Behavioral treatment for OAB is well supported by solid theoretical rationales, but evidence for the treatment is equivocal and leaves practitioners with many unanswered questions. Studies on the details of behavioral therapy for OAB are strongly needed.
{"title":"Interventions for Overactive Bladder: Review of Pelvic Floor Muscle Training and Urgency Control Strategies","authors":"Rebecca Reisch","doi":"10.1097/JWH.0000000000000148","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000148","url":null,"abstract":"Background: Overactive bladder (OAB) is a common condition with a negative impact on quality of life. Physical therapists utilize multiple treatments for OAB, including behavioral training such as pelvic floor muscle training and urgency control strategies. Objectives: The purposes of this narrative literature review were to describe the rationale and theory for behavioral training techniques for OAB, review published evidence for these techniques, and discuss additional questions provoked by the review as well as future research directions. Study Design: Narrative literature review. Methods: A 2018 review of PubMed, CINAHL, the Cochrane database, and the Trip database yielded 12 articles appropriate for evidence analysis. Review of Literature: Pelvic floor muscle training for OAB has been studied by multiple authors. Most outcomes are favorable, but there is inadequate evidence to support any specific training protocol. Similarly, modalities to aid pelvic floor muscle training and/or reduce urinary urgency generally have positive results but published studies are difficult to compare and ideal treatment parameters are unclear. Cognitive strategies as a component of treatment for OAB, while commonly used clinically, are understudied at this time. Overall, while there is evidence to support behavioral training, the currently available literature on this subject leaves many unanswered questions. Conclusion: Behavioral treatment for OAB is well supported by solid theoretical rationales, but evidence for the treatment is equivocal and leaves practitioners with many unanswered questions. Studies on the details of behavioral therapy for OAB are strongly needed.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"44 1","pages":"19 - 25"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45603139","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 : 2020-01-01DOI: 10.1097/JWH.0000000000000157
Rita E. Deering, Elizabeth S. Chumanov, M. Stiffler-Joachim, B. Heiderscheit
Supplemental Digital Content is Available in the Text. Background: Pregnancy and childbirth are associated with increased inter-recti distance (IRD)/diastasis recti abdominis (DRA), pelvic joint laxity, and decreased physical activity levels. Recreational running is an accessible, popular form of exercise that may challenge pelvic stability in postpartum women. Objectives: To assess the impact of an 8-week abdominal muscle retraining program on IRD and pelvic running mechanics in women up to 2 years postpartum. Study Design: Pre/posttest single-arm intervention study. Methods: Thirteen postpartum women (32.8 ± 2.7 years of age; 1-3 pregnancies; 7 weeks to 2 years postpartum) who were recreational runners participated. Ultrasound imaging measured IRD above and below the umbilicus. Thickness of the internal oblique (IO) and transversus abdominis (TrA) muscles was assessed with ultrasonography at rest and during performance of an abdominal draw-in maneuver. Participants underwent an 8-week abdominal muscle retraining program utilizing ultrasonography as biofeedback. Running gait was assessed with 3-dimensional motion capture at study enrollment (baseline), end of the intervention, and 6-week follow-up. Results: Inter-recti distance below the umbilicus decreased from baseline to end of intervention (P = .013) and remained stable at follow-up (P = .459). Inter-recti distance above the umbilicus, IO and TrA activation ratio, and running mechanics did not change (P > .05). Women reported increased running speed following the intervention (P = .021). Conclusion: An 8-week abdominal muscle retraining program reduced IRD below the umbilicus in recreational runners up to 2 years postpartum, suggesting therapeutic exercise may be part of conservative management for DRA.
{"title":"Exercise Program Reduces Inter-Recti Distance in Female Runners Up to 2 Years Postpartum","authors":"Rita E. Deering, Elizabeth S. Chumanov, M. Stiffler-Joachim, B. Heiderscheit","doi":"10.1097/JWH.0000000000000157","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000157","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Pregnancy and childbirth are associated with increased inter-recti distance (IRD)/diastasis recti abdominis (DRA), pelvic joint laxity, and decreased physical activity levels. Recreational running is an accessible, popular form of exercise that may challenge pelvic stability in postpartum women. Objectives: To assess the impact of an 8-week abdominal muscle retraining program on IRD and pelvic running mechanics in women up to 2 years postpartum. Study Design: Pre/posttest single-arm intervention study. Methods: Thirteen postpartum women (32.8 ± 2.7 years of age; 1-3 pregnancies; 7 weeks to 2 years postpartum) who were recreational runners participated. Ultrasound imaging measured IRD above and below the umbilicus. Thickness of the internal oblique (IO) and transversus abdominis (TrA) muscles was assessed with ultrasonography at rest and during performance of an abdominal draw-in maneuver. Participants underwent an 8-week abdominal muscle retraining program utilizing ultrasonography as biofeedback. Running gait was assessed with 3-dimensional motion capture at study enrollment (baseline), end of the intervention, and 6-week follow-up. Results: Inter-recti distance below the umbilicus decreased from baseline to end of intervention (P = .013) and remained stable at follow-up (P = .459). Inter-recti distance above the umbilicus, IO and TrA activation ratio, and running mechanics did not change (P > .05). Women reported increased running speed following the intervention (P = .021). Conclusion: An 8-week abdominal muscle retraining program reduced IRD below the umbilicus in recreational runners up to 2 years postpartum, suggesting therapeutic exercise may be part of conservative management for DRA.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"44 1","pages":"18 - 9"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48156536","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 : 2020-01-01DOI: 10.1097/jwh.0000000000000167
C. Chiarello
{"title":"Bridge the Divide: Create Your Connection from Research to Practice","authors":"C. Chiarello","doi":"10.1097/jwh.0000000000000167","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000167","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jwh.0000000000000167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61633668","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 : 2020-01-01DOI: 10.1097/jwh.0000000000000156
Mark D Bishop, Joel E Bialosky, Meryl J Alappattu
Manual therapy interventions are frequently used during the management of pelvic pain conditions. Pain relief after any intervention results from effects unrelated to the intervention, effects specific to the intervention, and effects of context in which the intervention is provided. Understanding these multiple mechanisms allows providers of manual therapy to maximize outcomes by deliberately harnessing each of these core elements of pain relief.
{"title":"Riding a Tiger: Maximizing Effects of Manual Therapies for Pelvic Pain.","authors":"Mark D Bishop, Joel E Bialosky, Meryl J Alappattu","doi":"10.1097/jwh.0000000000000156","DOIUrl":"10.1097/jwh.0000000000000156","url":null,"abstract":"<p><p>Manual therapy interventions are frequently used during the management of pelvic pain conditions. Pain relief after any intervention results from effects unrelated to the intervention, effects specific to the intervention, and effects of context in which the intervention is provided. Understanding these multiple mechanisms allows providers of manual therapy to maximize outcomes by deliberately harnessing each of these core elements of pain relief.</p>","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"44 1","pages":"32-38"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jwh.0000000000000156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39101936","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 : 2020-01-01DOI: 10.1097/jwh.0000000000000159
J. Stone
Dyspareunia is a common female sexual complaint, with an estimated prevalence both worldwide and in the United States of 8% to 21%. 1 Women who experience dyspareunia complain of pain with both initial and deep penetrative intercourse. They can also experience pain with arousal, orgasm, pelvic examinations, and tampon usage. Physical therapy ABSTRACT Introduction/Background: This case report details the care of a male patient with Peyronie disease to address the female partner’s recalcitrant dyspareunia, which has not previously been reported in medical literature. Case Description: The male partner was symptom free aside from a slight tightness that he described as a tugging sensation when erect, but the female partner was experiencing varying degrees of dyspareunia since the start of their sexual relationship. Clinical fi ndings included soft tissue restrictions in the abdomen and penis as well as limitations in hip mobility bilaterally. He was seen 14 times over 16 weeks. Treatment approach included soft tissue mobilization, hip joint mobilization, ultrasound, hip stretching, and penile traction stretching. Outcomes: The patient and his partner reported signifi cant improvement in penile mobility, disappearance of the penile curve, and pain-free sexual encounters. Discussion: This article represents a case in which treatment of the male partner was instrumental in fully addressing the female partner’s dyspareunia, which may represent a point of consideration for patients with recalcitrant dyspareunia whose partners also have Peyronie disease. Informed Consent: Obtained from the patient and the patient’s partner.
{"title":"Physical Therapy Intervention for Peyronie Disease as a Missing Link for Female Dyspareunia: A Case Report","authors":"J. Stone","doi":"10.1097/jwh.0000000000000159","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000159","url":null,"abstract":"Dyspareunia is a common female sexual complaint, with an estimated prevalence both worldwide and in the United States of 8% to 21%. 1 Women who experience dyspareunia complain of pain with both initial and deep penetrative intercourse. They can also experience pain with arousal, orgasm, pelvic examinations, and tampon usage. Physical therapy ABSTRACT Introduction/Background: This case report details the care of a male patient with Peyronie disease to address the female partner’s recalcitrant dyspareunia, which has not previously been reported in medical literature. Case Description: The male partner was symptom free aside from a slight tightness that he described as a tugging sensation when erect, but the female partner was experiencing varying degrees of dyspareunia since the start of their sexual relationship. Clinical fi ndings included soft tissue restrictions in the abdomen and penis as well as limitations in hip mobility bilaterally. He was seen 14 times over 16 weeks. Treatment approach included soft tissue mobilization, hip joint mobilization, ultrasound, hip stretching, and penile traction stretching. Outcomes: The patient and his partner reported signifi cant improvement in penile mobility, disappearance of the penile curve, and pain-free sexual encounters. Discussion: This article represents a case in which treatment of the male partner was instrumental in fully addressing the female partner’s dyspareunia, which may represent a point of consideration for patients with recalcitrant dyspareunia whose partners also have Peyronie disease. Informed Consent: Obtained from the patient and the patient’s partner.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jwh.0000000000000159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61633584","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 : 2020-01-01DOI: 10.1097/JWH.0000000000000163
Erin M. Mannen, Kathryn L. Havens, Alex Kahney, E. Nelson-Wong
Background: Infant carrying is necessary for caregivers of babies. While in-arms carrying of infants is common, babywearing offers hands-free infant transport. Postural impacts of carrying methods are unknown. Objectives: Goals of this biomechanics study were to quantify differences in women holding infants in arms and in baby carriers compared with unloaded conditions during prolonged standing, and subgroup women into those who develop pain during standing (PDs) and those who do not (NPDs) to investigate differences in responses to baby-carrying conditions. Study Design: Single-subject design. Methods: Ten healthy nulliparous females (aged 27.4 ± 4.1 years) performed 15-minute quiet standing trials with each foot on a force plate in 3 conditions: holding nothing (unloaded), holding an infant mannequin in arms (arms), and holding an infant mannequin in a baby carrier (carrier). Participants completed a 10-cm Visual Analog Scale for pain before and after each trial. Results: Thirty percent of participants reported pain in the unloaded and carrier conditions compared with 50% in the arms conditions. Participants shifted their weight more frequently, spent more time in asymmetrical stance, and had INTRODUCTION Babywearing, the practice of transporting an infant or child in a carrier on the body, provides physical closeness of an infant to the mother or caregiver. The infant-mother proximity has been shown to have emotional, physical, and physiological benefits for the baby in both animal and human species. Stemming from survival instincts, separation from the mother is viewed as a life-threatening situation for offspring, causing them significant distress.1 Maternal carrying of the offspring has been shown to trigger a calming response demonstrated by central, motor, and cardiac signals in distressed infants.2,3 In addition, skin-toskin contact of premature human babies with their mothers or other caregivers, called kangaroo care, has been shown to decrease infant mortality rates, increase breastfeeding success, reduce agitation and sleep apnea, and improve infant respiratory and temperature regulation.4–8 Furthermore, a separate study has linked babywearing to a decreased likelihood of hip dysplasia in infants and young children.9 Babywearing allows the caregiver to be physically close to the baby while remaining hands-free. Physical closeness benefits the mother as well as the baby. Mothers across species show increased 1Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock. 2University of Denver, Denver, Colorado. 3Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles. 4College of Physical Therapy, Regis University, Denver, Colorado. Conflicts of Interest and Source of Funding: This study was funded by Ergobaby, Inc., and National Institute of General Medical Sciences of the National Institutes of Health under Award Number P20GM125503. The funding
背景:婴儿携带是照顾婴儿的必要条件。虽然抱着婴儿很常见，但婴儿服提供了免提的婴儿运输方式。搬运方式对姿势的影响尚不清楚。目的:这项生物力学研究的目的是量化在长时间站立时抱婴儿的妇女和抱婴儿的妇女与不抱婴儿的情况下的差异，并将妇女分为站立时疼痛(PDs)和站立时不疼痛(npd)的妇女，以调查对抱婴儿情况的反应差异。研究设计:单受试者设计。方法:10名健康未生育女性(年龄27.4±4.1岁)在3种情况下进行静立15分钟的试验，分别是不抱(未抱)、抱婴儿模型(抱)和抱婴儿模型(抱)。参与者在每次试验前后都完成了一个10厘米的视觉模拟疼痛量表。结果:30%的参与者报告在空载和携带条件下疼痛，而在武器条件下为50%。参与者更频繁地改变体重，花更多的时间保持不对称的姿势，并进行了“介绍婴儿服”(INTRODUCTION babywear)，这种做法是将婴儿或儿童放在身体上的载体中，为婴儿与母亲或照顾者提供身体上的亲密感。在动物和人类物种中，母婴接近已被证明对婴儿有情感、身体和生理上的好处。由于生存本能，与母亲的分离被视为对后代的威胁，给他们带来巨大的痛苦母亲携带后代已经被证明可以触发一种平静反应，这种反应体现在痛苦婴儿的中枢、运动和心脏信号上。2,3此外，被称为袋鼠式护理的早产儿与母亲或其他照顾者的皮肤接触，已被证明可以降低婴儿死亡率，增加母乳喂养的成功率，减少躁动和睡眠呼吸暂停，并改善婴儿的呼吸和体温调节。此外，一项单独的研究表明，婴儿穿着与婴幼儿髋关节发育不良的可能性降低有关婴儿服可以让看护人在身体上接近婴儿的同时保持免提。身体上的亲密对母亲和婴儿都有好处。不同物种的母亲数量增加了1 .小石城阿肯色大学医学院整形外科学系。2 .科罗拉多州丹佛市丹佛大学。3 .南加州大学洛杉矶分校生物运动与物理治疗学系。4 .科罗拉多州丹佛市里吉斯大学物理治疗学院。利益冲突和资金来源:本研究由Ergobaby, Inc.和美国国立卫生研究院普通医学科学研究所资助，资助号为P20GM125503。资金来源对研究设计、实验、分析或稿件准备没有影响。通讯作者:Erin M. Mannen，博士，阿肯色大学医学科学，4301 West Markham St, Slot 531, Little Rock, AR 72205 (emannen@uams.edu)。DOI: 10.1097 / JWH.0000000000000163研究报告:抱孩子的方法对长时间站立时照顾者姿势摇摆和疼痛的影响Erin M. Mannen, PhD1,2 Kathryn L. Havens, PhD3, Alexandra Kahney, SPT2,4 Erika Nelson-Wong, PT, PhD4卷44•第2号•2020年4月/ 6月当检查PD与NPD亚组时，PD在所有情况下都保持稳定，尽管载体导致PD参与者更频繁地体重变化，这对PD来说是一个积极的变化。结论:臂内携带与无负重相比改变了体位摇摆，而使用婴儿背带与无负重相比提供了更相似的生物力学。使用婴儿背带的参与者表现出较少的疼痛报告，而站立时出现疼痛的护理人员可能会从婴儿背带中获得额外的好处。
{"title":"Baby-Carrying Method Impacts Caregiver Postural Sway and Pain During Prolonged Standing","authors":"Erin M. Mannen, Kathryn L. Havens, Alex Kahney, E. Nelson-Wong","doi":"10.1097/JWH.0000000000000163","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000163","url":null,"abstract":"Background: Infant carrying is necessary for caregivers of babies. While in-arms carrying of infants is common, babywearing offers hands-free infant transport. Postural impacts of carrying methods are unknown. Objectives: Goals of this biomechanics study were to quantify differences in women holding infants in arms and in baby carriers compared with unloaded conditions during prolonged standing, and subgroup women into those who develop pain during standing (PDs) and those who do not (NPDs) to investigate differences in responses to baby-carrying conditions. Study Design: Single-subject design. Methods: Ten healthy nulliparous females (aged 27.4 ± 4.1 years) performed 15-minute quiet standing trials with each foot on a force plate in 3 conditions: holding nothing (unloaded), holding an infant mannequin in arms (arms), and holding an infant mannequin in a baby carrier (carrier). Participants completed a 10-cm Visual Analog Scale for pain before and after each trial. Results: Thirty percent of participants reported pain in the unloaded and carrier conditions compared with 50% in the arms conditions. Participants shifted their weight more frequently, spent more time in asymmetrical stance, and had INTRODUCTION Babywearing, the practice of transporting an infant or child in a carrier on the body, provides physical closeness of an infant to the mother or caregiver. The infant-mother proximity has been shown to have emotional, physical, and physiological benefits for the baby in both animal and human species. Stemming from survival instincts, separation from the mother is viewed as a life-threatening situation for offspring, causing them significant distress.1 Maternal carrying of the offspring has been shown to trigger a calming response demonstrated by central, motor, and cardiac signals in distressed infants.2,3 In addition, skin-toskin contact of premature human babies with their mothers or other caregivers, called kangaroo care, has been shown to decrease infant mortality rates, increase breastfeeding success, reduce agitation and sleep apnea, and improve infant respiratory and temperature regulation.4–8 Furthermore, a separate study has linked babywearing to a decreased likelihood of hip dysplasia in infants and young children.9 Babywearing allows the caregiver to be physically close to the baby while remaining hands-free. Physical closeness benefits the mother as well as the baby. Mothers across species show increased 1Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock. 2University of Denver, Denver, Colorado. 3Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles. 4College of Physical Therapy, Regis University, Denver, Colorado. Conflicts of Interest and Source of Funding: This study was funded by Ergobaby, Inc., and National Institute of General Medical Sciences of the National Institutes of Health under Award Number P20GM125503. The funding","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61633614","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 : 2020-01-01DOI: 10.1097/jwh.0000000000000149
Carey Rothschild, Kristen C. Schellhase
Supplemental Digital Content is Available in the Text. Background: Participation in endurance running by adult females has grown considerably in recent years. The required training for long-distance running may predispose this population to the 3 interrelated components of the female athlete triad (FAT): low energy availability (EA), menstrual dysfunction, and low bone mineral density. Research investigating the FAT has primarily focused on adolescent and young adult females. Objective: To investigate the presence of components of the FAT in a group of adult female endurance runners. Study Design: Survey research report. Methods: A survey was developed and dispersed electronically to females 18 years and older in a local half-marathon and/or marathon training group. Data were collected between March and November 2016. Results: Seventy-two females with a mean age of 40.92 ± 9.61 years completed the survey. Subjects had an average height of 163.60 ± 6.41 cm, weighed an average of 62.24 ± 10.05 kg, and had 10 years of running experience. In total, 30.6% (n = 19) of participants reported an irregular menstrual cycle. Eighty percent (n = 58) of participants had tried to lose weight, 51% (n = 37) were rarely satisfied with the shape of their body, and 65.2% (n = 47) indicated a preoccupation with a desire to be thinner. Conclusions: Participants demonstrated signs of low EA and menstrual dysfunction, 2 components of the FAT. Menstrual dysfunction may have occurred because of low EA or perimenopausal state. Health care professionals including physical therapists should examine these characteristics in adult endurance female runners as they may be at risk for developing the FAT.
{"title":"Considerations for the Adult Female Endurance Runner: A Survey Analysis","authors":"Carey Rothschild, Kristen C. Schellhase","doi":"10.1097/jwh.0000000000000149","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000149","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Participation in endurance running by adult females has grown considerably in recent years. The required training for long-distance running may predispose this population to the 3 interrelated components of the female athlete triad (FAT): low energy availability (EA), menstrual dysfunction, and low bone mineral density. Research investigating the FAT has primarily focused on adolescent and young adult females. Objective: To investigate the presence of components of the FAT in a group of adult female endurance runners. Study Design: Survey research report. Methods: A survey was developed and dispersed electronically to females 18 years and older in a local half-marathon and/or marathon training group. Data were collected between March and November 2016. Results: Seventy-two females with a mean age of 40.92 ± 9.61 years completed the survey. Subjects had an average height of 163.60 ± 6.41 cm, weighed an average of 62.24 ± 10.05 kg, and had 10 years of running experience. In total, 30.6% (n = 19) of participants reported an irregular menstrual cycle. Eighty percent (n = 58) of participants had tried to lose weight, 51% (n = 37) were rarely satisfied with the shape of their body, and 65.2% (n = 47) indicated a preoccupation with a desire to be thinner. Conclusions: Participants demonstrated signs of low EA and menstrual dysfunction, 2 components of the FAT. Menstrual dysfunction may have occurred because of low EA or perimenopausal state. Health care professionals including physical therapists should examine these characteristics in adult endurance female runners as they may be at risk for developing the FAT.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"44 1","pages":"3 - 8"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jwh.0000000000000149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44884139","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 : 2020-01-01DOI: 10.1097/JWH.0000000000000162
Tara Rudolphi, D. Storm, K. Bonnett, T. Rich
Introduction/Background: Daytime incontinence (DI) in a school-aged child with typical development has a substantial impact on the affected family and child’s quality of life. The purpose of this descriptive retrospective case series is to add to the existing knowledge of nonpharmacological treatments for dysfunctional voiding (DV) in the pediatric population. Case Description: Participants included 4 children (median age of 8.9 ± 1.7 years) with typical development who presented to physical therapy (PT) with symptoms of DI. All participants had been successfully toilet-trained during the day for more than 2 years prior to onset of DI. All participants completed a comprehensive rehabilitation program with varying symptom severity at the start of therapy. The case series includes participants with co-occurring disorders including attention-deficit hyperactivity disorder (ADHD), anxiety, and combination ADHD and encopresis. Each child was evaluated for the frequency of DI and the parent completed a urinary symptom questionnaire pretreatment and at a 1to 2-year follow-up (median time to follow-up: 1 year, 4 months). The frequency of DI was also recorded at the last PT treatment. INTRODUCTION Pelvic floor dysfunction with daytime incontinence (DI) limits full engagement and participation of schoolaged children. While these children often have a history of being fully toilet trained, pelvic floor dysfunction can occur. Although the prevalence is unknown, one population study reported up to 16.9% of schoolaged children experience daytime urinary incontinence ranging from very mild to severe.1 In children without pelvic floor dysfunction, voiding occurs when there is an absence of a pelvic floor muscle (PFM) contraction with detrusor contraction. This allows for children to fully empty and manage their bladder during voiding without abnormal urinary retention. Commonly pediatric DI is secondary 1Genesis Pediatric Therapy Center, Coralville, Iowa. 2University of Iowa Hospitals and Clinics, Iowa City, Iowa. 3Minneapolis, Minnesota. An abstract of this work was presented at the APTA Combined Sections Meeting on January 25, 2019, with support by the Elaine Meadows Research Scholar Award presented to Tara Rudolphi. The authors declare no conflicts of interest. Corresponding Author: Tara Rudolphi, DPT, PO Box 43, Williamsburg, IA 52361 (Tara.rudolphi@gmail.com). DOI: 10.1097/JWH.0000000000000162 Case Report The Effect of a Combined Pelvic Floor Muscle Training and Gross Motor Strengthening Program on Urinary Incontinence in SchoolAged Children With Typical Development: A Descriptive Retrospective Case Series Tara Rudolphi, DPT1 Douglas Storm, MD2 Kristine Bonnett, ARNP2 Tonya Rich, PhD, OTR/L3 VOLUME 44 • NUMBER 2 • 0
{"title":"The Effect of a Combined Pelvic Floor Muscle Training and Gross Motor Strengthening Program on Urinary Incontinence in School-Aged Children With Typical Development: A Descriptive Retrospective Case Series","authors":"Tara Rudolphi, D. Storm, K. Bonnett, T. Rich","doi":"10.1097/JWH.0000000000000162","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000162","url":null,"abstract":"Introduction/Background: Daytime incontinence (DI) in a school-aged child with typical development has a substantial impact on the affected family and child’s quality of life. The purpose of this descriptive retrospective case series is to add to the existing knowledge of nonpharmacological treatments for dysfunctional voiding (DV) in the pediatric population. Case Description: Participants included 4 children (median age of 8.9 ± 1.7 years) with typical development who presented to physical therapy (PT) with symptoms of DI. All participants had been successfully toilet-trained during the day for more than 2 years prior to onset of DI. All participants completed a comprehensive rehabilitation program with varying symptom severity at the start of therapy. The case series includes participants with co-occurring disorders including attention-deficit hyperactivity disorder (ADHD), anxiety, and combination ADHD and encopresis. Each child was evaluated for the frequency of DI and the parent completed a urinary symptom questionnaire pretreatment and at a 1to 2-year follow-up (median time to follow-up: 1 year, 4 months). The frequency of DI was also recorded at the last PT treatment. INTRODUCTION Pelvic floor dysfunction with daytime incontinence (DI) limits full engagement and participation of schoolaged children. While these children often have a history of being fully toilet trained, pelvic floor dysfunction can occur. Although the prevalence is unknown, one population study reported up to 16.9% of schoolaged children experience daytime urinary incontinence ranging from very mild to severe.1 In children without pelvic floor dysfunction, voiding occurs when there is an absence of a pelvic floor muscle (PFM) contraction with detrusor contraction. This allows for children to fully empty and manage their bladder during voiding without abnormal urinary retention. Commonly pediatric DI is secondary 1Genesis Pediatric Therapy Center, Coralville, Iowa. 2University of Iowa Hospitals and Clinics, Iowa City, Iowa. 3Minneapolis, Minnesota. An abstract of this work was presented at the APTA Combined Sections Meeting on January 25, 2019, with support by the Elaine Meadows Research Scholar Award presented to Tara Rudolphi. The authors declare no conflicts of interest. Corresponding Author: Tara Rudolphi, DPT, PO Box 43, Williamsburg, IA 52361 (Tara.rudolphi@gmail.com). DOI: 10.1097/JWH.0000000000000162 Case Report The Effect of a Combined Pelvic Floor Muscle Training and Gross Motor Strengthening Program on Urinary Incontinence in SchoolAged Children With Typical Development: A Descriptive Retrospective Case Series Tara Rudolphi, DPT1 Douglas Storm, MD2 Kristine Bonnett, ARNP2 Tonya Rich, PhD, OTR/L3 VOLUME 44 • NUMBER 2 • 0","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61633597","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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