Pub Date : 2020-01-01DOI: 10.1097/JWH.0000000000000165
M. Bonis, J. Lormand, Christina M Walsh
Background: Over the next 30 years chronic health problems associated with pelvic floor dysfunction are projected to increase by 50%. Objective: To determine the efficacy of a noninvasive, pain-free procedure of behavioral modifications and a specialized exercise program to improve pain levels and quality of life. Study Design: A quantitative, longitudinal study was conducted. Methods: Forty-one women aged 43.2 ± 9.5 years (mean ± SD) with symptoms of pelvic floor dysfunction and pelvic organ prolapse were introduced to a protocol that included eight 45-minute live group sessions and a home exercise program to be performed at least 3 times per week. The participants were reassessed after completion of the protocol intervention. IBM SPSS Version 24 statistical programming was used, and Wilcoxon nonparametric analyses were applied to compare the preand INTRODUCTION Low back pain (LBP) is a condition of localized pain to the lumbar spine whose etiology is commonly unknown.1 Pelvic floor disorders (PFDs) occur when the muscles that comprise the pelvic floor fail to properly contract. This can cause urinary incontinence, pelvic organ prolapse, fecal incontinence, or other sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts.2 Current evidence shows that individuals with LBP have a significant decrease in pelvic floor function compared with individuals without LBP.3 Over 25% of all women and more than a third older than 65 years experience PFD. Even though it is a physiological problem, the psychosocial impact of PFD can be much more detrimental to the patient’s quality of life. Over the next 30 years chronic health problems associated with PFD are projected to increase by 50% due to the increasing numbers of women reaching the age of 65.4 PFD does not typically have one specific cause. Pregnancy/childbirth, age, hormonal changes, obesity, lower urinary tract infection, and pelvic surgery are Human Performance and Health Promotion Program, University of New Orleans, Louisiana. Bonis is a faculty member at University of New Orleans. Lormand and Walsh are self-employed clinicians who participate in the University of New Orleans-Human Performance and Health Promotion Program mentorinternship program. The research clinicians who administered the entire procedure to all of the participants are a licensed physical therapist (C.W.) and a clinical exercise physiologist (J.L.). The 2 clinicians collaborated and developed the procedure. The third member of the research group (M.B.) is an experienced researcher and an exercise science faculty member at the University of New Orleans who participated as the primary investigator, designed the study, and performed all of the statistical analyses. The authors declare no conflicts of interest. Corresponding Author: Marc Bonis, PhD, Human Performance and Health Promotion Program, University of New Orleans, 2000 Lakeshore Dr, ELCF Dept ED 348K, New Orleans, LA 70148 (mbonis@uno.edu). DOI: 1
背景:在未来30年，盆底功能障碍相关的慢性健康问题预计将增加50%。目的:确定非侵入性、无痛的行为改变程序和专门的运动计划对改善疼痛水平和生活质量的疗效。研究设计:进行定量、纵向研究。方法:41名年龄为43.2±9.5岁(平均±SD)，伴有盆底功能障碍和盆腔器官脱垂症状的女性被引入一个方案，包括8个45分钟的现场小组会议和一个每周至少3次的家庭锻炼计划。在完成方案干预后，对参与者进行重新评估。使用IBM SPSS Version 24统计程序，并应用Wilcoxon非参数分析来比较研究前和研究简介:腰痛(LBP)是腰椎局部疼痛的一种情况，其病因通常未知盆底疾病(PFDs)发生时，组成盆底的肌肉不能正常收缩。这可能导致尿失禁，盆腔器官脱垂，大便失禁，或其他感觉和排空异常的下泌尿道和胃肠道目前的证据表明，与没有腰痛的人相比，有腰痛的人盆底功能明显下降。3超过25%的女性和超过三分之一的65岁以上的老年人经历过PFD。尽管这是一个生理问题，但PFD的社会心理影响可能对患者的生活质量更有害。在今后30年中，由于65.4岁以上妇女人数的增加，预计与PFD相关的慢性健康问题将增加50%。怀孕/分娩，年龄，激素变化，肥胖，下尿路感染和骨盆手术是人类表现和健康促进计划，路易斯安那州新奥尔良大学。博尼斯是新奥尔良大学的一名教员。洛曼德和沃尔什是参加新奥尔良大学人类表现和健康促进计划导师实习计划的自雇临床医生。对所有参与者执行整个过程的临床医生是一位有执照的物理治疗师(C.W.)和一位临床运动生理学家(J.L.)。两位临床医生合作并开发了该程序。研究小组的第三位成员(m.b.a.)是新奥尔良大学一位经验丰富的研究人员和运动科学教员，他作为主要调查员参与了研究，设计了这项研究，并进行了所有的统计分析。作者声明无利益冲突。通讯作者:Marc Bonis博士，人类表现和健康促进计划，新奥尔良大学，2000年。lakesshore博士，ELCF系主任348K，新奥尔良，LA 70148 (mbonis@uno.edu)。DOI: 10.1097 / JWH.0000000000000165研究报告:运动和行为干预对盆底功能障碍和腰骨盆疼痛的直接影响Marc Bonis, Jennifer Lormand博士，BS Christina Walsh, PT vol 44•NUMBER 2•2020年4月/ 6月的研究后数据，以确定是否发生了疼痛和/或功能障碍的显着缓解。结果:该手术显著改善了腰痛(Oswestry, z(41) = - 4.068, P < 0.05)、与盆底障碍症状相关的生活质量(盆底困扰问卷-短表20,z(41) = - 5.317, P < 0.05)、盆底障碍症状对生活的影响(盆底影响问卷-短表7,z(41) = - 3.825, P < 0.05)、脊柱分离(z(41) = - 4.806, P < 0.05)、盆底肌肉激活(z(41) = - 5.583, P < 0.05)、骨盆对准(z(41) =−3.207,P < 0.05)。结论:无创、无痛手术可显著缓解盆底功能障碍和腰痛症状。
{"title":"Immediate Effects of Exercise and Behavioral Interventions for Pelvic Floor Dysfunction and Lumbopelvic Pain","authors":"M. Bonis, J. Lormand, Christina M Walsh","doi":"10.1097/JWH.0000000000000165","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000165","url":null,"abstract":"Background: Over the next 30 years chronic health problems associated with pelvic floor dysfunction are projected to increase by 50%. Objective: To determine the efficacy of a noninvasive, pain-free procedure of behavioral modifications and a specialized exercise program to improve pain levels and quality of life. Study Design: A quantitative, longitudinal study was conducted. Methods: Forty-one women aged 43.2 ± 9.5 years (mean ± SD) with symptoms of pelvic floor dysfunction and pelvic organ prolapse were introduced to a protocol that included eight 45-minute live group sessions and a home exercise program to be performed at least 3 times per week. The participants were reassessed after completion of the protocol intervention. IBM SPSS Version 24 statistical programming was used, and Wilcoxon nonparametric analyses were applied to compare the preand INTRODUCTION Low back pain (LBP) is a condition of localized pain to the lumbar spine whose etiology is commonly unknown.1 Pelvic floor disorders (PFDs) occur when the muscles that comprise the pelvic floor fail to properly contract. This can cause urinary incontinence, pelvic organ prolapse, fecal incontinence, or other sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts.2 Current evidence shows that individuals with LBP have a significant decrease in pelvic floor function compared with individuals without LBP.3 Over 25% of all women and more than a third older than 65 years experience PFD. Even though it is a physiological problem, the psychosocial impact of PFD can be much more detrimental to the patient’s quality of life. Over the next 30 years chronic health problems associated with PFD are projected to increase by 50% due to the increasing numbers of women reaching the age of 65.4 PFD does not typically have one specific cause. Pregnancy/childbirth, age, hormonal changes, obesity, lower urinary tract infection, and pelvic surgery are Human Performance and Health Promotion Program, University of New Orleans, Louisiana. Bonis is a faculty member at University of New Orleans. Lormand and Walsh are self-employed clinicians who participate in the University of New Orleans-Human Performance and Health Promotion Program mentorinternship program. The research clinicians who administered the entire procedure to all of the participants are a licensed physical therapist (C.W.) and a clinical exercise physiologist (J.L.). The 2 clinicians collaborated and developed the procedure. The third member of the research group (M.B.) is an experienced researcher and an exercise science faculty member at the University of New Orleans who participated as the primary investigator, designed the study, and performed all of the statistical analyses. The authors declare no conflicts of interest. Corresponding Author: Marc Bonis, PhD, Human Performance and Health Promotion Program, University of New Orleans, 2000 Lakeshore Dr, ELCF Dept ED 348K, New Orleans, LA 70148 (mbonis@uno.edu). DOI: 1","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61633655","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.0000000000000158
Alison Happel-Parkins, Katharina A. Azim, Amy Moses
Background: Research has shown that up to 53% of adult women, at some point in their lives, suffer from pelvic floor dysfunction in the United States, although it is frequently underdiagnosed. Dyspareunia is a type of pelvic floor dysfunction that is identified as pain with sexual intercourse, tampon insertion, vaginal examinations, vaginal stimulation, and other occurrences involving vaginal touch. There are a limited number of studies that use qualitative approaches investigating women’s experiences of dyspareunia. Objectives: The purpose of this qualitative study was to explore the emotional, physical, and psychological experiences of self-identified Christian women from the Midsouthern United States who have been recently diagnosed with dyspareunia associated with pelvic floor muscle overactivity. The research question was: How do self-identified Christian women in the Midsouthern United States experience dyspareunia? Study Design: Narrative inquiry was the qualitative methodology used for this study. Methods: Methods of data collection included questionnaires followed by semistructured interviews with 8 women. Results: Thematic analysis was used to discuss 4 themes: (1) misdiagnosis and dismissal (personal and medical) of chronic dyspareunia; (2) individualized strategies for coping with chronic dyspareunia; (3) sex (mis)education: influences of abstinence-only approaches, purity culture, and peer pressure; and (4) understandings about sex, religion, and pelvic pain. Conclusion: Primary care physicians, gynecologists, and pelvic floor physical therapists are encouraged to recognize the importance of factoring sociocultural aspects, INTRODUCTION Research has shown that up to 53% of adult women, at some point in their lives, suffer from pelvic floor dysfunction in the United States,1–3 although it is frequently underdiagnosed.4–6 Further, pelvic floor dysfunction affects 41% of premenopausal women specifically.7 While definitions vary, dyspareunia is generally described as a type of pelvic floor dysfunction classified by pain with attempted or completed penile-vaginal sexual intercourse.8 More specifically, deep dyspareunia entails pain inside the vagina, usually with deeper penetration, while superficial or introital dyspareunia involves pain on vaginal entry or vaginal introitus.9 A distinction is also made between pain with first intercourse attempt (primary dyspareunia) and pain after a period of pain-free intercourse (secondary dyspareunia).10 Apart from attempted intercourse, pain can also occur with tampon insertion, vaginal examinations, and vaginal stimulation that may or may not be penetrative involving fingers, dilators, vibrators, etc.8,11 Lifetime estimates for women experiencing chronic pain during sexual intercourse range from 10% to 28%.12 Occurrence increases significantly for women who have given birth vaginally, with 85.7% experiencing painful first vaginal sex within 1 year postpartum, and 44.7% and 43.4% reporting consiste
{"title":"“I Just Beared Through It”: Southern US Christian Women's Experiences of Chronic Dyspareunia","authors":"Alison Happel-Parkins, Katharina A. Azim, Amy Moses","doi":"10.1097/JWH.0000000000000158","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000158","url":null,"abstract":"Background: Research has shown that up to 53% of adult women, at some point in their lives, suffer from pelvic floor dysfunction in the United States, although it is frequently underdiagnosed. Dyspareunia is a type of pelvic floor dysfunction that is identified as pain with sexual intercourse, tampon insertion, vaginal examinations, vaginal stimulation, and other occurrences involving vaginal touch. There are a limited number of studies that use qualitative approaches investigating women’s experiences of dyspareunia. Objectives: The purpose of this qualitative study was to explore the emotional, physical, and psychological experiences of self-identified Christian women from the Midsouthern United States who have been recently diagnosed with dyspareunia associated with pelvic floor muscle overactivity. The research question was: How do self-identified Christian women in the Midsouthern United States experience dyspareunia? Study Design: Narrative inquiry was the qualitative methodology used for this study. Methods: Methods of data collection included questionnaires followed by semistructured interviews with 8 women. Results: Thematic analysis was used to discuss 4 themes: (1) misdiagnosis and dismissal (personal and medical) of chronic dyspareunia; (2) individualized strategies for coping with chronic dyspareunia; (3) sex (mis)education: influences of abstinence-only approaches, purity culture, and peer pressure; and (4) understandings about sex, religion, and pelvic pain. Conclusion: Primary care physicians, gynecologists, and pelvic floor physical therapists are encouraged to recognize the importance of factoring sociocultural aspects, INTRODUCTION Research has shown that up to 53% of adult women, at some point in their lives, suffer from pelvic floor dysfunction in the United States,1–3 although it is frequently underdiagnosed.4–6 Further, pelvic floor dysfunction affects 41% of premenopausal women specifically.7 While definitions vary, dyspareunia is generally described as a type of pelvic floor dysfunction classified by pain with attempted or completed penile-vaginal sexual intercourse.8 More specifically, deep dyspareunia entails pain inside the vagina, usually with deeper penetration, while superficial or introital dyspareunia involves pain on vaginal entry or vaginal introitus.9 A distinction is also made between pain with first intercourse attempt (primary dyspareunia) and pain after a period of pain-free intercourse (secondary dyspareunia).10 Apart from attempted intercourse, pain can also occur with tampon insertion, vaginal examinations, and vaginal stimulation that may or may not be penetrative involving fingers, dilators, vibrators, etc.8,11 Lifetime estimates for women experiencing chronic pain during sexual intercourse range from 10% to 28%.12 Occurrence increases significantly for women who have given birth vaginally, with 85.7% experiencing painful first vaginal sex within 1 year postpartum, and 44.7% and 43.4% reporting consiste","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61633543","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.0000000000000161
{"title":"Academy of Pelvic Health Physical Therapy Combined Sections Meeting Posters and Platforms","authors":"","doi":"10.1097/jwh.0000000000000161","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000161","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jwh.0000000000000161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47902619","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 : 2019-10-01DOI: 10.1097/jwh.0000000000000151
J. Zager, B. Shelly, Jeffrey J. Miller
{"title":"Book Reviews","authors":"J. Zager, B. Shelly, Jeffrey J. Miller","doi":"10.1097/jwh.0000000000000151","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000151","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jwh.0000000000000151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41961781","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 : 2019-10-01DOI: 10.1097/JWH.0000000000000146
Kailey Snyder, C. Hanson, J. Hill, Danae M. Dinkel
Supplemental Digital Content is Available in the Text. Background: Engaging in physical activity and breastfeeding are 2 of the healthiest behaviors a new mother can participate in, yet a majority of mothers are not achieving physical activity or breastfeeding recommendations. Breastfeeding mothers may experience additional barriers to physical activity; however, more research is needed. Therefore, the purpose of this cross-sectional study was to determine the physical activity levels of breastfeeding women as well as to better understand their motivation and barriers for engaging in physical activity. Methods: A total of 633 breastfeeding mothers completed a 30-question survey developed under the constructs of self-determination theory. Results: Findings indicate the majority of breastfeeding mothers are engaging in light activity (eg, walking) regularly; nevertheless, 1 in 5 mothers is predominantly sedentary and only 1 in 20 mothers is engaging in heavy exercise (eg, running) regularly. Furthermore, mothers appear motivated by extrinsic factors related to improving fitness and appearance. Finally, physical discomfort due to breastfeeding and concerns for reduction in milk supply were found to be substantial barriers to physical activity. Conclusion: These findings suggest breastfeeding women may need additional support for engaging in physical activity and further education and resource development is needed.
{"title":"Perceptions of Physical Activity While Breastfeeding Using the Self-determination Theory","authors":"Kailey Snyder, C. Hanson, J. Hill, Danae M. Dinkel","doi":"10.1097/JWH.0000000000000146","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000146","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Engaging in physical activity and breastfeeding are 2 of the healthiest behaviors a new mother can participate in, yet a majority of mothers are not achieving physical activity or breastfeeding recommendations. Breastfeeding mothers may experience additional barriers to physical activity; however, more research is needed. Therefore, the purpose of this cross-sectional study was to determine the physical activity levels of breastfeeding women as well as to better understand their motivation and barriers for engaging in physical activity. Methods: A total of 633 breastfeeding mothers completed a 30-question survey developed under the constructs of self-determination theory. Results: Findings indicate the majority of breastfeeding mothers are engaging in light activity (eg, walking) regularly; nevertheless, 1 in 5 mothers is predominantly sedentary and only 1 in 20 mothers is engaging in heavy exercise (eg, running) regularly. Furthermore, mothers appear motivated by extrinsic factors related to improving fitness and appearance. Finally, physical discomfort due to breastfeeding and concerns for reduction in milk supply were found to be substantial barriers to physical activity. Conclusion: These findings suggest breastfeeding women may need additional support for engaging in physical activity and further education and resource development is needed.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43352126","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 : 2019-10-01DOI: 10.1097/JWH.0000000000000150
Margaret Q. McConville, J. Schilz, Deborah Doerfler, Ron Andrews
Purpose: To provide information on objective diagnostic methods, clinical implications, and appropriate interventions for older male patients presenting with signs and symptoms indicative of diastasis recti. Methods: Searches were conducted for the diagnosis, clinical implications, and treatment of diastasis recti to provide an analysis on current published data. Because of a limited amount of published work directly related to diastasis recti in males, broad search criteria were utilized. References of selected articles were searched for additional articles appropriate to the aforementioned topics and a current list of relevant studies was compiled. Results: Several articles were reviewed on appropriate tools and techniques to evaluate the presence or absence of diastasis recti. Articles analyzed to determine clinical implications in older males presenting with diastasis recti indicated the importance of taking a thorough subjective history to determine appropriate treatment approaches and establishing awareness clinically of potential underlying conditions that may indicate when further screening is appropriate for patients. Discussion: Although diastasis recti in males is relatively rare, physical therapists should be aware of clinical methods for diagnosis, possible implications indicating the need for further screening, and intervention approaches that address anatomical and functional relationships between the anterior abdominal wall, low back, and pelvic floor, when working with patients.
{"title":"A Review of Literature on the Diagnosis, Clinical Implications, and Treatment of Diastasis Recti in Older Males","authors":"Margaret Q. McConville, J. Schilz, Deborah Doerfler, Ron Andrews","doi":"10.1097/JWH.0000000000000150","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000150","url":null,"abstract":"Purpose: To provide information on objective diagnostic methods, clinical implications, and appropriate interventions for older male patients presenting with signs and symptoms indicative of diastasis recti. Methods: Searches were conducted for the diagnosis, clinical implications, and treatment of diastasis recti to provide an analysis on current published data. Because of a limited amount of published work directly related to diastasis recti in males, broad search criteria were utilized. References of selected articles were searched for additional articles appropriate to the aforementioned topics and a current list of relevant studies was compiled. Results: Several articles were reviewed on appropriate tools and techniques to evaluate the presence or absence of diastasis recti. Articles analyzed to determine clinical implications in older males presenting with diastasis recti indicated the importance of taking a thorough subjective history to determine appropriate treatment approaches and establishing awareness clinically of potential underlying conditions that may indicate when further screening is appropriate for patients. Discussion: Although diastasis recti in males is relatively rare, physical therapists should be aware of clinical methods for diagnosis, possible implications indicating the need for further screening, and intervention approaches that address anatomical and functional relationships between the anterior abdominal wall, low back, and pelvic floor, when working with patients.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42763417","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 : 2019-10-01DOI: 10.1097/JWH.0000000000000147
G. Kolb, E. Kolb, Cherrilyn Richmond, Craig Hanson
Background: Female stress urinary incontinence is effectively treated with pelvic floor physical therapy. However, many of the devices available to therapists necessitate vaginal insertion, which many women perceive as invasive. The Elitone device delivers a noninvasive alternative for delivering electrical muscle stimulation to the pelvic floor, which may promote broader access to this therapeutic modality. Further, the device's configuration enables home use, which may be used to complement in-clinic therapy sessions. Objective: This research investigates the safety and efficacy of surface-applied electrical muscle stimulation in the treatment of female stress urinary incontinence in an at-home, patient-administered use case. Study Design: Cohort study without control group. Methods: Twenty female participants with mild/moderate stress urinary incontinence self-administered daily treatments with the Elitone device for 6 weeks. Participants recorded incontinence episodes and absorbent pad use in a daily log. Pre- and poststudy questionnaires were used to assess quality of life, participant satisfaction, and product usability. Results: Incontinence episode frequency, pad usage, and quality-of-life measures improved to a clinically significant degree for 75%, 85%, and 67% of participants, respectively. The pre- to poststudy changes were statistically significant (P < .001) for all 3 measures. Eighty-three percent of participants were satisfied with the treatment. Conclusion: Participants receiving treatment with the conservative, noninvasive Elitone device achieved meaningful improvement in incontinence symptoms across multiple, patient-centric outcome measures. The degree of improvement aligned with historical performance of more invasive, intravaginal therapies. The therapy may particularly benefit those women who oppose use of vaginally inserted devices. Further, although this study evaluated efficacy as a stand-alone, at-home treatment, physical therapists may realize additional benefits by using the device as an at-home complement to in-office therapy sessions.
{"title":"Surface-Applied Electrical Muscle Stimulation for Self-administered Treatment of Female Stress Urinary Incontinence","authors":"G. Kolb, E. Kolb, Cherrilyn Richmond, Craig Hanson","doi":"10.1097/JWH.0000000000000147","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000147","url":null,"abstract":"Background: Female stress urinary incontinence is effectively treated with pelvic floor physical therapy. However, many of the devices available to therapists necessitate vaginal insertion, which many women perceive as invasive. The Elitone device delivers a noninvasive alternative for delivering electrical muscle stimulation to the pelvic floor, which may promote broader access to this therapeutic modality. Further, the device's configuration enables home use, which may be used to complement in-clinic therapy sessions. Objective: This research investigates the safety and efficacy of surface-applied electrical muscle stimulation in the treatment of female stress urinary incontinence in an at-home, patient-administered use case. Study Design: Cohort study without control group. Methods: Twenty female participants with mild/moderate stress urinary incontinence self-administered daily treatments with the Elitone device for 6 weeks. Participants recorded incontinence episodes and absorbent pad use in a daily log. Pre- and poststudy questionnaires were used to assess quality of life, participant satisfaction, and product usability. Results: Incontinence episode frequency, pad usage, and quality-of-life measures improved to a clinically significant degree for 75%, 85%, and 67% of participants, respectively. The pre- to poststudy changes were statistically significant (P < .001) for all 3 measures. Eighty-three percent of participants were satisfied with the treatment. Conclusion: Participants receiving treatment with the conservative, noninvasive Elitone device achieved meaningful improvement in incontinence symptoms across multiple, patient-centric outcome measures. The degree of improvement aligned with historical performance of more invasive, intravaginal therapies. The therapy may particularly benefit those women who oppose use of vaginally inserted devices. Further, although this study evaluated efficacy as a stand-alone, at-home treatment, physical therapists may realize additional benefits by using the device as an at-home complement to in-office therapy sessions.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42143034","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 : 2019-07-01DOI: 10.1097/jwh.0000000000000143
Rebecca Stephenson, B. Shelly
{"title":"Book Reviews","authors":"Rebecca Stephenson, B. Shelly","doi":"10.1097/jwh.0000000000000143","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000143","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jwh.0000000000000143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45487357","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 : 2019-06-01DOI: 10.1097/JWH.0000000000000141
Erin H. Hartigan, J. McAuley, M. Lawrence, Carly A. Keafer, A. Ball, A. Michaud, M. DeSilva
Supplemental Digital Content is Available in the Text. Objective: To describe pelvic floor muscle (PFM) function, hip mobility, and hip strength profiles and compare measures between women with and without self-reported stress urinary incontinence (SUI). Study Design: Descriptive. Background: Women with SUI present with PFM and hip impairments; yet comparative data in asymptomatic women are lacking. Methods and Measures: Adult women with (n = 21) or without (n = 20) SUI, with regular menses, were recruited. PFM performance, passive hip range-of-motion angles, and hip maximum isometric voluntary contractions (Nm/kg) (Biodex) were measured. Values were compared between groups and legs (dominant [Dom] and nondominant [Non-dom]) (significance: P < .05). Results: Women with SUI were older (P < .001), had higher parity, more tender points (Dom, P = .020), greater prone hip internal rotation (IR) angles (Non-dom, P = .025), lesser flexibility per Ober test (Non-dom, P = .013; Dom, P = .050), lower seated hip external rotation (ER) force (Non-dom, P = .008; Dom, P = .033), and lower hip abduction force (Non-dom and Dom, P < .001) than women without SUI. Leg differences for the SUI group were prone hip IR angles (P = .033), seated hip IR force (P = .015), and prone hip ER force (P < .001). Leg differences in women without SUI were PFM power (P = .005), prone hip angles (IR, P = .038; ER, P = .004), and prone hip ER force (P < .001). Conclusions: The lack of significant differences in PFM function between the 2 groups was unexpected. Greater hip strength and mobility along with unique between-leg differences may suggest a coping mechanism in asymptomatic women with similar PFM function as women with SUI. Investigating relationships among PFM and hip profiles and severity of SUI appears warranted. We have included a Video Abstract that highlights interesting findings in our article (see the Video Abstract, Supplemental Digital Content 1, available at: http://links.lww.com/JWHPT/A23)
补充数字内容可在文本中获得。目的:描述盆底肌(PFM)功能、髋关节活动度和髋关节力量概况，并比较有和没有自我报告压力性尿失禁(SUI)的女性的测量结果。研究设计:描述性。背景:SUI女性伴有PFM和髋关节损伤;然而，缺乏无症状妇女的比较数据。方法与措施:招募有SUI (n = 21)或无SUI (n = 20)、月经规律的成年女性。测量PFM性能、被动髋关节活动范围角和髋关节最大等长自主收缩(Nm/kg) (Biodex)。各组间及腿间(显性[Dom]与非显性[Non-dom])值比较(显著性:P < 0.05)。结果:SUI患者年龄较大(P < 0.001)，胎次较高，压痛点较多(Dom, P = 0.020)，俯卧髋关节内旋(IR)角度较大(非Dom, P = 0.025)， other试验柔顺度较小(非Dom, P = 0.013;Dom, P = 0.050)，下坐位髋关节外旋力(Non-dom, P = 0.008;和下髋关节外展力(Non-dom和Dom, P < 0.001)。SUI组的腿部差异为俯卧髋关节IR角度(P = 0.033)、坐位髋关节IR力(P = 0.015)和俯卧髋关节ER力(P < 0.001)。无SUI女性的腿部差异为PFM功率(P = 0.005)，俯卧髋关节角度(IR, P = 0.038;ER, P = 0.004)和俯卧位髋关节ER力(P < 0.001)。结论:两组间PFM功能无明显差异。更大的髋关节力量和活动能力以及独特的腿间差异可能提示无症状女性与SUI女性具有相似PFM功能的应对机制。研究PFM与髋关节轮廓和SUI严重程度之间的关系似乎是有必要的。我们在文章中加入了一个视频摘要，突出了有趣的发现(参见视频摘要，补充数字内容1，可在http://links.lww.com/JWHPT/A23获得)。
{"title":"Pelvic Floor Muscle Performance, Hip Mobility, and Hip Strength in Women With and Without Self-Reported Stress Urinary Incontinence","authors":"Erin H. Hartigan, J. McAuley, M. Lawrence, Carly A. Keafer, A. Ball, A. Michaud, M. DeSilva","doi":"10.1097/JWH.0000000000000141","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000141","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Objective: To describe pelvic floor muscle (PFM) function, hip mobility, and hip strength profiles and compare measures between women with and without self-reported stress urinary incontinence (SUI). Study Design: Descriptive. Background: Women with SUI present with PFM and hip impairments; yet comparative data in asymptomatic women are lacking. Methods and Measures: Adult women with (n = 21) or without (n = 20) SUI, with regular menses, were recruited. PFM performance, passive hip range-of-motion angles, and hip maximum isometric voluntary contractions (Nm/kg) (Biodex) were measured. Values were compared between groups and legs (dominant [Dom] and nondominant [Non-dom]) (significance: P < .05). Results: Women with SUI were older (P < .001), had higher parity, more tender points (Dom, P = .020), greater prone hip internal rotation (IR) angles (Non-dom, P = .025), lesser flexibility per Ober test (Non-dom, P = .013; Dom, P = .050), lower seated hip external rotation (ER) force (Non-dom, P = .008; Dom, P = .033), and lower hip abduction force (Non-dom and Dom, P < .001) than women without SUI. Leg differences for the SUI group were prone hip IR angles (P = .033), seated hip IR force (P = .015), and prone hip ER force (P < .001). Leg differences in women without SUI were PFM power (P = .005), prone hip angles (IR, P = .038; ER, P = .004), and prone hip ER force (P < .001). Conclusions: The lack of significant differences in PFM function between the 2 groups was unexpected. Greater hip strength and mobility along with unique between-leg differences may suggest a coping mechanism in asymptomatic women with similar PFM function as women with SUI. Investigating relationships among PFM and hip profiles and severity of SUI appears warranted. We have included a Video Abstract that highlights interesting findings in our article (see the Video Abstract, Supplemental Digital Content 1, available at: http://links.lww.com/JWHPT/A23)","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41279518","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 : 2019-05-21DOI: 10.1097/JWH.0000000000000133
S. Christopher, J. Mccullough, S. Snodgrass, C. Cook
Background: Lumbopelvic pain is common during pregnancy and postpartum. This pain has been linked to a variety of comorbidities, such as depression. Although pain is common in the postpartum period, the etiology of first-onset pain is unclear and the risk factors associated with this pain in the postpartum period are unknown. Objectives: The objective of the review was to determine risk factors for first-onset lumbopelvic pain during the postpartum period. Study Design: Systematic review. Methods: Included articles were prospective cohort studies that identified modifiable and nonmodifiable risk factors for first-onset lumbopelvic postpartum pain. Articles were selected following a comprehensive search of 4 databases. The Quality in Prognostic Studies tool was used to evaluate the quality of studies. Risk factors from the articles were categorized as extrinsic, intrinsic, or mixed and ranked by the strength of their association statistic. Results: Four articles met the inclusion criteria. The pooled incidence of first-onset lumbopelvic pain was 32%. Of the 11 risk factors investigated for low back pain, cesarean delivery (CD) with epidural anesthesia, duration of first stage of labor, age of the mother, race, and urinary tract infections were significantly predictive of first-onset low back pain. Nine risk factors were investigated for pelvic pain; none were significant. Conclusion: First-onset low back pain is present among postpartum women. The 5 risk factors identified in single studies were nonmodifiable. High-quality prognostic studies need to more consistently investigate risk factors for first-onset back pain in the postpartum pain.
{"title":"Predictive Risk Factors for First-Onset Lumbopelvic Pain in Postpartum Women: A Systematic Review","authors":"S. Christopher, J. Mccullough, S. Snodgrass, C. Cook","doi":"10.1097/JWH.0000000000000133","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000133","url":null,"abstract":"Background: Lumbopelvic pain is common during pregnancy and postpartum. This pain has been linked to a variety of comorbidities, such as depression. Although pain is common in the postpartum period, the etiology of first-onset pain is unclear and the risk factors associated with this pain in the postpartum period are unknown. Objectives: The objective of the review was to determine risk factors for first-onset lumbopelvic pain during the postpartum period. Study Design: Systematic review. Methods: Included articles were prospective cohort studies that identified modifiable and nonmodifiable risk factors for first-onset lumbopelvic postpartum pain. Articles were selected following a comprehensive search of 4 databases. The Quality in Prognostic Studies tool was used to evaluate the quality of studies. Risk factors from the articles were categorized as extrinsic, intrinsic, or mixed and ranked by the strength of their association statistic. Results: Four articles met the inclusion criteria. The pooled incidence of first-onset lumbopelvic pain was 32%. Of the 11 risk factors investigated for low back pain, cesarean delivery (CD) with epidural anesthesia, duration of first stage of labor, age of the mother, race, and urinary tract infections were significantly predictive of first-onset low back pain. Nine risk factors were investigated for pelvic pain; none were significant. Conclusion: First-onset low back pain is present among postpartum women. The 5 risk factors identified in single studies were nonmodifiable. High-quality prognostic studies need to more consistently investigate risk factors for first-onset back pain in the postpartum pain.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JWH.0000000000000133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45899576","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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