Effects of Physical Therapy on Pelvic Floor Dysfunction Among Women; A Randomized Controlled Trial
Physical Therapy in Pelvic Floor Dysfunction
DOI:
https://doi.org/10.55735/hjprs.v3i2.120Keywords:
Kegel exercises, pelvic floor muscles, pelvic floor physical therapy, perineometerAbstract
Background: Pelvic floor dysfunction is the inability to relax and integrate the pelvic muscles appropriately. Constipation, bladder/bowel incontinence, and frequent bladder urges are the common symptoms. Objective: To determine the effects of physical therapy on pelvic floor dysfunction among women. Methods: It was a randomized controlled trial conducted between February to December 2021. About 72 patients were included using convenient sampling and they were equally divided into an experimental group receiving pelvic floor physical therapy and a control group receiving routine care. The woman aged between 18 to 60 years having pelvic floor dysfunction were included in the trial. Patients with pelvic organ prolapse more than stage II, urinary or vaginal tract infections and inability to understand or follow instructions were excluded. The assessment was made at baseline and after 4th week of intervention. Variables like age, body mass index and parity were presented as mean and standard deviation. The normality of the data was assessed using the Shapiro-Wilk test. The difference between pre and post-treatment readings was calculated using paired sample t-test for this parametric data. Statistical significance was set at p≤0.05. Results: The demographics including age, body mass index and parity were found to be 49.31 (12.43%), 25.71(4.56%) and 2.6(0.81%) in the pelvic floor physical therapy group and 51.23 (9.37%), 26.33(5.32%) and 2.2(93%) in the control group respectively, without any significant difference (p-value>0.05). After treatment at the 4th-week assessment, peak perineometer values (cmH2O) were found to be 6.4(5.8) in the experimental group versus 10.3(6.7) in the control group, pelvic floor distress inventory short form 27.43(17.6) versus 42.8(31.8) and short form of pelvic floor impact questionnaire 9.86(4.39) versus 16.87(6.78), with a significant difference in favor of physical therapy group (p-value>0.05). Conclusion: The study concluded that pelvic floor physical therapy is significantly better as compared to the control group for relieving pelvic floor dysfunction including its control, coordination and distress.
References
Seppan P, Muhammed I, Mohammad ZIK, Sathyanathan SB. Pathobiology of ischiocavernosus and bulbospongiosus muscles in long-term diabetic male rats and its implication on erectile dysfunction. The Aging Male 2020; 23(5): 979-90.
Zhao G, Zhu R, Jiang S, Xu C, Xu N, Wang Y. Soft tissue restrictors of femoral elevation in direct anterior approach—an anatomic study. Journal of Orthopaedic Surgery and Research 2018; 13(1): 1-7.
Quaghebeur J, Petros P, Wyndaele J-J, De Wachter S. Pelvic-floor function, dysfunction, and treatment. European Journal of Obstetrics & Gynecology and Reproductive Biology 2021; 265: 143-9.
Malinowski MN, Swain AR, Kim CH. Anatomy of the sacroiliac joint. Sacroiliac Joint Pain: A Comprehensive Guide to Interventional and Surgical Procedures 2021: 3.
Perrin M, Eklof B, Maleti O. The vein glossary. J Vasc Surg Venous Lymphat Disord 2018; 6(5): 11-217.
Meister MR, Sutcliffe S, Ghetti C, Chu CM, Spitznagle TM, Lowder JL. A pilot trial of movement-based pelvic floor physical therapy to address pelvic floor myofascial pain and lower urinary tract symptoms. International Urogynecology Journal 2022: 1-10.
van Reijn-Baggen DA, Han-Geurts IJ, Voorham-van der Zalm PJ, Pelger RC, Hagenaars-van Miert CH, Laan ET. Pelvic floor physical therapy for pelvic floor hypertonicity: a systematic review of treatment efficacy. Sexual Medicine Reviews 2021.
Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology 2019; 31(6): 485-93.
Basnet R. Impact of pelvic floor muscle training in pelvic organ prolapse. International Urogynecology Journal 2021; 32(6): 1351-60.
de Bruin EI, Van der Zwan J, Bögels SM. A RCT comparing daily mindfulness meditations, biofeedback exercises, and daily physical exercise on attention control, executive functioning, mindful awareness, self-compassion, and worrying in stressed young adults. Mindfulness 2016; 7(5): 1182-92.
Hill DA, Taylor CA. Dyspareunia in women. American family physician 2021; 103(10): 597-604.
Bedaiwy MA, Allaire C, Yong P, Alfaraj S. Medical management of endometriosis in patients with chronic pelvic pain. Seminars in reproductive medicine; 2017: Thieme Medical Publishers; 2017. p. 038-53.
Khademian Z, Ara FK, Gholamzadeh S. The effect of self care education based on orem’s nursing theory on quality of life and self-efficacy in patients with hypertension: a quasi-experimental study. International journal of community based nursing and midwifery 2020; 8(2): 140.
Pereira GMV, Juliato CRT, de Almeida CM, et al. Effect of radiofrequency and pelvic floor muscle training in the treatment of women with vaginal laxity: A study protocol. PloS one 2021; 16(11): e0259650.
Nipa SI, Sriboonreung T, Paungmali A, Phongnarisorn C. The Effects of Pelvic Floor Muscle Exercise Combined with Core Stability Exercise on Women with Stress Urinary Incontinence following the Treatment of Nonspecific Chronic Low Back Pain. Advances in Urology 2022; 2022.
Dangal G, Poudel R, Shrestha R, et al. Outcome of sacrospinous ligament fixation of the vault during repair of pelvic organ prolapse. Journal of Nepal Health Research Council 2018; 16(3): 321-4.
El‐Hefnawy AS, Soliman HMM, Abd‐Elbary SOM, Shereif WI. Long‐standing nonulcerative bladder pain syndrome: Impact of Thiele massage on bladder and sexual domains. LUTS: Lower Urinary Tract Symptoms 2020; 12(2): 123-7.
Jeong S-G, Cynn H-S, Lee J-H, Choi S, Kim D. Effect of modified clamshell exercise on gluteus medius, quadratus lumborum and anterior hip flexor in participants with gluteus medius weakness. Journal of the Korean Society of Physical Medicine 2019; 14(2): 9-19.
Brennan L, Dorronzoro Zubiete E, Caulfield B. Feedback design in targeted exercise digital biofeedback systems for home rehabilitation: A scoping review. Sensors 2019; 20(1): 181.
Park SJ, Park JW, Kwon Y. Consideration of the Exercise position for Facilitating Gluteus Medius Maximally in Normal Adults. The Journal of Korean Physical Therapy 2019; 31(1): 62-6.
Mattsson NK, Nieminen K, Heikkinen A-M, et al. Validation of the short forms of the pelvic floor distress inventory (PFDI-20), pelvic floor impact questionnaire (PFIQ-7), and pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12) in Finnish. Health Qual Life Outcomes 2017; 15(1): 1-7.
Culligan PJ, Scherer J, Dyer K, et al. A randomized clinical trial comparing pelvic floor muscle training to a Pilates exercise program for improving pelvic muscle strength. International urogynecology journal 2010; 21(4): 401-8.
Abrams P, Andersson K-E, Birder L, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourology and Urodynamics: Official Journal of the International Continence Society 2010; 29(1): 213-40.
Stowell JT, Zavaletta VA, Carroll EF, Grimstad FW. Multidisciplinary approach to imaging for gender-affirming surgery: engaging surgeons, radiologists, and patients to ensure a positive imaging experience. Annals of Translational Medicine 2021; 9(7).
Critchley CJ. Physical Therapy Is an Important Component of Postpartum Care in the Fourth Trimester. Physical therapy 2022; 102(5): pzac021.
Reuter U, Goadsby PJ, Lanteri-Minet M, et al. Efficacy and tolerability of erenumab in patients with episodic migraine in whom two-to-four previous preventive treatments were unsuccessful: a randomised, double-blind, placebo-controlled, phase 3b study. The Lancet 2018; 392(10161): 2280-7.
Mathisen TF, Rosenvinge JH, Friborg O, et al. Is physical exercise and dietary therapy a feasible alternative to cognitive behavior therapy in treatment of eating disorders? A randomized controlled trial of two group therapies. International Journal of Eating Disorders 2020; 53(4): 574-85.
Ren S, Gao Y, Yang Z, et al. The effect of pelvic floor muscle training on pelvic floor dysfunction in pregnant and postpartum women. Physical Activity and Health 2020; 4(1).
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