Efficacy of Physical Therapy in the Management of Reproductive Disorders

Abstract

Several textbooks and anecdotal reports exist on the management of reproductive disor- ders by physical therapy (PHT). However, the recommendations from these sources are often not supported by recent empirical outcome evidence. Thus, there is a need for a comprehensive, up-to-date appraisal of the effectiveness of PHT in the management of reproductive disorders. An exhaustive review of the relevant articles published between 1988 and 2019 was undertaken on the primary electronic databases. The search produced 352 “ hits, ” but only 47 of them met the stated purpose of the review and subsequently classified into nine disease domains. The overwhelming majority (91%) of the 47 articles reviewed found the PHT modalities being investigated to be effective. The credibility of the work ranges from “ poor ” (for the case reports) to “ strong ” (for the meta-analysis). The pubococcygeus contraction exercise training (PCET), aka Kegel ’ s exercise, was the most studied modality, followed by aerobic exercise. Although substantial evidence suggests that PCET and transvaginal electrical stimulation are effective for reducing the symptoms of stress urinary incontinence (UI), the data on adjunctive techniques (EMG biofeedback, and vaginal cones) are less consistent. There is presently no reliable evidence to support the use of PCET in combination with EMG biofeedback and electrical stimulation to relieve overactive bladder and improve sexual function in men. The conflicting findings are because many of the published studies are heterogeneous in methodology with vari- ant time frame follow-up; therefore, making firm conclusion difficult. There is a need for more randomized controlled trials (RCT) with adequate sample sizes and the use of sensitive, reproducible, and valid outcome measures. In conclusion, systematic reviews and meta-analyses are needed to bolster the rationale for recommending PHT in the management of chronic pelvic diseases in women. primary research conference proceedings, and lay articles in the press using the keywords of hypoactive sexual desire disorder, female sexual arousal disorder, female orgasmic disorder, and persistent genital arousal disorder. psychotherapy, cognitive-behavioral therapy, peer and partner support, nondirective counseling, relaxation/massage therapy, infant sleep interventions, infant-mother relationship therapy, and maternal exercise that met the set inclusion criteria were analyzed. The author concluded that he could not ascertain the relative effectiveness of most of the non-pharmacological treatments because of weak and disparate experimental design issues.