Journal of women's health physical therapy最新文献

{"title":"Beyond the Musculoskeletal System: Considering Whole-Systems Readiness for Running Postpartum","authors":"G. Donnelly, E. Brockwell, A. Rankin, I. Moore","doi":"10.1097/JWH.0000000000000218","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000218","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Postpartum women frequently engage in running. In the absence of official guidance on returning-to-running postpartum, physical therapists rely on clinical experience alongside the available literature. Subsequently, the traditional evaluation of postpartum readiness for running tends to focus on musculoskeletal factors. This clinical commentary addresses how to evaluate and manage postpartum return-to-running in a systematic order by discussing relevant whole-systems considerations beyond the musculoskeletal system, while also highlighting possible interactions between relevant considerations. Discussion: Using a whole-systems biopsychosocial approach, physical therapists should consider the following when managing and evaluating readiness to return-to-running: physical deconditioning, changes to body mass, sleeping patterns, breastfeeding, relative energy deficiency in sport, postpartum fatigue and thyroid autoimmunity, fear of movement, psychological well-being, and socioeconomic considerations. Undertaking a risk-benefit analysis on a case-by-case basis using clinical reasoning to determine readiness to return-to-running postpartum should incorporate these considerations and their possible interactions, alongside considerations of a musculoskeletal evaluation and graded exercise progression. Conclusions: Return-to-running postpartum requires an individualized, whole-systems biopsychosocial approach with graded exercise progression, similar to the management of return to sport following musculoskeletal injuries. A video abstract for this article is available at: http://links.lww.com/JWHPT/A51","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"46 1","pages":"48 - 56"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43753950","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}

{"title":"The Importance of Information: Prenatal Education Surrounding Birth-Related Pelvic Floor Trauma Mitigates Symptom-Related Distress","authors":"K. Johnson, Paula G. Williams, A. Hill","doi":"10.1097/JWH.0000000000000229","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000229","url":null,"abstract":"Background: Birth-related pelvic floor trauma and its sequelae (PFTS) are associated with higher rates of perinatal mood and anxiety disorders in the fourth trimester. The fourth trimester is a critical window for long-term health outcomes, and identifying factors that buffer the impact of PFTS is an important research priority. Objectives: We hypothesized that lack of prenatal pelvic floor-focused education may be associated with greater distress following PFTS. Study Design: Hypotheses were investigated using a repeated-measures (study 1; n = 36) and cross-sectional (study 2; n = 226) design among participants reporting PFTS. Questionnaires were completed online, and included qualitative and quantitative responses. Methods: Study 1 participants completed a questionnaire within the first 8 weeks and approximately 3 months postpartum. Study 2 participants (≤5 years postpartum) completed a 1-time questionnaire. We examined associations among pelvic floor education, pelvic floor symptoms, and indices of mental health. Moderation analyses were conducted (study 2) to test whether the association between pelvic floor and mental health symptoms varied depending on level of discrepancy between postpartum expectation and experience. Results: In both studies, a high percentage of participants reported a lack of pelvic floor education, and significant associations were seen between pelvic floor and psychological symptoms. In study 2, individuals who reported high discrepancy between expectations and experience had the strongest associations between pelvic floor and psychological symptoms; for those reporting low discrepancy, the association was nonsignificant. Conclusion: Prenatal pelvic floor education is a key aspect not just in reducing risk of PFTS, but mitigating distress if it does occur.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"36 1","pages":"62 - 72"},"PeriodicalIF":0.0,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46640788","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}

{"title":"From the Core to the Floor—Utilizing a Webinar to Provide Pelvic Health Education","authors":"Cara Morrison, Angela Pereira, Kimika Masuda, Kari Bargstadt-Wilson, Julie Peterson, Kailey Snyder","doi":"10.1097/JWH.0000000000000225","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000225","url":null,"abstract":"Background: Childbirth can increase the risk of urinary and fecal incontinence and pelvic organ prolapse; however, research indicates postpartum women have limited knowledge of these conditions. Objectives: (1) To determine whether a webinar can improve postpartum women's knowledge related to the structures, functions, muscles, and strengthening of the pelvic floor and (2) to explore changes in perception of postpartum women's understanding of the core/pelvic floor and their role in urinary incontinence (UI) and pelvic organ prolapse (POP). Methods: Women who had given birth within the last year and were older than 19 years were recruited via social media. Women completed a demographic survey, Prolapse and Incontinence Knowledge Questionnaire (PIKQ), and a telephonic interview before and after viewing a 1-time online webinar produced by a Women's Health Physical Therapy (DPT) Resident. Survey data were analyzed via independent t tests. Qualitative data were analyzed via a latent content recurrent cross-sectional analysis. Results: A total of 16 women participated in this study. There were significant improvements in pre- versus postwebinar. Specific to qualitative findings, the main knowledge changes seen from pre- to postwebinar interviews included greater awareness of specific exercises with proper progression and sequencing, improved descriptions of UI and POP, and improved cuing of a Kegel. Conclusion: A pelvic health education webinar can result in improvements in pelvic health knowledge. More research is needed to determine whether this increase in knowledge translates to a greater likelihood to engage in pelvic floor strengthening exercises and ultimately whether it reduces pelvic floor dysfunction.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"36 1","pages":"95 - 99"},"PeriodicalIF":0.0,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46875730","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}

{"title":"Book Reviews","authors":"Rachel Hohman, W. Bartley","doi":"10.1097/jwh.0000000000000220","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000220","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44702199","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}

{"title":"Movement Impairments in Women with and without Urinary Urgency/Frequency.","authors":"Nicole A Erbes,&nbsp;Stefanie Nicole Foster,&nbsp;Marcie Harris-Hayes,&nbsp;Theresa M Spitznagle","doi":"10.1097/jwh.0000000000000211","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000211","url":null,"abstract":"<p><strong>Objectives: </strong>1) examine the relationship between spine, hip, and pelvis movement patterns and urinary urgency and frequency 2) report the prevalence of pelvic girdle and hip joint impairments among women with and without urinary urgency and frequency 3) report the most common movement impairments observed in women with and without urinary urgency and frequency.</p><p><strong>Methods: </strong>Women age 18-60 with urinary urgency and frequency were matched 1:1 to women without on age, body mass index, and vaginal parity. Participants completed primary movement tests of the hip, pelvis and spine. Additional clinical tests included Stork test, sidelying position, pubic symphysis palpation, flexion-abduction-external rotation, flexion-adduction-internal rotation, and seated hip internal and external rotation. Urge symptoms were monitored before and during each test. Movement patterns and positioning of the thoracic and lumbar spine, pelvis, and hips were observed. Secondary tests to correct a movement or positional impairment were performed if an impairment was noted or if symptoms were provoked during the primary test.</p><p><strong>Results: </strong>42 women completed testing. More participants with urinary urgency and frequency 1) demonstrated impairments during forward bend, single leg stance, sidelying and Stork tests; 2) reported urgency provocation during forward bend, flexion-adduction-internal rotation test, pubic symphysis palpation, and hip internal rotation; and 3) reported symptom relief with sidelying position secondary test; and secondary tests of the thoracic, lumbar and hip regions compared to those without.</p><p><strong>Conclusion: </strong>Musculoskeletal impairments may be associated with urinary urgency and frequency and should therefore be considered when determining management options for these patients.</p>","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 4","pages":"164-173"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741169/pdf/nihms-1698241.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39799866","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}

{"title":"How Do We Define Pelvic Health?","authors":"C. Chiarello","doi":"10.1097/jwh.0000000000000219","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000219","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43316176","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}

{"title":"Efficacy of a Core Strengthening Program for Diastasis Rectus Abdominis in Postpartum Women: A Prospective Observational Study","authors":"M. Leopold, Kristen A Santiago, Jennifer Cheng, Leah A. Keller, Zafir Abutalib, J. Bonder, G. Sharma, A. Tenforde, E. Casey","doi":"10.1097/JWH.0000000000000214","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000214","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Diastasis rectus abdominis (DRA) is characterized by a widening between the rectus abdominis muscles and thinning of the linea alba. It is common during pregnancy and may contribute to postpartum low back pain (LBP) and stress urinary incontinence (SUI). Core strengthening is thought to improve DRA, but there is no widely accepted exercise program. Objectives: To assess changes in interrectus distance (IRD) and participant-reported outcomes (PROs) after an online core strengthening program in postpartum women with DRA. Study Design: Prospective observational study. Methods: Forty-three postpartum women (36.7 ± 3.5 years) with DRA, which was diagnosed as an IRD 2.0 cm or more using musculoskeletal ultrasound, participated in a 12-week online core strengthening program focused on daily transversus abdominis activation with coordinated breathing and pelvic floor muscle engagement. IRD and PROs were assessed at baseline and 12 weeks. A subset of 19 women participated in an additional 12-week maintenance phase, and outcomes assessments were performed at 24 weeks. Results: The 12-week online core strengthening program significantly decreased IRD above and below the umbilicus at rest (slope [95% confidence interval]: −0.56 [−0.74, −0.38] and −0.26 [−0.45, −0.06]; P < .001 and P = .009, respectively) and below the umbilicus during contraction (−0.39 [−0.58, −0.20]; P < .001). Improvements in LBP-related disability (P = .002) and SUI (P = .001) were also observed. Participation in the maintenance phase significantly improved IRD at 24 weeks compared with 12 weeks (P < .0125). Satisfaction averaged 7.43 ± 2.23. Conclusions: The 12-week online core strengthening program reduced IRD and improved LBP-related disability and SUI. Program participation for 12 additional weeks further reduced IRD. These results suggest that the online core strengthening program can be used in postpartum women with DRA.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"147 - 163"},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46926388","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}

{"title":"Effect of Rehabilitative Ultrasound Imaging (RUSI) Biofeedback on Improving Pelvic Floor Muscle Function in Individuals With Stress Urinary Incontinence: A Systematic Review","authors":"Jennifer A. LaCross, Laurel Proulx, Kelli J Brizzolara, J. Humphrey","doi":"10.1097/JWH.0000000000000217","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000217","url":null,"abstract":"Background: Pelvic floor muscle training is a common intervention for the treatment of stress urinary incontinence (SUI). One method utilized to augment muscle training is biofeedback. Rehabilitative ultrasound imaging (RUSI) is a noninvasive biofeedback tool. Objectives: The purpose of this review was to determine the effect of RUSI on pelvic floor muscle function, quality of life, volume of urinary leakage, and severity of urinary leakage in females and males with urinary incontinence and, when possible, compare these results to those of other biofeedback interventions. Study Design: Systematic review. Methods: PubMed, CINAHL, Science Direct, Scopus, Web of Science, and MEDLINE were searched for titles from peer-reviewed journals and conference proceedings from January 2010 to May 2020. An updated search was performed in January 2021. Inclusion criteria included studies with participants 18 years or older with urinary incontinence. The primary experimental intervention was transabdominal or transperineal RUSI. Results: Nine studies were included in this review. The ability to correctly contract the pelvic floor was achieved by more than 95% of participants following RUSI biofeedback training. Although outcomes were not consistently reported, RUSI intervention resulted in a decrease in incontinence severity and number of incontinence episodes per week, as well as improved pelvic floor strength, self-rating of improvement, task-specific self-efficacy, and quality of life. Conclusion: The results of this review provide moderate evidence to support the use of RUSI biofeedback via a transabdominal or transperineal approach in males and females with SUI to improve motor performance of the pelvic floor.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"174 - 189"},"PeriodicalIF":0.0,"publicationDate":"2021-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44110464","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}

{"title":"Nurses' Perspectives of the Need for Physical Therapy Services During an Acute Postpartum Stay: A Focus Group","authors":"Kate Divine, Paige Duvall, Lenzie Weicht, Karen Abraham","doi":"10.1097/jwh.0000000000000216","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000216","url":null,"abstract":"Hypothesis/Purpose: Complications in the postpartum period can include pain, urinary incontinence, diastasis recti abdominis, and pelvic floor injury. Physical therapists are in a unique position to address these concerns during the acute postpartum stay. However, there is a lack of consensus regarding the role of physical therapy (PT) in this patient population. Mother-Baby (MB) nurses work closely with postpartum mothers; therefore, the purpose of this study was to gain nurses' perspectives of their knowledge of and need for PT in the acute postpartum setting. Subjects: Nine MB nurses and 1 newly graduated nurse with MB experience from 2 hospitals near Winchester, Virginia, participated. Materials/Methods: Contact was made with nurse managers to arrange a time for the focus group. A demographic questionnaire was distributed prior to the session. A student moderator led the semistructured interview with preselected open-ended questions. The focus groups were audio/video recorded and transcribed. Transcriptions were used for theme coding and concept map development. Results: Five participants were present for each focus group. Four main themes and 1 subtheme emerged. These included lack of understanding of PT scope of practice with a subtheme of special circumstances, limited time, role overlap, and appropriate timing of PT. Lack of understanding of PT scope of practice was the overarching theme. Conclusion: MB nurses demonstrated a limited understanding of the PT scope of practice and their potential role postpartum. Further education and interdisciplinary collaboration may be beneficial to enhance postpartum care in the United States.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"36 1","pages":"87 - 94"},"PeriodicalIF":0.0,"publicationDate":"2021-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49225434","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}

{"title":"Mini-Trampoline Jumping as an Exercise Intervention for Postmenopausal Women Who Experienced a Stroke: A Case Report","authors":"A. Fricke, P. Fink, Sally D. Lark, T. Mundel, Sarah P. Shultz","doi":"10.1097/JWH.0000000000000212","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000212","url":null,"abstract":"Introduction: This case report details a mini-trampoline exercise intervention for a 56-year-old postmenopausal woman who experienced a stroke 7 years ago, which has not previously been reported in medical literature. Case Description: The patient was diagnosed with a cerebral infarction on the left hemisphere following 3 aneurysms at 49 years of age. The patient underwent extensive physical rehabilitation for 6 years, which included physiotherapy, swimming, walking, and attending a cardiac exercise clinic. Although she is able to walk unaided, she still experiences a right-sided hemiparetic gait. Outcomes: The patient showed great improvements in walking speed, lower leg strength, flexibility, pelvic floor muscle strength, bone health, and some aspects of balance following a supervised 12-week mini-trampoline exercise intervention and 12-week follow up. Discussion: This article represents a case in which a mini-trampoline exercise intervention improved physical function and female-specific health risk factors in a postmenopausal woman who experienced a stroke 7 years ago.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"45 1","pages":"201 - 208"},"PeriodicalIF":0.0,"publicationDate":"2021-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44868267","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}