Journal of women's health physical therapy最新文献

{"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":"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.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}

{"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":"34 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.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}

{"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":" ","pages":""},"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}

{"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":" ","pages":""},"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}

{"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":"43 1","pages":"180 - 187"},"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}

{"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":"43 1","pages":"202 - 208"},"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}

{"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":"43 1","pages":"188 - 193"},"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}

{"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":" ","pages":""},"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}

{"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":"220 1","pages":"160 - 170"},"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}

{"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":" ","pages":""},"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}