September 7, 2011 Pelvic Physiotherapy Distance Journal Club

Time - 8:30 PM EST for one hour

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This month’s discussion

Dietz HP, Simpson JM. Levator trauma is associated with pelvic organ prolapse. BJOG 2008;115:979-984.

Beales DJ, O’Sullivan PB, Briffa NK. Motor control patterns during an active straight leg raise in pain-free subjects.  Spine 2008;34(1):E1-E8.

Beales DJ, O’Sullivan PB, Briffa NK. Motor control patterns during an active straight leg raise in chronic pelvic girdle pain subjects.  Spine 2009;34(9):861-870.

Stuge B, Garrett A, Jenssen H, Grotle M: The Pelvic Girdle Questionnaire: A Condition-Specific Instrument for Asssessing Activity Limitations and Symptoms in People with Pelvic Girdle Pain. Phys Ther. 2011;91:1-11.

August 10, 2011 Michelle Spicka

Objective:  The objective of this study was to develop a condition-specific measure, the Pelvic Girdle Questionnaire (PGQ), for sue during pregnancy and postpartum.

Introduction:

1) In general, literature does not make a clear distinction between pregnancy-related low back pain (LBP) and pelvic girdle pain (PGP) but there is growing evidence that PGP disorders comprise a distinct subgroup with a unique clinical presentation and a need for specific management.

                a. For adequate evaluation of interventions, reliable and valid outcome measures are needed

2) Outcome measures that have been validated for LBP are not necessarily the most appropriate ones for PGP

a. The Pregnancy Mobility Index (van de Pol, et al 2006) has activity items that are based on literature research and clinic experience but does not include the views of patients.

b. Current outcome measures may not adequately capture the specific problems and consequences that patients describe, and there is a discrepancy between patients’ scores and their feedback.

3) This study was designed to develop a condition-specific measure for use both during pregnancy and postpartum in research and clinical practice.  After the application of Rasch analysis, the final questionnaire was assessed for test-retest reliability and construct validity.

Benetti TH, Santos MF, Mergulhao MEA, Fagundes JJ, Ayrizono MJS, Coy CSR: Variation of the Anal Resting Pressure Induced by Postexpiratory Apnea Effort in Patients with Constipation. Arq Gastroenterol 2011; 48(1):30-5.

August 10, 2011 Michelle Spicka

Objective:  

To analyze, by manometric data, the anal pressure variation at rest, during evacuation effort by using the Valsalva maneuver and forced post-expiratory apnea in subjects with secondary constipation.

Introduction:

1.  Functional evacuation disorders that lead to constipation are not completely understood (dyskinesia of the pelvic floor) but functional change is common (though underestimated) as a cause of chronic constipation and studies report that 50% of individuals suffer from constipation.

                a. Dyskinesia of the pelvic floor is characterized by difficulty initiating the evacuation and

sensation of incomplete evacuation secondary to failure of relaxation of the puborectal and external anal sphincter or contraction of those muscles during evacuation.

b. The observation that the Valsalva, used by some patients at the end of the evacuation effort, could be an aggravating favor of constipation led to this study to compare this variable with apnea after forced expiration.

c. Patients with dyskinesia of the pelvic floor tend to have decreased rectal sensitivity and muscular incoordination during the act of evacuation, showing an unconscious paradoxical contraction, exacerbated by the Valsalva.

August 10, 2011 Pelvic Physiotherapy Distance Journal Club

We had continued discussions of the effect of intra-abdominal pressure on the PFM.  More questions, some new ideas, lots of stimulating discussion.  Check out the pod cast.  Outlines of the talks are posting in this blog with links to more articles and references.

This month’s discussion

Stuge B, Garrett A, Jenssen H, Grotle M: The Pelvic Girdle Questionnaire: A Condition-Specific Instrument for Asssessing Activity Limitations and Symptoms in People with Pelvic Girdle Pain. Phys Ther. 2011;91:1-11.

Benetti TH, Santos MF, Mergulhao MEA, Fagundes JJ, Ayrizono MJS, Coy CSR: Variation of the Anal Resting Pressure Induced by Postexpiratory Apnea Effort in Patients with Constipation. Arq Gastroenterol 2011; 48(1):30-5.

Continue the discussion on LinkedIn group - Pelvic Physical Therpay Distance Journal Club
http://www.linkedin.com/groups?gid=3997188&trk=hb_side_g