Objective: To examine evidence for an effect of
physiotherapy as a sole intervention or significant component of a
multidisciplinary intervention on pain.
2. Diagnoses included were pelvic adhesion, pelvic congestion syndrome, bladder pain syndrome, urethral pain syndrome, and IBS (excluded diagnoses were malignancy, primary dysmenorrheal, endometriosis, pregnancy, infections, active chronic PID, vulvodynia/vulvar pain syndrome) Interesting they removed a large part of the patients we see specifically vulvodynia
3. Validated outcome measure
4. Experimental intervention of PT alone or in combination with other medical or psychological therapies
5. Prospective quantitative study design (retrospective studies or studies with historical controls were excluded)
There were 6
randomized clinical trials, 1 cohort study and 3 case studies. Sample sizes ranged from 21 to 370
participants. PT interventions,
treatment frequencies and duration varied tremendously across the 11 studies. Outcome measures also varied substantially
across the studies.
Outcome/Results:
1.
None of the data could be pooled for analysis
because of the vast differences between the studies2. There was an inability to meta-analyze the results of the included studies which was a limitation in this review.
3. The majority of the studies included in this review investigated the effect of PT in combination with medical or psychological treatment so the stand-alone value of PT treatment could not be determined.
2. Current recommendations for specific PT treatments are not evidence based
3. Only small, single studies have been undertaken of most of these interventions and that greatly limits available evidence on which clinical practice can be based.
4. Primary research should be designed and conducted to test the effect of PT interventions for CPP since the available research is significantly lacking on multiple levels.
Thought Questions:
1.
What does this mean for current practice?2. What would be the results of the inclusion criteria was different?
3. A major limitation is that there are no research studies that explore physical therapy (as an intervention) alone and that PT was included with multiple different disciplines in treatment of a patient but isn’t that how most of us treat CPP? It takes a village…right?
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