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Tuesday, January 24, 2012

Four interesting articles

Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study.   The Lancet, Volume 378, Issue 9798, Pages 1244 - 1253, 1 October 2011
15 min per day or 90 min per week of moderate exercise had a 14% reduced risk of morality.  This was true across all ages, sexes, and even when cardiovascular risks were present. 



Etiological, Diagnostic and Therapeutic Consideration of the Myofascial Component in Chronic Pelvic Pain. Díaz-Mohedo E, Barón-López FJ, Pineda-Galán C.  Actas Urol Esp. 2011 Sep 12. [Epub ahead of print]  [Article in English, Spanish]
Too bad my Spanish is not better.  Full article is available but only the abstract is in English.  Very interesting. 


Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA 2011 Sep 28;306(12):1344-1351. Barry MJ et al. http://www.ncbi.nlm.nih.gov/pubmed/21954478  
Study is not in support benefit of saw palmetto use.


Management of nocturia. Faisal Rauf Khan et al. Trends in urology and men’s health. Vol 2, issue 5, 4-43, sept/ oct 2011 http://onlinelibrary.wiley.com/doi/10.1002/tre.223/pdf
Wells done summary.  Full article available free. 

Wednesday, January 18, 2012

A randomized clinical trial for women with vulvodynia: cognitive-behavioral therapy vs. supportive psychotherapy.

Masheb R. M., Kerns R. D., Lozano C. et al.  A randomized clinical trial for women with vulvodynia: cognitive-behavioral therapy vs. supportive psychotherapy.  Pain.  2009; 141: 31-40.
Appraiser: Stephanie Bush, DPT
1/11/12

Clinical Bottom Line:
Psychosocial treatments for vulvodynia are effective and well-tolerated, and CBT, a directed treatment approach that involves specific pain-relevant coping and self-management skills, yields better outcomes in pain severity, sexual function, and patient satisfaction compared to a less directed approach.

Randomized, controlled trial shows biofeedback to be superior to alternative treatments for patients with pelvic floor dyssynergia-type constipation.

Heymen S, Scarlett Y, Jones K, Ringel Y, Drossman D, Whitehead W. Randomized, controlled trial shows biofeedback to be superior to alternative treatments for patients with pelvic floor dyssynergia-type constipation. Dis Colon Rectum. 2007;50:428-441.
Appraised by: Beth Northrop PT, DPT
January 11, 2012

Clinical Bottom Line: Incorporating biofeedback training with behavioral training is effective for improving constipation symptoms and quality of life in patients with pelvic floor dyssynergia.
Study design: single-blinded randomized controlled trial with intention to treat

Sunday, January 8, 2012

PTJ January 2012 and J of Women’s Health PT December 2011

This month’s issue of PTJ has several interesting articles.
“Catastrophizing during and after pregnancy” sheds some light on pain perception surrounding pregnancy and postpartum recovery.  The tool sited (Pain catastrophizing scale) is easily available by a quick Google search http://www.aaompt.org/education/conference10/Break_Out_Sessions/Pain_Catastrophizing_Scale.doc with scoring information http://www.qcomp.com.au/media/29380/pain-catastrophising-scale---scoringpcs[1].pdf  and validation studies  http://www.ncbi.nlm.nih.gov/pubmed/10984864 .  Centralization of pain is a topic rightfully receiving a great deal of research, discussion and publications.  A recent publication in PTJ  (Psychological Factors in Chronic Pelvic Pain in Women: Relevance and Application of the Fear-Avoidance Model of Pain PHYS THER October 2011 91:1542-1550)  discussed the use of the “Fear avoidance scale” in patients with pelvic pain.  I suspect this tool (Pain catastrophizing scale) could also be used in CPP.  

December Journal of Women’s Health PT has a wonderful article along this same topic “The puzzle of pelvic pain”.  It dives into the topic of pain perception and gives practical suggestions with evidence.  Great article (might be in the March journal club).  Must read.  CSM programing will also support this topic. 

January PTJ also includes a comparison of several tools used in the assessment of pelvic girdle pain.  The Pelvic Girdle Questionnaire came out on top with good psychometrics and discriminant validity.  Caution should be given as one of the authors of this study (Britt Stuge) is one of the researchers of the Pelvic Girdle Questionnaire.  Still it is a very good tool.  The full scale is available in the July 2011 PTJ.  This paper was also reviewed in the August Pelvic Physiotherapy Distance Journal club http://pelvicpt.blogspot.com/2011/08/stuge-b-garrett-jenssen-h-grotle-m.html 

So good to see pelvic PT in the main stream publications on a regular basis. 

Friday, January 6, 2012

January 11,2012 Pelvic Physiotherapy Distance Journal Club

Time - for one hour

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This month’s discussion
Masheb RM, et al. A randomized clinical trial for women with vulvodynia: cognitive behavioral therapy vs supportive psychotherapy. Pain 2009;141:31-40.

Heyman S, et al. Randomized, controlled trial shows biofeedback to be superior to alternative treatments for patients with pelvic floor dyssynergia-type constipation.  Disc Colon Rect 2007;50(4):428-441.