6/5/13 Pelvic Physiotherapy Distance Journal Club

Time - 8:30 PM EST for one hour

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This month’s discussion - outlines will be provided before the call. Bring post-op activity protocols and outcome ideas.

Measuring outcomes in urogynecological surgery: "perspective is everything".  Parker-Autry CY, Barber MD, Kenton K, Richter HE. Int Urogynecol J (2013) 24:15-25.

Activity restrictions after gynecological surgery: is there evidence?  Nygaard IE, Hamad NM, Shaw JM. Int Urogynecol J (2013) 24:719-724.

 

Four Interesting Articles

Staying on top of the research is a daunting task these days.  Here are a few good articles I have come across lately.  Will post more as I can. 
Anyone wanting to help with article review email me at beth@bethshelly.com.  Not looking for a long review, just a sentence - those interested are expected to read the article.

 Low back pain does not improve with surgical treatment of pelvic organ prolapse. Lau T, et al. Int Urogynecol J (2013) 24:147-153.

 

How Does Foam Rolling Work?

This is a great blog post – check it out.  Respectful of science with a health does of skepticism.  It comes to a conclusion I would strongly agree with and uses strategies our pelvic pain patient can benefit from.  Also has a You Tube from David Butler on the role of internal pain chemicals.  http://www.bettermovement.org/2013/how-does-foam-rolling-work/?goback=%2Egde_2387209_member_240379913 

I have not looked at the program he sells but have used Feldenkras with my patients with good success.  Happy rolling!!

OAB Central

This web site is sponsored and created by AUGS (American Urogynecolological Society) and provided a wealth of information for professionals treating OAB.  Although the majority of treatment is related to medications this site does have many files applicable to PTs including a few full articles, patient forms, links to algorithms for treatment, webinars, and more.   It is all free an certainly worth a look if you are passionate about EBM and the treatment of OAB.

http://oabcentral.org/index.php

Stress Urinary Incontinence in Pregnant Women: A Review of Prevalence, Pathophysiology, and Treatment Authors: B. Sangsawang and N. Sangsawang

Authors: B. Sangsawang and N. Sangsawang   
 International Urogynecology Journal –23 February 2013         
 Reviewer: Jane O’Brien, PT, MSPT – 05.08.13
1. Primary Aim – To explain the pathophysiology leading to Stress UI during pregnancy and Stress UI prevalence and treatment during pregnancy.
2. Background – Stress UI
a. Involuntary loss of urine on physical exertion such as cough, sneeze or lifting
b. Most common type of UI for pregnant women.
c. Brummen: Risk factors for SUI 1 year after delivery: older maternal age and LUTS during pregnancy at week 12.  C -section has protective effect on  bothersome SUI at 1 yr post delivery
d. Affects the quality of life in physical activity, traveling, social relationships and emotional health.  QoL worsens with increasing gestational age.  Many studies indicate women with UI during pregnancy are at higher risk for postpartum UI than those without UI during pregnancy
e. Risk factors for development of SUI during pregnancy are pregnancy and delivery related factors.

TRANSVAGINAL E-STIM with SURFACE EMG BIOFEEDBACK IN MANAGING STRESS UI IN WOMEN OF PREMENOPAUSAL AGE: A double-blind, placebo-controlled, randomized clinical trial

Terlikowski, R, etal International Urogynecology Journal – 27 February 2013
Reviewer:  Jane O’Brien, PT, MSPT – 05.08.13
Background:   PFMT for SUI can have improvement rates as high as 70% short term… Long term declines to 50% maybe due to declining adherence rates to program.
ES helps strengthen PFM, ease SUI, can help control urgency by acting on nerves and decreasing bladder irritability. Ideal parameters seem to be 20-50HZ, 15-30 min, at max tolerable intensity for 4-12 weeks.
Surface EMG (sEMG) , evals SUI treatment outcome by recording change in voltage over the muscle fiber membrane that initiates the contraction. Skeletal muscle: relationship btw EMG activity and force ie higher activity level correspond to increase force.

May 8, 2013 Pelvic Physiotherapy Distance Journal Club

 This month’s discussion - outlines at www.pelvicpt.blogspot.com

Terlikowski R, et al. Transvaginal electrical stimulation with surface-EMG biofeedback in managing stress urinary incontinence in women of premenopausal age: a double-blind, placebo controlled, randomized clinical trial. Int Urogynecol J. available on line ahead of print. DOI 10.1007/s00192-013-2071-5.

 Sangswang B, Sangswang N. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J. available on line ahead of print. DOI 10.1007/s00192-013-2071-7.

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Schedule for 2013 is as follows:
June  5 – Beth Shelly
July 10 - Michelle Spicka
August 7  - Laura Scheufele
September 11- Ann Dunbar
October 9 - MJ Strahaul
November 6 - Trisha Jenkyns
December 4 – Michelle Spicka