https://fccdl.in/hkOGPec5z
Next call Jan 6 - post prostatectomy UI treatment
Wednesday, December 16, 2015
Dec Pelvic PT Distance Journal Club recording
https://fccdl.in/hkOGPec5z
Next call Jan 6 - post prostatectomy UI treatment
Tuesday, December 15, 2015
Postpartum pelvic floor muscle training and pelvic organ prolapse- a randomized trial of primiparous women
MJ Strauhal, PT, DPT, BCB-PMD
Pelvic
Physiotherapy Distance Journal Club
December 9, 2015
Primary Aim:
evaluate the effectiveness of a 4 month postpartum PFMT program on stage
of pelvic organ prolapse (POP), bladder neck position, and POP symptoms in
primiparous women following vaginal delivery
Background:
- POP is common and distressing
- Prevalence of POP differs when based on clinical
exam (>30%) versus symptom “bother” (5-10%)
- When symptomatic, POP causes discomfort, reduced
QOL, limitation of ADL’s
- Lifetime cumulative risk for POP surgery is
7-11%, reoperation is common, and
complications associated with mesh can be severe, warranting early
nonsurgical prevention and treatment
- 3-6 months postpartum occurrence rate of POP >
stage II is 18-56%
- 15-40% of primip wm have a mj. LA defectà when detected by US imaging, postpartum wm with
LA defect were 2x as likely to have POP stage II or > than those with
intact LA
- RCT’s have shown that PFMT is effective in
reducing POP symptoms and/or stage in middle-aged wm
- Systematic review concluded Level 1, grade A
evidence for PFMT in treatment of POP
- Assessor blind RCT found that PFMT improved PFM
strength and thickness, lifted the bladder neck (BN) and rectal ampulla,
narrowed the UGH and reduced mm length in wm with POP
Three-Dimensional Modeling of the Pelvic Floor Support Systems of Subjects with and without Pelvic Organ Prolapse.
http://dx.doi.org/10.1155/2015/845985
Pelvic PT Distance Journal Club December 9, 2015 MJ Strauhal
Purpose and Background:
·
Develop
three-dimensional finite element models of the whole pelvic support systems of
subjects with and without pelvic organ prolapse (POP) that can be used to
simulate anterior and posterior wall prolapses
o
Prevalence
of POP by symptoms report and “bother” is 3-6%; by clinical exam is 50%
(different reference than Bo et al, but similar #’s)
o
Subtle
injuries of the pelvic floor support system may lead to POP
o
Numerical
simulations provide a tool to study pelvic function and the effect of support
defects
o
Previous
studies did not take into account the vaginal cavity which is of “great
significance” when evaluating the mechanical behavior of POP
§
Previous
studies oversimplified the structure of the ligaments and the vagina
Wednesday, November 11, 2015
The Immediate Effects on Inter-rectus Distance of Abdominal Crunch and Drawing-in Exercises During Pregnancy and the Postpartum Period
Pelvic Distance Journal Club
November
2015
Trisha
Jenkyns PT, DPT, WCS
Study Objective/Purpose
Primary
goal
·
To look at 2 abdominal-strengthening exercises,
o
Drawing-in and the abdominal crunch
·
The effect of these 2 exercises on the Inter Rectus
Distance (IRD) at certain time points:
o
Gestational weeks 35 to 41
o
Postpartum at 6-8, 12-14, and 24-26 weeks
Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain
Mota PGF, Pascoal AGBA, Carita AIAD, Bø K. Manual Therapy 2015; 20, 200-205
Pelvic Distance Journal Club November 2015
Trisha Jenkyns PT, DPT, WCS
Study Objective/Purpose
The aim of this study was to investigate the prevalence
of DRA at gestational week 35 and three time-points postpartum, possible
risk factors, and the relationship between DRA and lumbo-pelvic pain.
Brief Background: Authors note that there are no high quality
clinical studies to support theories about DRA causing long term sequelae like lumbo-pelvic pain and abnormal posture
Study Design: Longitudinal observational study following
first time pregnant women from gestational week 35 till 6 months postpartum.
Wednesday, October 21, 2015
Pelvic Floor Muscle Activation and Strength Components
Elizabeth
Lewis, PT, OCS, WCS
Oct. 14,
2015
Pelvic
Physical Therapy Distance Journal Club
Description: This systematic review had a stated
purpose of developing a better understanding of PFM activation and strength
components in order to develop more specific PFM training regimens for female
SUI patients. The aim of this systematic
review was to summarize/evaluate existing studies investigating PFM
activation/strength components which influence female continence and SUI.
Effects of walking speeds and carrying techniques
Received: 24 September 2014
/Accepted: 27 November 2014 /Published online: 20 December 20
Elizabeth Lewis, PT, OCS, WCS
Oct 14, 2015
Pelvic Physical Therapy Distance
Journal Club
Clinical
Question: What is known about any specific
functional activities and their impact on intra-abdominal pressure? Similar topic was discussed June 2013, see outline here. http://pelvicpt.blogspot.com/2013/06/activity-restrictions-after.html
Clinical
Bottom Line: IAP can be monitored in women
outside of a lab during functional activities of lift/carry and walking. Mean IAP increases with walking speed and the
most common ways of carrying a baby in a car seat (front, side or awkward
carry) had significantly higher associated IAP’s than back pack carry.
Sunday, September 13, 2015
September Pelvic PT Distance Journal Club Recording
http://fccdl.in/YD4LIkrEg
Next call October 14, 2015
“Vaginal Shape at Resting Pelvic MRI: Predictor of Pelvic Floor Weakness?”
Cora Huit
Pelvic PT distance journal club Sept 2, 2015
Aim: The goal of
this study was to determine if vaginal shape was related to pelvic floor
weakness.
Design: Population: This study was done
retrospectively using images from a radiology database of 32 women who were
referred for pelvic floor imaging between 1998 and 2007. The same data was
collected from the radiology database for a control group of 44 women who were
referred for pelvic floor imaging for the following health concerns: fibroids,
adnexal mass, nongynecological caner or mass, pelvic pain, endometrial evaluation,
gynecological caner and retrovaginal fistula.
Review of: Postpartum Recovery of Levator Hiatus and Bladder Neck Mobility in Relation to Pregnancy
Cora Huit
Pelvic PT Distance Journal Club Sept 2, 2015
Aim: To determine
the changes in pelvic floor morphology, specifically of the levator hiatus and
the bladder neck, during and after pregnancy for women delivery vaginally and
having cesarean sections.
Design: An observational,
longitudinally study using ultrasonography to exam women’s pelvic floor changes
at 21 and 37 weeks pregnant and 6 weeks, 6 months and 12 months postpartum.
Friday, August 28, 2015
Update your approach to Male UI
Here are a few new articles on the PFM recruitment patterns of continent males. Hoping there will be similar info soon for patient UI but this is the best we have now. All are free full text articles.
Dynamics of male pelvic floor muscle contraction observed with transperineal ultrasound imaging differ between voluntary and evoked coughs. - http://www.ncbi.nlm.nih.gov/pubmed/24526580
A new method to quantify male pelvic floor displacement from 2D transperineal ultrasound images. - http://www.ncbi.nlm.nih.gov/pubmed/23332998
Novel insight into the dynamics of male pelvic floor contractions through transperineal ultrasound imaging. - http://www.ncbi.nlm.nih.gov/pubmed/22902016
Dynamics of male pelvic floor muscle contraction observed with transperineal ultrasound imaging differ between voluntary and evoked coughs. - http://www.ncbi.nlm.nih.gov/pubmed/24526580
A new method to quantify male pelvic floor displacement from 2D transperineal ultrasound images. - http://www.ncbi.nlm.nih.gov/pubmed/23332998
Novel insight into the dynamics of male pelvic floor contractions through transperineal ultrasound imaging. - http://www.ncbi.nlm.nih.gov/pubmed/22902016
Wednesday, August 12, 2015
August Pelvic PT Distance Journal Club recording and outlines
Guided imagery for IC and IBS check out the outlines on this blog and the recording here. Next call Sept 2 http://fccdl.in/YoJp0hHCx
Gut-directed guided affective imagery as an adjunct to dietary modification in irritable bowel syndrome.
Laura Scheufele, PT, DPT, WCS
August 5, 2015
Pelvic PT Distance Journal Club
Aim: Study the effect of
guided affective imagery on the irritable bowel symptom severity and quality of
life when combined with lifestyle modifcations in patients with IBS.
“Guided affective
imagery (GAI) is a form of psychotherapy, which involves focusing on the mental
images to induce relaxation. The principle behind GAI is the interruption of
stress-provoking thoughts with a relaxing image, thereby inducing relaxation. “
Guided imagery for women with interstitial cystitis: results of a prospective, randomized controlled pilot study.
Carrico D, Peters K, and Diokno, A. Journal of alternative
and complementary medicine. 2008. Volume 14. Issue 1. Page 53 - 60.
Laura Scheufele, PT, DPT, WCS
August 5, 2015
Pelvic PT Distance Journal club
Aim: Explore the effects of
guided imagery on pelvic pain and urinary symptoms in women with IC.
Design: Prospective,
randomized, controlled pilot study. Authors decided that 30 subjects (15 in
each arm) would adequately provide preliminary data to decide if larger-powered
study would be warranted.
“Guided imagery uses words to direct one’s thoughts and
attention to imagined visual, auditory, tactile, or olfactory sensations to
elicit the psychologic and physiologic response of relaxation. “
Several theories for how the physiological effect is achieved
with guided imagery including Gate Control Theory of pain and endorphin release.
Saturday, July 18, 2015
Morrissey, D, et al. Botulism Toxin A Injections Into Pelvic floor Muscles Under Electromyographic Guidance for Women with Refractory High-tone Pelvic Floor Dysfunction: A 6-Month Prospective Pilot Study.
Additional article for discussion
July 8, 2015 Pelvic PT Distance Journal Club
Jane Franczak
Objective: to examine the efficacy of EMG guided botox for pain
and increased QoL for high tone pelvic floor dysfunction (HTPFD).
OnabotulinumtoxinA ( botox) is a neurotoxin which inhibits the
release of acetylcholine and leads to ms paralysis. May last 3-6 months.
Guidance from EMG can lead to precise location of high tone or TPs to ensure
accurate delivery and lead to improved QoL.
A pilot randomized trial of levator injections versus physical therapy for treatment of pelvic floor myalgia and sexual pain
Zoorob, D. et al,
Int Urogynecol J (2015) 26:845-852.
Question investigated: Are PT and Levator Trigger point Injections (LTPI
comparable as treatment for improving chronic pain and sexual function (PFM
Pelvic floor myalgia )?
Materials and methods: ramdomized trial btw a
course of vaginal injections of triamcinolone and bupivacaine vs. pelvic floor
PT for treatment of PFM.
Patients: chosen by 1 of 2 MDs, with self-reported
pelvic pain and evidence of MTPs in pelvic floor ( PR, PC, IC, C and OI). No
prior pelvic rehab or LTPI .Randomized to either group.
Aged 18+, sexually active, pain with
intercourse, Excluded if: pregnant, used aspirin within a week of study, hx untreated
pelvic absess, cardiac arrhythmia,
bladder pain syndrome, current pelvic rehab or LTPI.
The Relationship Between Incontinence, Breathing Disorders, Gastrointestinal Symptoms,
Michelle
D. Smith, PhD,* Anne Russell, MMedStat,w and Paul W. Hodges, PhD
Clin
J Pain, Vol 30 (2), Feb 2014, 162-7.
July 8, 2015
Pelvic PT Distance Journal Club
Jane Franczak
Summary:
Question asked: Does the presence of 1 disorder
increased the risk for another?
Current data suggests/assumes causal pathway from resp.
disorder, incontinence, and GI leads to
back pain ,
But it IS POSSIBLE that BP may contribute to development of
other disorders.
Sunday, June 7, 2015
Comparison of the sonographic features of the abdominal wall muscles and connective tissues in individuals with and without lumbopelvic pain
Ann
Dunbar PT, DPT, MS, WCS
June
3, 2015
Introduction
- Muscles of the
abdominal wall, multifidii, pelvic floor, and respiratory diaphragm
function to pressurize the abdominopelvic cavity for load transfer.
- Researchers have identified functional deficits in abdominal mm in persons with lumbopelvic pain (LPP) however, most studies consider only the transverse abdominis and internal oblique. Morphologically the 4 layers are different.
Primary Aim: “ to measure and
compare the resting thickness of the 4 abdominal wall muscles and their
perimuscular connective tissue (PMCT) planes, as well as interrecti distance
(IRD) in persons with and without lumbopelvic pain, using ultrasound imaging.
Functional gastrointestinal disorders are associated with the joint hypermobility syndrome in secondary care: a case-control study
Fikree
A, Aktar R, Grahame R, Hakim AJ, Morris JK, Knowles CH, Aziz Q; 2015
Neurogastroenterol 27: (569-579).
Ann Dunbar PT, DPT, MS, WCS
June
3, 2015
Introduction
- Functional gastrointestinal
disorders (FGID) account for 40% of visits to GI clinics.
- Despite increasing focus on
research, diagnostic biomarkers and etiology are not well established.
- It is well established that inflammatory
connective tissue disorders are associated with GI dysfunction and
evidence is increasing that non-inflammatory disorders (such as joint
hypermobility disorders) may also be related.
- Due to lack of distinct
biomarker, current gold standard for diagnosing joint hypermobility
syndrome (JHS) is 1998 Brighton classification for JHS (see Table 1 in
article).
- It has been recognized more
recently that JHS is a disorder of multiple systems (eg chronic pain
syndromes, dysautonomia, urinary symptoms, GI symptoms, and anxiety
disorders). GI sx such as globus, bloating, reflux, postprandial fullness,
and early satiety have a high prevalence in rheumatology and genetics
clinics. In GI clinics, 1/3 of pts have undiagnosed JHS suggesting association
between GI symptoms and this syndrome however, conclusive evidence is
limited due to lack of controlled studies.
Friday, May 29, 2015
Adherance in PFM training
5 landmark papers written by internationally known PTs on adherence in PFM training
|
Scoping review of
adherence promotion theories in pelvic floor muscle training - 2011 ICS
State-of-the-Science Seminar research paper I of IV
Doreen McClurg, Helena Frawley, Jean Hay-Smith, Sarah Dean, Shu-Yueh Chen, Pauline Chiarelli, Frances Mair and Chantale Dumoulin Article first published online: 21 MAY 2015 | DOI: 10.1002/nau.22769 |
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Pelvic-floor-muscle
training adherence: Tools, measurements and strategies—2011 ICS
State-of-the-Science Seminar research paper II
Chantal Dumoulin, Dianne Alewijnse, Kari Bo, Suzanne Hagen, Diane Stark, Marijke Van Kampen, Julia Herbert, Jean Hay-Smith, Helena Frawley, Doreen McClurg and Sarah Dean Article first published online: 21 MAY 2015 | DOI: 10.1002/nau.22794 |
|
Pelvic-floor-muscle-training
adherence “modifiers”: A review of primary qualitative studies—2011 ICS State-of-the-Science
Seminar research paper III of IV
Jean Hay-Smith, Sarah Dean, Kathryn Burgio, Doreen McClurg, Helena Frawley and Chantale Dumoulin Article first published online: 21 MAY 2015 | DOI: 10.1002/nau.22771 |
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Health professionals’
and patients’ perspectives on pelvic floor muscle training adherence—2011 ICS State-of-the-Science
Seminar research paper IV of IV
Helena C. Frawley, Doreen McClurg, Aishath Mahfooza, Jean Hay-Smith and Chantale Dumoulin Article first published online: 21 MAY 2015 | DOI: 10.1002/nau.22774 |
|
2014 consensus statement
on improving pelvic floor muscle training adherence: International Continence
Society 2011 State-of-the-Science Seminar
Chantale Dumoulin, Jean Hay-Smith, Helena Frawley, Doreen McClurg, Dianne Alewijnse, Kari Bo, Kathryn Burgio, Shu-Yueh Chen, Pauline Chiarelli, Sarah Dean, Suzanne Hagen, Julia Herbert, Aishath Mahfooza, Frances Mair, Diane Stark and Marijke Van Kampen Article first published online: 21 MAY 2015 | DOI: 10.1002/nau.22796 |
Saturday, May 9, 2015
May #PelvicPTjournalclub recording
May #PelvicPTjournalclub
recording http://rs2386.freeconferencecall.com:80/fcc/cgi-bin/play.mp3/2096471000-436790-54.mp3
Vulvodynia and labrial tears, male PFM ex instructions
Next call June 3
Outlines posted on this blog www.pelvicpt.blogspot.com
Vulvodynia and Concomitant Femoro-Acetabular Impingement: Long-Term Follow-Up After Hip Arthroscopy. Coady, D et al. J Lower Gen Tract Dis 2015;19).
Michelle Spicka, DPT
May 6th, 2015
Pelvic Physical Therapy Distance Journal Club
Description: The
researchers hypothesized that in patients with vulvodynia and femoro-acetabular
impingement, vulvar pain may actually be generated by the effect of
femoro-acetabular impingement on pelvic floor structures and treatment with
arthroscopy may improve vulvodynia.
Vulvodynia affects 8-16% of women but effective treatment is
often difficult due to inadequate understanding of the causes.
Close relationships between intra-articular hip disorders,
pelvic floor and chronic pain in the pelvis in proximity to the hip have
recently been recognized. Femoro-acetabular
impingement can refer pain into the pelvic floor via the obturator internus and
other shared muscles and connective tissues and leads to the development of
nonoptimal movement patterns.
Pattern of Activation of Pelvic Floor Muscles in Men Differs With Verbal Instructions. Stafford R, et al. Neurourol Urodyn. 2015 March 1. Doi: 10.1002/nau.22745.
May 6th, 2015
Pelvic Physical Therapy Distance Journal Club
Description: Pelvic
floor muscle exercises have been found to help with post-prostatectomy urinary
incontinence in men but there is a lack of consistency of the instructions used
to teach men to activate the pelvic floor muscles. Because the efficacy of a pelvic floor muscle
exercise program for treatment of incontinence after prostatectomy is likely to
depend on if and how the muscles of urinary continence are activated, optimal
methods to achieve activation have received limited attention.
The aim of this study is to investigate the effect of
instruction on activation of pelvic floor muscles in men as quantified by
transperineal ultrasound imaging and to validate these measures with invasive
EMG recordings.
Friday, April 10, 2015
April 8, 2015 Pelvic PT Distance Journal Club
Recording
http://rs2386.freeconferencecall.com:80/fcc/cgi-bin/play.mp3/2096471000-436790-53.mp3
Outline is posted on the blog www.pelvicpt.blogspot.com
Next call is May 6,2015
A pilot randomized controlled trial to evaluate pelvic floor muscle training for urinary incontinence among gynecological cancer survivors, Rutledge TL, et al, Gynecol Oncol 132(2014)154-158.
Pelvic PT Distance Journal Club, April 8,
2015
Background:
Same authors previously reports high rates of
UI (67% of 200) and sexual dysfunction among gynecological cancer survivors
Rutledge TL, Heckman SR, Qualls C,
Muller CY, Rogers RG. Pelvic floor disorders and sexual function in gynecologic
cancer survivors: a cohort study. Am J Obstet Gynecol 2010;203(5):514e1–7 [Epub
2010/09/28].
·
effectiveness of PFMT and behavioral therapy, has not been evaluated in
gynecologic cancer survivors.
·
effectiveness of these interventions may differ in cancer survivors since
radiation, chemotherapy and radical pel-vic surgery can result in significant
anatomical functional changes in the pelvis and lower urinary tract, including
damage of nerve fibers and compromise of vascular supply with resultant
fibrosis.
Sunday, March 15, 2015
New articles on Pub med
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1.
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Cadeddu
F, Salis F, De Luca E, Ciangola I, Milito G.
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Tech Coloproctol. 2015 Mar 6. [Epub ahead
of print]
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PMID:
25744688 [PubMed - as supplied by publisher]
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2.
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Egger
MJ, Hamad NM, Hitchcock RW, Coleman TJ, Shaw JM, Hsu Y, Nygaard IE.
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Female Pelvic Med Reconstr Surg. 2015 Feb 27. [Epub ahead
of print]
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PMID:
25730430 [PubMed - as supplied by publisher]
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3.
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Stafford
RE, Ashton-Miller JA, Constantinou C, Coughlin G, Lutton NJ, Hodges PW.
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Neurourol Urodyn. 2015 Mar 1. doi:
10.1002/nau.22745. [Epub ahead of print]
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PMID:
25727781 [PubMed - as supplied by publisher]
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4.
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Lin
YH, Yang HY, Hung SL, Chen HP, Liu KW, Chen TB, Chi SC.
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Eur J Cancer Care (Engl). 2015 Feb 12. doi:
10.1111/ecc.12292. [Epub ahead of print]
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PMID:
25684312 [PubMed - as supplied by publisher]
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5.
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Coleman
TJ, Nygaard IE, Holder DN, Egger MJ, Hitchcock R.
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Int Urogynecol J. 2015 Feb 12. [Epub ahead
of print]
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PMID:
25672647 [PubMed - as supplied by publisher]
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6.
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Kao
HT, Hayter M, Hinchliff S, Tsai CH, Hsu MT.
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J Clin Nurs. 2015 Feb 7. doi: 10.1111/jocn.12783. [Epub ahead of print]
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PMID:
25662587 [PubMed - as supplied by publisher]
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7.
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MacArthur
C, Ismail K.
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BJOG. 2014 Dec;121 Suppl 7:67-72. doi: 10.1111/1471-0528.13150.
No abstract available.
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PMID:
25488091 [PubMed - indexed for MEDLINE]
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8.
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Wood
LN, Anger JT.
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BMJ. 2014 Sep 15;349:g4531. doi: 10.1136/bmj.g4531. Review.
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PMID:
25225003 [PubMed - indexed for MEDLINE] Free
Article
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