March 7, 2012 Pelvic Physiotherapy Distance Journal Club

Time - 8:30 PM EST for one hour

FreeConfrenceCall.com This month’s call is using a different number ********

• 559-546-1401 access code 375984#
• Email Beth if you are having trouble accessing the call - beth@bethshelly.com
• Please keep background noise to a minimum (see below for more details)

This month’s discussion

Anal sphincter fatigue: is the mechanism peripheral or central? Schabrun SM, Stafford RE, Hodges PW. Neurourol and Urodynam 2011;30:1550-1556.

**** Primary author Siobhan Schabrun PhD, B.Physio from The University of Queensland will join us for the call. ******

Investigation of optimal cues to instruction for pelvic floor muscle contraction: A pilot study using 2D ultrasound imaging in pre-menopausal, nulliparous, continent women.  Crotty K, Bartram CI, Pitkin J, Cairns MC, Taylor PC, Dorey G, Chatoor D. Neurourol and Urodynam 2011 30:1620-1626.

Free Stuff

Just want to remind everyone of the large amount of free articles available in the field of Pelvic PT.

Pub Med http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed

Just did a quick search with “pelvic floor muscle exercises” and came up with 715 documents – 73 free full text.  Some are not in English and a few are very old but the majority are very good papers published by good researchers in reputable journals. 

Free full PDF.com  http://www.freefullpdf.com/

This site is not so good at finding a specific paper but will help with a wide search.  The filters are not so good and many that come up are not appropriate.  I plugged in “pelvic floor muscle exercises” and came up with 147,000. The first is an article on the comparison of two PFM training programs published in 2011 – nice article, third citation is a Cochrane review. 

Saturday, April 16, 2011 post on this blog also has free resources

http://pelvicpt.blogspot.com/2011/04/free-resources-for-pelvic-physical.html

IOPTWH http://www.ioptwh.org/

Also wanted to remind members of the Section on Women’s Health that they are also members of the International Organization of Women’s Health Physical Therapists and have access to many list servs to ask clinical questions.  Reach out, ask questions, read, or post.  Just keep learning. 

The Journal of Sexual Medicine. Volume 9, Issue 2

Exercise is Associated with Better Erectile Function in Men Under 40 as Evaluated by the International Index of Erectile Function. Wayland Hsiao MD, Adam B. Shrewsberry MD, Kelvin A. Moses MD, PhD, Timothy V. Johnson MD, Amanda W. Cai BA, Peter Stuhldreher MD, Beau Dusseault MD, Chad W.M. Ritenour MD ^. The Journal of Sexual Medicine. Volume 9, Issue 2, pages 524–530, February 2012.

                The title of this paper says it all.  Get those men out and exercising. 

Sexual Functioning in Women and Men with Fibromyalgia. Fernando Rico-Villademoros MD1,*, Elena P. Calandre MD1, Carmen M. Rodríguez-López MD1, Jocelyne García-Carrillo PhD1, Javier Ballesteros MD2, Javier Hidalgo-Tallón MD1, Juan M. García-Leiva PhD1.  The Journal of Sexual Medicine. Volume 9, Issue 2, pages 542–549, February 2012. 

293 patients with fibromyalgia (276 females and 17 males) and 86 healthy controls (72 females and 14 males). The frequency of sexual dysfunction was significantly higher in patients with fibromyalgia than in controls for both females (86.9% vs. 23.6%) and males (76.5% vs. 6.7%).

Vaginismus: Heightened Harm Avoidance and Pain Catastrophizing Cognitions. Charmaine Borg MSc1,*, Madelon L. Peters PhD2,  Willibrord Weijmar Schultz MD, PhD3, Peter J. de Jong PhD1. The Journal of Sexual Medicine. Volume 9, Issue 2, pages 558–567, February 2012

This study consisted of three groups: a lifelong vaginismus group (N = 35), a dyspareunia group (N = 33), and women without sexual complaints (N = 54).  The study found women with vaginismus showed significantly heightened levels of catastrophic pain cognitions compared with the other two groups.  This finding was  shown to have cumulative predictive validity for the presence of vaginismus and may be important in treatment offered. 

The urine stream interruption test (UST)

For many years healthcare practitioners have been recommending that patients stop their urine to learn and training the PFMs.  Below is a collection of papers on the maneuver.  You may draw your own conclusion but I do not recommend this test as a measure of function or a training maneuver. 

1.       Sampselle CM, DeLancey JOD. The urine stream interruption test and pelvic muscle function Nurs Res 1992 41(2):73-77.

First article describe the test using a uroflow chair.  The showed repeatability and correlation between decreased PFM strength and slower speed of interrupting urine flow. 

Average time till stop:

·         Nulliparous = 1.96 seconds

·         Primiparas = 3.6 seconds

·         Multiparous = 4.4 seconds.  20 subjects.