Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicenter randomized controlled trial

Hagen S, Stark D, Glazener C, Dickson S, Barry S, Elders A, Frawley H, Galea MP, Logan J, Mc Donald A, McPherson G, Moore KH, Norrie J, Walker A, Wilson D. Lancet. 2014; 383:796-806.

Ann Dunbar PT, DPT, MS, WCS

September 10, 2014

Introduction:  

• Pelvic organ prolapse (P)to some degree is found on examination in 40% of women over 50
• Women with prolapse may present with bladder, vaginal, bowel, abdominal, back and sexual sx affecting daily living and QOL
• Conservative intervention offered for women who are not candidates for surgery or who have P low in severity; Interventions could include physical, mechanical, and lifestyle interventions as well as care offered by women’s health PTs
• Physiotherapists (PTs) provide pelvic floor muscle training (PFMT) aimed at improving strength, endurance, and coordination of PFMs
• Additional research needed to determine medium and long term effectiveness of PFMT as well as cost-effectiveness   

Primary Aim:  To assess whether (1)   One-on-one PFMT would reduce sx of P as well as the need for further treatment.  (2)  One-to-one PFMT would be cost effective compared with patient education handout on P lifestyle advice.

Study Design:  RCT

Your Pace Yoga: Optimizing Bladder Control by Dustienne Miller

www.yourpaceyoga.com

 

This is Dustienne's second video and it is as wonderful as the first (your pace yoga for pelvic pain).  This 1 hour and 20 minute DVD provides instruction in pelvic awareness and PFM contraction is many different position.    Visualization and breath are incorporated into many yoga positions enhancing the correct muscle action.  Relaxation of the PFM is also stressed making this applicable to patients who are toward the end of treatment of overactive PFM who need to restore strength and stability of the area without reactivating muscle spasm.  This can be used as a home exercise to enhance individualized treatment.  Thanks Dustienne for another helpful DVD.

Aug Pelvic PT journal club recording link

http://rs2386.freeconferencecall.com:80/fcc/cgi-bin/play.mp3/2096471000-436790-45.mp3

Please let me know if you cannot open this link beth@bethshelly.com

Outlines for this call are posted on this blog.

next call Sept 10th

Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (Part II: Treatment)

Bove A, Bellini M, Battaglia E, et al. World J Gastroenterol. 2012 September 28;18(36):4994-5013. Focusing on biofeedback treatment/”Rehabilitative Treatment”

AIGO: Italian Association of Hospital Gastroenterologists

SICCR: Italian Society of Colo-Rectal Surgery

Laura Scheufele PT, DPT, WCS

August 5, 2014

Background from Consensus statement AIGO/SICCR: Diagnosis and treatment of chronic constipation and obstructed defecation (part I: Diagnosis)

The Joint Committee AIGO/SICCR is made up of members of these two scientific societies, elected on the basis of their experience in treating functional and organic problems of the colon and rectum.

Biofeedback for treatment of chronic idiopathic constipation in adults.

Woodward S, Norton C, Chiarelli P. Cochrane Database of Systematic Reviews 2014, Issue 3. Art. No.: CD008486. DOI: 10.1002/14651858.CD008486.pub2.

Laura Scheufele, PT, DPT, WCS

August 6, 2014

Purpose: Examine the effectiveness and side effects of biofeedback (BF) therapy used for the treatment of chronic constipation in adults who are unable to relax the muscles ,which control bowel movements.

Aim: Answer the question “Does biofeedback decrease physical or psychological morbidity and symptom distress and improve QoL in patients with a diagnosis of chronic constipation (functional constipation.)