Introduction and hypothesis Dyspareunia, the symptom of painful sexual intercourse, is a common sexual dysfunction in reproductive-aged women. Because of its multifactorial etiology, a multidisciplinary approach may be required to treat it. Musculoskeletal factors play an important role; thus, rehabilitating the pelvic floor and modifying the tone of the pelvic floor muscles (PFMs) may be an effective way to treat this dysfunction. The aim of this randomized controlled clinical study was to evaluate the effects of pelvic floor rehabilitation techniques on dyspareunia. Methods Of 84 women, assessed for eligibility, 64 women with dyspareunia were randomized into two groups: the experimental group (n = 32) received electrotherapy, manual therapy, and PFM exercises and the control group (n = 32) had no treatment while on the waiting list. Evaluations of PFM strength and endurance, sexual function, and pain were made directly before and after 3 months of treatment and at the 3-month follow-up. Results Between-group changes showed significant improvement in the experimental group in comparison with control group. Mean difference in the PFM strength (according to the 0-5 Oxford scale) between groups was 2.01 and the mean difference of endurance was 6.26 s. Also, the mean difference in the Female Sexual Function Index score (the score ranges from 2 to 95) was 51.05, and the mean difference in the VAS score was 7.32. All of the changes were statistically significant (p < 0.05). Conclusions According to the results, pelvic floor rehabilitation is an important part of a multidisciplinary treatment approach to dyspareunia.
[Purpose] This review article is designed to expose physiotherapists to a physiotherapy
assessment of stress urinary incontinence (SUI) and the treatment and possibly preventive
roles that they might play for women with SUI. Specifically, the goal of this article is
to provide an understanding of pelvic floor muscle function and the implications that this
function has for physiotherapy treatment by reviewing articles published in this area.
[Methods] A range of databases was searched to identify articles that address
physiotherapy for SUI, including the Cochrane Library, Medline, and CINAHL. [Results]
According to the articles identified in our databases research, greater improvements in
SUI occur when women receive a supervised exercise program of at least three months. The
effectiveness of physiotherapy treatment is increased if the exercise program is based on
some principles, such as intensity, duration, resembling functional task, and the position
in which the exercise for pelvic floor muscles is performed. Biofeedback and electrical
stimulation may also be clinically useful and acceptable modalities for some women with
SUI. [Conclusion] We concluded that the plan for physiotherapy care should be
individualized for each patient and include standard physiotherapy interventions.
Increased deep flexor endurance and decreased EMG activity of SCM, AS and SC muscles suggest an important role for stabilizing exercises on reducing the activity of superficial muscles in chronic neck pain.
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