Diagnosis Dialog for Women's Health Conditions: The Process and Proposed Pelvic Floor Muscle Diagnoses

Spitznagle, Theresa; Cabelka, Christin; Clinton, Susan C.; Abraham, Karen; Norton, Barbara J.

doi:10.1097/jwh.0000000000000086

Cited by 14 publications

(19 citation statements)

References 39 publications

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“…This study is one of the first studies to investigate different aspects of PFM and abdominal muscle function in South African women with POP in order to relate it to a model of motor control, core stability and a biopsychosocial approach within an ICF framework. Considering the complexity of the pathology of PFD and POP and the interaction of contextual factors with body functions and structures (World Health Organisation 2001), a model for physiotherapeutic management of POP has been proposed where the focus should be on the movement impairments underlying and interacting with the symptoms, signs, organ dysfunction, activity limitations and participation restriction (Spitznagle et al 2017; World Health Organisation 2001). However, the focus of this paper was only on the movement impairments of the PFM and abdominal muscles, while it identified and recognised contextual factors that most likely will interact with these movement impairments.…”

Section: Discussionmentioning

confidence: 99%

“…Many women may also have symptoms (such as urinary or faecal incontinence, pelvic pain and sexual dysfunction) for years, leading to adaptation of their lifestyle and physical activities (Wang et al 2012). However, very little is known about the movement impairments and activity restrictions in women with POP in South Africa underlying these adaptations (Spitznagle et al 2017).…”

Section: Introductionmentioning

confidence: 99%

“…The proposal is that diagnosis and treatment of these patients should be guided by a combination of movement-related signs, symptoms, impairments, activity and participation restrictions (International Classification of Function, Disability and Health [ICF] framework). The movement impairment should however provide the basis for diagnosis and treatment (Spitznagle et al 2017).…”

Section: Introductionmentioning

confidence: 99%

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An International Classification of Function, Disability and Health (ICF)-based investigation of movement impairment in women with pelvic organ prolapse

Brandt

Vuuren

2019

South African Journal of Physiotherapy

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Background There is little evidence on movement impairment of the abdominal and pelvic floor muscles (PFM) in women with pelvic organ prolapse (POP). Objectives The aim of this study was to determine the movement impairments and interactions between the PFM and abdominal muscles in POP. Method The PFM and abdominal muscles of 100 conveniently sampled South African women with POP were assessed by ultrasonography, electromyography (EMG), the PERFECT scale, Sahrmann scale and a Pressure Biofeedback Unit (PBU). A demographic questionnaire determined contextual factors (exercise and medical history) and Visual Faces Scale pain intensities. Data were analysed descriptively and with Spearman and Pearson correlation coefficients. Results Participants (59 ± 9.31 years) were mostly unemployed (80%), physically inactive (85%), with comorbidities, heart or vascular disease, hypothyroidism and depression. The mean levator hiatus at rest (56.38 mm, standard deviation [SD] 9.95), thickness (5.1 mm, SD 1.41), amount of movement (4.28 mm, SD 6.84), strength (level 1.89, SD 1.13) and endurance (4.04 s, SD 3.32) of the PFM indicated dysfunction. Median values of zero were found for the Sahrmann scale (interquartile [IQ] range [0–1]) and PBU (IQ range [0–2]) and 10.95 µV for abdominal EMG (IQ range [7.9–17.8]). Pelvic floor muscle strength, endurance, movement and EMG activity correlation was fair ( r > 0.4, p < 0.001), as was PFM strength, endurance and abdominal muscle function ( r > 0.4, p < 0.05). Conclusion Movement impairment of local and global stability and mobility functions of PFM and abdominal muscles was present, as well as correlations between these functions. Addressing these impairments may affect the identified contextual factors (socio-economic, psychological and lifestyle factors) and the possible activity limitations and participation restrictions in patients with POP. Further research is needed to investigate these interactions. Clinical implications The findings suggest that assessment and management of patients with POP might need to be based on a comprehensive neuro-musculoskeletal assessment and a holistic approach. Standardised protocols for patients with pelvic floor dysfunction (PFD) should therefore be used with caution. Randomised controlled trials should investigate patient-specific and holistic intervention approaches.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An International Classification of Function, Disability and Health (ICF)-based investigation of movement impairment in women with pelvic organ prolapse

Brandt

Vuuren

2019

South African Journal of Physiotherapy

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“…Research in the field of pelvic and women’s health physiotherapy originally focused mainly on the biomedical aspects (impairments) of PFD. This phenomenon might partially be explained by the literature emphasising that movement impairment should provide the basis for diagnosis and treatment of dysfunction (Spitznagle et al 2017 ). This statement is correctly based on the signature pedagogy of physiotherapy that is defined as ‘human movement’ (Jensen et al 2017 ).…”

Section: Current Evidence and Research Focus Areas As Related To The Bpsmmentioning

confidence: 99%

“…model of care; PFMs, pelvic floor muscles; PFMT, pelvic floor muscle training. http://www.sajp.co.za Open Accesssymptoms, signs and impairments related to movement, activity and participation restrictions which might require a deeper understanding and investigation within the BPSM(Spitznagle et al 2017).Daluiso-King and Hebron (2020) conducted a concept analysis and expansion on the current BPSM. Their findings propose a holistic framework for musculoskeletal care.…”

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confidence: 99%

Physiotherapy and pelvic floor health within a contemporary biopsychosocial model of care: From research to education and clinical practice

Brandt

2021

South African Journal of Physiotherapy

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Background: Pelvic floor dysfunction (PFD) is a common problem in both men and women. Despite the high prevalence and negative effects on quality of life, there is still a lack of research in this area which translates into clinical practice and education.Objectives: My study discusses how gaps and controversies in current research and evidence on PFD might be addressed by positioning PFD within a contemporary biopsychosocial model of care (BPSM).Method: Various databases were searched for relevant studies published between 2010 and 2020 to support hypotheses and statements.Results: My study focuses on the available evidence of PFD in both men and women as related to the themes and sub-themes of the BPSM, and how this available evidence might translate into education and clinical practice. It highlights areas of research, education and clinical practice that need to be explored and how the different components of healthcare may influence one another.Conclusion: Biomedical aspects regarding pelvic health are mostly investigated and taught, whilst psychological, cognitive, behavioural, social and occupational factors, individualised care, communication and therapeutic alliances are still under-investigated and not integrated or translated at a sufficient level into research, education and clinical practice.Clinical implications: Incorporating the integration of all factors of the BPSM into research is important for effective knowledge translation and enhancement of a de-compartmentalised approach to management. The interaction between the different components of the BPSM should be investigated especially in a South African population.

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Physical Therapy for Women with Obstetric Fistula

Spitznagle

2022

Global Maternal and Child Health

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Diagnosis Dialog for Women's Health Conditions: The Process and Proposed Pelvic Floor Muscle Diagnoses

Cited by 14 publications

References 39 publications

An International Classification of Function, Disability and Health (ICF)-based investigation of movement impairment in women with pelvic organ prolapse

An International Classification of Function, Disability and Health (ICF)-based investigation of movement impairment in women with pelvic organ prolapse

Physiotherapy and pelvic floor health within a contemporary biopsychosocial model of care: From research to education and clinical practice

Physical Therapy for Women with Obstetric Fistula

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