Motor Function and Perception of Health in Women with Provoked Vestibulodynia

Abstract

Background: Provoked vestibulodynia (PVD) is a prevalent and disabling condition in women that may be associated with reduced quality of life and impairment of physical functioning. Aim: To investigate whether women with PVD have different motor functions, posture and breathing patterns, and whether they perceive their physical health differently, compared with asymptomatic controls. Methods and Main Outcome Measure: The Standardized Mensendieck Test (SMT) and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) were used to assess differences between 35 women with PVD and 35 healthy controls. Results: There were no statistically significant differences in any of the 5 motor domains of the SMT between the women with PVD and those without PVD: standing posture, 4.0 (0.6) vs 5.0 (0.6); gait, 4.7 (0.6) vs 4.8 (0.6); movement, 4.8 (0.8) vs 5.1 (0.6); sitting posture, 4.7 (1.0) vs 4.9 (0.8); respiration, 4.7 (1.0) vs 4.7 (0.9). Women with PVD scored significantly lower in all domains on the SF-36 (adjusted Bonferroni P ¼ .002) except physical functioning. Clinical Implications: Given the lack of difference in the SF-36 physical functioning domain and in all 5 domains of the SMT between women with PVD and those without PVD, the value of interventions focusing on general physical function is unclear. Strengths & Limitations: A study strength is the use of an assessor-blinded case-control design, trained physiotherapists to conduct the tests, and valid and reliable outcome measures. A limitation is the homogeneity of the sample of young nulliparous women, which limits the generalizability of our findings to other study populations. Conclusion: Young nulliparous women with PVD did not score differently from a group of healthy controls on assessment of overall physical functioning or on standing posture, gait, movement, sitting posture, and respiration. However, the score for perception of general health was lower in the women with PVD compared with controls. I.

Chronic Vulvar Pain and Health-Related Quality of Life in Women with Vulvodynia

“…On the other hand, years passed since the vulvodynia diagnosis correlated positively with quality of life, but the correlation was significant only in the environmental domain. In the study by Naetss et al [ 58 ], the quality of life of patients with provoked vestibulodynia was compared to a healthy control group using the SF-36 questionnaire. Healthy controls had statistically significantly higher scores in every QOL domain, except the physical functioning and emotional domains, indicating that chronic vulvar pain decreases quality of life.…”

Exclusive manual perineal rehabilitation with lidocaine 2% gel in the treatment of provoked vestibulodynia: results from a single-arm interventional study

“…Recovering the functionality of the pelvic floor, in term of awareness, contraction, relaxation, and normal tone, is one of the most important points of physical treatment. According to other studies [ 35 , 36 ], the present one used both active PFMs contraction and active PFMs relaxation to achieve a reduction in tone and an improvement of the awareness of the pelvic floor [ 35 – 37 ]. Likewise, some authors added the simultaneous intervention of global muscle relaxation and breathing techniques to their studies [ 38 , 39 ].…”

“…Women with PVD show a lower score of perception of general health compared to controls [ 37 ]. Based on the SF-36 results, Naess et al indicated the perceived impact of PVD on these women’s lives in their study [ 37 ].…”

“…Women with PVD show a lower score of perception of general health compared to controls [ 37 ]. Based on the SF-36 results, Naess et al indicated the perceived impact of PVD on these women’s lives in their study [ 37 ]. They highlighted the need to learn techniques to control the fear of pain, decrease the apprehension of a future attempt of vaginal penetration, and manage the pain-coping strategies [ 37 , 40 ], which is a reason for including global relaxation and breathing techniques in the protocol of treatment.…”

“…Based on the SF-36 results, Naess et al indicated the perceived impact of PVD on these women’s lives in their study [ 37 ]. They highlighted the need to learn techniques to control the fear of pain, decrease the apprehension of a future attempt of vaginal penetration, and manage the pain-coping strategies [ 37 , 40 ], which is a reason for including global relaxation and breathing techniques in the protocol of treatment. And because higher rates of sexual dysfunctions have been reported among women with PVD [ 17 ], psychoeducation on sexuality was delivered by the physiotherapist during the sessions.…”