Evidence-Based Physical Therapy for the Pelvic Floor

Siv Mørkved, Kari Bø, Marijke Van Kampen, Bary Berghmans

Description

Bridging the gap between evidence-based research and clinical practice, Physical Therapy for the Pelvic Floor has become an invaluable resource to practitioners treating patients with disorders of the pelvic floor. The second edition is now presented in a full colour, hardback format, encompassing the wealth of new research in this area which has emerged in recent years.

Kari Bø and her team focus on the evidence, from basic studies (theories or rationales for treatment) and RCTs (appraisal of effectiveness) to the implications of these for clinical practice, while also covering pelvic floor dysfunction in specific groups, including men, children, elite athletes, the elderly, pregnant women and those with neurological diseases. Crucially, recommendations on how to start, continue and progress treatment are also given with detailed treatment strategies around pelvic floor muscle training, biofeedback and electrical stimulation.

• aligns scientific research with clinical practice
• detailed treatment strategies
• innovative practice guidelines supported by a sound evidence base
• colour illustrations of pelvic floor anatomy and related neuroanatomy/ neurophysiology
• MRIs and ultrasounds showing normal and dysfunctional pelvic floor

• incorporates vital new research and material
• uses key summary boxes throughout new edition to highlight quick reference points
• now in full colour throughout and a hardback format

Sujets

• Physical Therapy
• Allied Health Services
• Medical
• Médecine

Informations

• Publié par: Churchill Livingstone
• Date de parution: 04 novembre 2014
• Nombre de lectures: 0
• EAN13: 9780702060731
• Langue: English
• Poids de l'ouvrage: 6 Mo

Extrait

Evidence-Based Physical Therapy for the Pelvic Floor
Bridging Science and Clinical Practice
Second Edition
Kari Bø, PT, MSc, PhD
Professor, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
Bary Berghmans, PT, MSc, PhD
Health Scientist and Clinical Epidemiologist, Pelvic Care Centre Maastricht, Maastricht University Medical Center+, Maastricht, The Netherlands
Siv Mørkved, PT, MSc, PhD
Professor, Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
Marijke Van Kampen, PT, MSc, PhD
Professor, KU Leuven, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven, Belgium

Forewords by
Robert Freeman, MD, FRCOG
Consultant in Urogynaecology, Plymouth Hospitals NHS Trust, UK; Honorary Professor, Plymouth University Peninsula Schools of Medicine and Dentistry, UK; President, International Urogynecological Association
Christopher Chapple, BSc, MD, FRCS (Urol), FEBU
Consultant Urological Surgeon, Royal Hallamshire Hospital, Sheffield, UK; Honorary Professor of Urology, University of Sheffield, UK; Visiting Professor of Urology, Sheffield Hallam University, UK; Secretary General Elect, European Association of Urology
Table of Contents
Cover image
Title page
Copyright
Contributors
Foreword
Foreword
Preface
Chapter 1: Overview of physical therapy for pelvic floor dysfunction
Pelvic floor dysfunction
Physical therapy for the pelvic floor
Role of the physical therapist in pelvic floor dysfunction
Chapter 2: Critical appraisal of randomized trials and systematic reviews of the effects of physical therapy interventions for the pelvic floor
Randomized trials and systematic reviews
Separating the wheat from the chaff: detecting bias in trials and reviews
Assessing relevance of trials and systematic reviews
Using estimates of effects of intervention to make decisions about intervention
Chapter 3: Functional anatomy of the female pelvic floor
Acknowledgement
Introduction
How is urinary continence maintained?
The Urinary Sphincteric Closure System
Clinical Correlates of Urethral Anatomy and Effects of Aging
Urethral (And Anterior Vaginal Wall) Support System
Pelvic Floor Function Relevant to Stress Urinary Incontinence
Urethrovesical Pressure Dynamics
Clinical Implications of Levator Functional Anatomy
Anatomy of the Posterior Vaginal Wall Support as it Applies to Rectocele
Chapter 4: Neuroanatomy and neurophysiology of pelvic floor muscles
Introduction
Innervation of pelvic floor muscles
Neural control of sacral functions
Neurophysiology of pelvic floor muscles
Awareness of muscle
Neuromuscular injury to the pelvic floor due to vaginal delivery
Conclusion
Chapter 5: Measurement of pelvic floor muscle function and strength, and pelvic organ prolapse
5.1 Introduction
Acknowledgement
Classification and definitions
5.2 Visual observation and palpation
Visual observation
Clinical recommendations
Vaginal palpation
Clinical recommendations
5.3 Electromyography
Introduction
Muscle fibre, motor unit, muscle
Kinesiological EMG
EMG methods to differentiate normal from pathological muscle
Usefulness of EMG in clinical practice and research
Use of kinesiological EMG and CN EMG in particular patient groups
Clinical recommendations
5.4 Vaginal squeeze pressure measurement
Responsiveness
Intra- and inter-tester reliability
Validity
Placement of the device
Size and shapes of the device
Influence from increased abdominal pressure
Sensitivity and specificity
Conclusion
Clinical recommendations
5.5 Pelvic floor dynamometry
Introduction
In vitro Calibration studies
Test–retest reliability studies
Acceptance
Validity studies
Conclusion
Clinical recommendations (based on the Montreal dynamometer)
5.6 Urethral pressure measurements
Definitions
Methods of measuring urethral pressure profilometry
Factors affecting maximum urethral closure pressures
Standardization of urethral pressure measurements
Normal urethral pressure profiles
Resting urethral pressure profiles
Stress urethral pressure profiles
Urethral reflectometry
Conclusion
Clinical recommendations
5.7 Ultrasound in the assessment of PFM and pelvic organ descent
Introduction
Technique
Bladder neck position and mobility
Levator activity
Prolapse quantification
3D/4D Pelvic floor imaging
Clinical research using 3D/4D pelvic floor ultrasound
Outlook
Conclusions
Clinical recommendations
5.8 MRI of intact and injured female pelvic floor muscles
Introduction
Mri anatomy of the normal levator ani muscle structure
Mri appearance of the levator ani muscles
Birth is a major event causing pelvic floor dysfunction
What are the clinical implications of levator ani muscle injury?
Issues in rehabilitation
Chapter 6: Pelvic floor and exercise science
6.1 Motor learning
Ability to contract the pelvic floor muscles
Practical teaching of correct PFM contraction
6.2 Strength training
Introduction to the concept of strength training for pelvic floor muscles
Terminology and definitions
Determinants of muscle strength
Dose–response issues
How to increase muscle strength and underlying components
Recommendation for effective training dosage for pelvic floor muscle training
Clinical recommendations
Chapter 7: Female pelvic floor dysfunctions and evidence-based physical therapy
7.1 Female stress urinary incontinence
Prevalence, causes and pathophysiology
Prevalence of SUI
Causes and pathophysiology of SUI
Conclusion
Lifestyle interventions
Modifiable factors associated with urinary incontinence
Evidence to support the impact of lifestyle changes on symptoms of pelvic floor dysfunction
Motivating lifestyle changes
How might lifestyle changes be encouraged in clinical practice?
Is there evidence of the use of behaviour models within continence promotion?
Clinical recommendations
Bladder training
Introduction
Bladder training protocols
Prevention
Treatment
Conclusion
Clinical recommendations
Pelvic floor muscle training for SUI
Introduction
Rationale for PFMT for SUI
Methods
Evidence for PFMT to treat SUI
Conclusion
Clinical recommendations
Electrical stimulation for SUI
Introduction
Methods
Evidence for electrical stimulation to treat SUI symptoms
Conclusion
Clinical recommendations
7.2 Female overactive bladder
Pelvic floor muscle training for overactive bladder
Introduction
Rationale for effect of PFMT for OAB
Methods
Evidence for PFMT to treat OAB symptoms
Conclusion
Clinical recommendations
Electrical stimulation for overactive bladder
Introduction
Rationale for electrical stimulation for OAB
Evidence for electrical stimulation to treat OAB (symptoms)
Conclusion
Clinical recommendations
7.3 Urinary incontinence related to the peripartum period
Introduction
Research methods
Results
Discussion
Conclusion
Acknowledgment
7.4 Pelvic organ prolapse
Clinical assessment of pelvic organ prolapse
Background
History
Questionnaires
Physical examination
Conclusion
Use of pessaries to prevent and treat pelvic organ prolapse
Introduction
Evidence for the use of pessaries to manage POP
Rationale for the role of PTs in pessary fitting
Clinical recommendations
Pelvic floor muscle training in prevention and treatment of pelvic organ prolapse
Introduction
Rationale for PFMT in prevention and treatment of POP
Evidence for PFMT in the prevention and treatment of POP
Conclusion
Clinical recommendations
7.5 Female sexual dysfunction
Assessment
Introduction
The complexity of women’s sexuality
Classification of FSD
Women’s sexual desire/interest disorder
Arousal disorders
Orgasmic disorders
Sexual pain disorders
Ethical, legal and counselling related considerations
Conclusion
Treatment
Introduction
Diagnostic key points
Principles of FSD therapy
When the physical therapist counts
Conclusion
Chapter 8: Male pelvic floor dysfunctions and evidence-based physical therapy
8.1 Urinary incontinence and other lower urinary tract symptoms
Introduction
Postprostatectomy incontinence
Evidence for effect of PFMT in prevention and treatment of urinary incontinence
Summary and clinical recommendations
Terminal and post-void dribble
Evidence for effect of PFMT for treatment of post-micturition dribble
Summary and clinical recommendations
Conclusion
8.2 Male sexual dysfunction
Classification, prevalence and pathophysiology of male sexual dysfunction and role of the PFM
Evidence for the role of physi