Physical therapy treatment of pelvic floor over activity disorders: A systematic review

 Lorin Abdian1, Rachel Kafri2

1 Lorin Abdian, BA student in physical therapy,Ben-Gurion University of the Negev
2 Dr. Kafri, PhD, PT, Physiotherapist for pelvic and pelvic floor rehabilitation. Self-employed

Introduction: Pelvic floor over activity is defined as a state in which the pelvic floor muscles do not relax or may even contract when functional relaxation is necessary. The symptoms include voiding and defecation disorders, pelvic pain and pain during intercourse (dyspareunia). These disorders are very common and may have a negative influence on the health of women, men and children. Physical therapy treatments aim to resolve these disorders in a variety of methods, including manual techniques, exercises, behavioral treatment, biofeedback and electrotherapy. Because there is a wide range of treatments, it is important to test their efficacy for these symptoms.

Objective: This review describe the treatments currently used in the physical therapy field for pelvic floor overactivity syndromes. First, the pathophysiology, etiology and common syndromes will be described, and then the diagnosis and treatment methods currently available in physical therapy will be examined.
Methods: A structured search was conducted using Pubmed, ClinicalKey, Google Scholar and the computerized database of the Ben Gurion University medical library.

Results: Out of 15 clinical trials, 5 examined treatment technique compared to control group, 3 compared between different treatments and 7 examined a single treatment, without any control or comparison. Only 6 of these trials were randomized control trials.

The main treatments examined in these trials were manual therapy, biofeedback, exercises, electrical stimulation, behavioral treatment, and combinations thereof. Only a few trials presented statistically significant results.

Discussion and conclusions: Given the dearth of studies with high-quality methodology, it is difficult to assess the best treatment methods for patients suffering from pelvic floor overactivity. Further high-quality clinical trials are necessary in order to identify the best treatments for these disorders.
Key words: Pelvic floor Hyperactivity, Overactivity, Hypertonicity
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