Predictors of Pelvic Floor Muscle Dysfunction Among Women With Lumbopelvic Pain.
Adult
Catastrophization
/ complications
Confidence Intervals
Cross-Sectional Studies
Female
Humans
Low Back Pain
/ physiopathology
Middle Aged
Muscle Weakness
/ diagnosis
Muscle, Skeletal
/ physiopathology
Odds Ratio
Pain Measurement
/ methods
Palpation
Pelvic Floor
/ physiopathology
Pelvic Pain
/ physiopathology
Self Report
Urinary Bladder, Overactive
Journal
Physical therapy
ISSN: 1538-6724
Titre abrégé: Phys Ther
Pays: United States
ID NLM: 0022623
Informations de publication
Date de publication:
16 12 2019
16 12 2019
Historique:
received:
02
09
2019
accepted:
25
03
2019
pubmed:
11
9
2019
medline:
20
3
2020
entrez:
11
9
2019
Statut:
ppublish
Résumé
There is evidence to suggest that a large proportion of individuals seeking care for lumbopelvic pain also have pelvic floor muscle dysfunction (PFMD). Because the majority of physical therapists do not have the requisite training to adequately assess pelvic floor musculature, determining predictors of PFMD could be clinically useful. The objective was to establish a combination of factors (self-report and physical) predictive of PFMD in women with lumbopelvic pain. This was a cross-sectional study. Participants completed a battery of self-report and physical assessments (masked assessors). Three clinical findings characterized PFMD: weakness of the pelvic floor, lack of coordination of the pelvic floor, and pelvic floor muscle tenderness on palpation (bilateral obturator internus). Univariate and multivariate logistic regression analyses were used to determine the extent to which different predictors were associated with PFMD. One hundred eight women with self-reported lumbopelvic pain (within the past week) were included in the study (mean age = 40.4 years; SD = 12.6 years). None of the examined factors predicted pelvic floor muscle weakness. Two factors independently predicted pelvic floor muscle tenderness on palpation: very strong and/or uncontrollable urinary urges (odds ratio [OR] = 2.93; 95% confidence interval [CI] = 1.13-7.59) and Central Sensitization Inventory scores of 40 or greater (OR = 3.13; 95% CI = 1.08-9.10). The sample consisted of young women, some of whom were not actively seeking care. Additionally, the technique for assessing pelvic floor muscle tenderness on palpation requires further validation. Women who have lumbopelvic pain, uncontrollable urinary urgency, and central sensitization were, on average, 2 times more likely to test positive for pelvic floor muscle tenderness on palpation. Further studies are needed to validate and extend these findings.
Sections du résumé
BACKGROUND
There is evidence to suggest that a large proportion of individuals seeking care for lumbopelvic pain also have pelvic floor muscle dysfunction (PFMD). Because the majority of physical therapists do not have the requisite training to adequately assess pelvic floor musculature, determining predictors of PFMD could be clinically useful.
OBJECTIVE
The objective was to establish a combination of factors (self-report and physical) predictive of PFMD in women with lumbopelvic pain.
DESIGN
This was a cross-sectional study.
METHODS
Participants completed a battery of self-report and physical assessments (masked assessors). Three clinical findings characterized PFMD: weakness of the pelvic floor, lack of coordination of the pelvic floor, and pelvic floor muscle tenderness on palpation (bilateral obturator internus). Univariate and multivariate logistic regression analyses were used to determine the extent to which different predictors were associated with PFMD.
RESULTS
One hundred eight women with self-reported lumbopelvic pain (within the past week) were included in the study (mean age = 40.4 years; SD = 12.6 years). None of the examined factors predicted pelvic floor muscle weakness. Two factors independently predicted pelvic floor muscle tenderness on palpation: very strong and/or uncontrollable urinary urges (odds ratio [OR] = 2.93; 95% confidence interval [CI] = 1.13-7.59) and Central Sensitization Inventory scores of 40 or greater (OR = 3.13; 95% CI = 1.08-9.10).
LIMITATIONS
The sample consisted of young women, some of whom were not actively seeking care. Additionally, the technique for assessing pelvic floor muscle tenderness on palpation requires further validation.
CONCLUSIONS
Women who have lumbopelvic pain, uncontrollable urinary urgency, and central sensitization were, on average, 2 times more likely to test positive for pelvic floor muscle tenderness on palpation. Further studies are needed to validate and extend these findings.
Identifiants
pubmed: 31504926
pii: 5558224
doi: 10.1093/ptj/pzz124
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1703-1711Informations de copyright
© 2019 American Physical Therapy Association.