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

Corlia Brandt

doi:10.4102/sajp.v77i1.1538

Abstract

BackgroundPelvic 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.ObjectivesMy 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).MethodVarious databases were searched for relevant studies published between 2010 and 2020 to support hypotheses and statements.ResultsMy 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.ConclusionBiomedical 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 implicationsIncorporating 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.

Highlights

Pelvic floor dysfunction (PFD) is a common problem experienced in both men and women
Following a biopsychosocial approach and taking into account the creation of an optimal learning environment emphasise the need to determine and understand all aspects of the biopsychosocial model (BPSM) to compile an individualised training programme for the patient. The latter plan of care optimises patient adherence but at the same time demonstrates the complexity of clinician and patient interaction and communication to lead to effective treatment (Kurtz et al 2003). Research reviewed in this manuscript, as related to the contemporary BPSM and PFD in men and women, has mainly focused on the investigation of biomedical aspects
Evidence exists on the beneficial effects of pelvic http://www.sajp.co.za floor muscles training (PFMT) for PFD such as incontinence, pelvic organ prolapse (POP) and sexual dysfunction

Summary

Introduction

Pelvic floor dysfunction (PFD) is a common problem experienced in both men and women. It includes problems such as urinary and faecal incontinence, pelvic pain, constipation, sexual dysfunction and pelvic organ prolapse – and the disorders often coexist (Bo 2012). Despite the high prevalence of PFD, there is still a lack of research in this area and a lack of evidence regarding the most optimal management of many of these conditions. Healthcare and research, including the management of pelvic dysfunction, were originally based on a biomedical approach which focused only on biological factors, such as weak pelvic floor muscles (PFMs) in the case of PFD. 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

Methods

Conclusion