Physiotherapy In Women Research Articles

The importance of physiotherapy in women with osteoporosis: an observational study

Osteoporosis is the most prevalent metabolic bone disease, characterized by a gradual decrease in bone mineral density. The aim of this study was to highlight the importance of physiotherapy in women with osteoporosis in the district of Elbasan, Albania. Data from 90 patients (newly diagnosed and previously diagnosed) during the period 2022-2023 were included in the study. The study population was classified into two groups: patients who received only pharmacological treatment and patients who, in addition to medications, underwent physiotherapy sessions and regular physical activity. The data were obtained from medical records and interviews conducted with patients referred to the rheumatologist at the Polyclinic of Specialties, Regional Hospital “Xhaferr Kongoli” Elbasan, as well as from family doctors in primary health care. The statistical program SPSS (Statistical Package for Social Sciences), version 23, was used to analyze the study data. The questionnaire variables were interpreted using a five-point Likert scale. Correlative statistical relationships were evaluated using Pearson Correlation coefficient and the level of reliability (significance). Functional relationships between variables were presented through the mathematical equations of logistic regression. The population group that engaged in regular physical activity and physiotherapy in addition to pharmacological treatment showed a higher degree of functional improvement in their daily activities. The incorporation of physiotherapy procedures for patients with osteoporosis and the restructuring of medical protocols for the prevention and treatment of this disease are considered successful steps in reducing the human and socio-economic costs and the serious impact of fractures on functional abilities.

Low-Value Practices for Pelvic Floor Dysfunction-Choosing Wisely Recommendations from the Brazilian Association of Physiotherapy in Women's Health: Observational Study.

The Choosing Wisely campaign is an international initiative that is aimed at promoting a dialog between professionals, helping the population to choose an evidence-based, truly necessary and risk-free care. The aim of the study was to develop the Choosing Wisely Brazil list on Women's Health Physiotherapy in the area of the pelvic floor. A observational study was carried out between January 2022 and July 2023, proposed by the Brazilian Association of Physiotherapy in Women's Health, and developed by researchers working in the area of the pelvic floor. The development of the list consisted of six stages: a panel of experts, consensus building, national research, a review by the Choosing Wisely Brazil team, preparation of the list, and publication of the recommendations. Descriptive and content analyses were carried out in order to include evidence-based recommendations with over 80% agreement by physiotherapists in Brazil. The expert panel was made up of 25 physiotherapists who submitted 63 recommendations. Seven physiotherapists/researchers carried out a critical analysis of the literature and refined the recommendations, resulting in 11 recommendations that were put to a national vote, in which 222 physiotherapists took part. After a review by the Choosing Wisely Brazil team, five recommendations with an average agreement of 88.2% agreement were chosen for publication. The Choosing Wisely Brazil team in Physiotherapy in Women's Health/Pelvic Floor proposed a list of five recommendations that showed a high agreement among Brazilian physiotherapists working in the area.

Awareness of Role of Physiotherapy in Women with Hypothyroidism

Background: Hypothyroidism is a common condition among women that interferes with the quality of life due to its various symptoms, which include fatigue, joint and muscle pain, weight gain, and a slowed heart rate. When it comes to treating the symptoms of hypothyroidism, physiotherapy plays a crucial role. The medications for hypothyroidism will work on hormonal imbalance, but Physiotherapy focuses on the management of symptoms such as cramping and weakening in the muscles, shortness of breath, weight gain, numbness and tingling sensation in hands and fingers, and puffy faces seen in hypothyroidism. By focusing on these symptoms, physiotherapy can relieve various symptoms raised due to hypothyroidism and promote a happier, healthier lifestyle. Aim: This study aims to study the awareness of role of Physiotherapy in women with hypothyroidism. Objectives: The objective is to check the awareness level of physiotherapy among women diagnosed with hypothyroidism. Materials and Method: This was an observational study, and 82 participants were included in it. The survey was created using a variety of criteria to determine the overall understanding level. The self-administered questionnaire was prepared and circulated offline to women diagnosed with hypothyroidism depending on inclusion and exclusion criteria. The data was then analysed. Results: The statistical study revealed that women with hypothyroidism are less aware of the significance of Physiotherapy. Conclusion: There is a direct need to take measures to raise awareness of the need for physiotherapy in patients diagnosed with hypothyroidism for the management of complications and symptoms.

Social inequalities in the use of physiotherapy in women diagnosed with breast cancer in Barcelona: DAMA cohort

PurposeThis study aimed to analyze social inequalities in the use and access of physiotherapy service and its clinical and socio-economic determinants in women diagnosed with breast cancer in the hospital network of Barcelona.MethodsData from 2235 women belonging to the mixed (prospective and retrospective) DAMA Cohort were analyzed, including demographic, socio-economic, clinical, and breast cancer treatment outcomes. To determine the influence of such variables on access to physiotherapy, different Poisson regression models with robust variance (obtaining Prevalence Ratios and confidence intervals) were estimated.ResultsAlthough when experiencing different chronic and acute symptoms, only between 20 and 35% of women visited physiotherapist. Two out of 3 women reported to have received insufficient information about medical care and rehabilitation. Age of women, job occupation, education level, having a mutual or private insurance, as well as outcomes related to breast cancer, appear to be factors influencing the access to physiotherapy.ConclusionsSocial and economic inequalities exist on the access to physiotherapy by women diagnosed with breast cancer, which is generally low, and may clearly impact on their functional recovery. Promoting strategies to reduce social bias, as well as improve communication and patient information regarding physiotherapy may be of interest for a better health care in breast cancer diagnosed women.

Physiotherapy practice in women’s health: awareness and attitudes of obstetricians and gynecologists in Ghana

BackgroundPhysiotherapy is relatively well integrated into women’s health in many high-income countries (HICs) as compared to low- and middle- countries (LMICs) like Ghana. Suboptimal integration of physiotherapy in modern obstetrics and gynecology especially in low resource settings is partly due to issues related to the awareness and attitudes of referring physicians. This study assessed the awareness and attitude levels towards physiotherapy in women’s health among obstetricians/gynecologists and factors associated with its utilization in Ghana.MethodsA cross-sectional study was conducted among obstetricians/gynecologists working at a tertiary hospital in Ghana using an “Awareness and Attitude Questionnaire” adapted from a standardized questionnaire. Chi-square test or Fisher exact test was performed and logistic regression was used to assess the association between doctors’ awareness level of physiotherapy’s role in women’s health and years of clinical practice.ResultsSixty-one (61) respondents comprising 7 consultants, 20 senior residents and 34 junior residents, with age median age of 35 years (range: 29–65 years) were recruited. There were more males than females (82% versus 18%) with a mean (SD) duration of practice of (9.41 ± 4.71) years. The participants reported a considerable awareness of physiotherapists’ role in obstetrics (between 72.1% for intrapartum to 91.8% for postnatal) but wide variation in gynecology (from 19.7% in PID to 95. 1% in uterine prolapse). Consultants were more (71.4%) aware of the role of physiotherapy in antenatal care and gynecology while senior residents had more awareness in intrapartum and postnatal care. Junior residents generally showed lowest awareness levels. Duration of clinical practice (≥ 10years) was not significantly associated with doctors’ awareness regarding the importance of physiotherapy in childbirth. There were mixed findings concerning doctors’ attitudes toward physiotherapy: (1) 41% indicated that physiotherapists have been effective in their inter-professional relationship; (2) none of the doctors strongly agreed that physiotherapy may not contribute significantly to the complete well-being of gynecological patients. The main factors influencing utilization of physiotherapy were the perceived notion of non-availability of physiotherapists to cover various wards and physiotherapists not attending ward rounds with doctors to facilitate more education on the scope of physiotherapy practice.ConclusionAlthough obstetricians/gynecologists showed appreciable awareness and attitudes towards physiotherapy, there remains a considerable gap in provider education to ensure optimal utilization of physiotherapy in contemporary obstetrics and gynecology. Further research is recommended to assess implementation challenges associated with regular utilization of physiotherapy services in women’s health in the hospital.

O14 Experiences with pregnancy and pregnancy-related physiotherapy in women with Charcot-Marie-Tooth disease. A qualitative interview study

O14 Experiences with pregnancy and pregnancy-related physiotherapy in women with Charcot-Marie-Tooth disease. A qualitative interview study

Rola i dostępność fizjoterapii w połogu w ocenie kobiet

Rola i dostępność fizjoterapii w połogu w ocenie kobiet

Pelvic physiotherapy in the treatment of urinary incontinence in women from Manaus

Background: Despite the gold standard in the treatment of urinary incontinence (UI) since 2005, specific studies on the population of Manaus, Brazil, are scarce. Aims: To evaluate the effectiveness of Pelvic Physiotherapy in women with UI. Method: Quasiexperimental study in women registered at the Open University Foundation for the Third Age, with complaints of UI, excluding those who missed three or more appointments. Results: A total of 24 women participated in the study with a mean age of 60.41±9.15 years. The most reported type of urinary incontinence was Stress. There was an improvement in symptoms in all participants who lost urine in a stream. More than half (66.66%) reported improvement in symptoms at reassessment. Conclusion: Pelvic Physiotherapy is efficient in the treatment of urinary incontinence in women along with the improvement of symptoms, leading to an improvement in quality of life.

Manual Lymph Drainage With Progressive Arm Exercises for Axillary Web Syndrome After Breast Cancer Surgery: A Randomized Controlled Trial.

This study aimed to determine the effectiveness of a physical therapist-designed program tailored to axillary web syndrome (AWS) in women after breast cancer surgery. A prospective, single-center, assessor-blinded, randomized controlled trial was conducted at the Physiotherapy in Women's Health Research Unit of the Alcalá University (Madrid, Spain). Ninety-six women with AWS were assigned to the physical therapy group (manual lymph drainage [MLD] using resorption strokes and arm exercises as if performing median nerve neurodynamic glide exercises with no neural loading; n = 48) or the control group (standard arm exercises; n = 48), with both groups receiving treatment 3 times a week for 3weeks. Both interventions included an educational component. Compared with the control group, the physical therapy group showed significant and clinically relevant improvements in the primary outcome (self-reported pain intensity) at the primary and 3-month follow-ups. Significant and clinically relevant differences between groups were also found in the secondary outcomes (shoulder active range of motion, shoulder disability, and physical and functional aspects of health-related quality of life) at the primary follow-up and in the secondary outcomes as well as the trial outcome index at the 3-month follow-up. No significant differences were found at the 6-month follow-up in either primary or secondary outcomes. The physical therapy program tailored to AWS was found to be effective for AWS symptoms in women after breast cancer surgery, both immediately after the program and after 3months. To our knowledge, this is the first appropriately designed study to demonstrate the effectiveness of MLD with progressive arm exercises for AWS. Clinicians and health service providers should consider how to provide survivors of breast cancer with AWS the opportunity to participate in physical therapy programs, including MLD with progressive arm exercises. For axillary web syndrome following breast cancer surgery, a physical therapist can design a treatment program including manual lymph drainage and progressive arm exercises, which has been shown to result in reduced pain and improved motion compared with standard arm exercises.

Fisioterapia em obstetrícia pelos olhos das gestantes: um estudo qualitativo

Abstract Introduction: Physiotherapy in women's health emerged with the aim of promoting and maintaining physical and emotional health from the beginning to the end of pregnancy, through preventive measures against possible injuries that may occur during pregnancy, childbirth and the postpartum. Access to knowledge about obstetric physiotherapy among pregnant women is increasing, which may contribute to a search for trained professionals. Objective: To analyze the perception of pregnant women about obstetric physiotherapy. Methods: This is a qualitative study carried out at the Materno Infantil Center, in Capanema, Parana state (PR), using a semistructured interview. Content analysis used the Bardin method to categorize the thematic axes. Results: Seven pregnant women aged between 18-24 years (57%), 23-32 weeks of gestation (42%), multiparous (71%), with secondary education (42%) and income between 1-3 monthly minimum wages (86 %) were included in the study. It was found that participants’ perception of physiotherapy was inaccurate, because none of the women had accessed this treatment. The women stated that physiotherapists reduce labor pain, but they have no knowledge of how these professionals work in the postpartum. Conclusion: It is concluded that it is necessary to increase information on the contribution of physiotherapists during prenatal care, delivery and postpartum.

ROTINAS DE UM SERVIÇO DE FISIOTERAPIA EM SAÚDE DA MULHER EM UM CENTRO OBSTÉTRICO

Over the past 20-30 years, greater emphasis has been placed on promoting and rescuing the natural and physiological characteristics of delivery and birth. In this context, assistance based on the biomechanics and physiology of childbirth through the Physiotherapist in Women\’s Health approach complements the parturient\’s global and humanized care. The purpose of this article is to show what the literature recommends in physiotherapeutic care for parturient women and to publicize the behaviors employed in the assistance group of Physiotherapy in Women\’s Health within the Pre-Childbirth and Childbirth Rooms of a maternity hospital. The target population is composed of pregnant women of habitual risk, with gestational age between 37 and 42 weeks, in active phase of labor, with fetus in cephalic presentation and with normal heartbeat frequency. Within the routine of the service, the physiotherapist performs the evaluation and reassessment, gives guidance, encourages walking and free movement, performs kinesiotherapy during labor with or without facilitators (gym ball, balance disc and others) and non-pharmacological methods (transcutaneous electrical nerve stimulation – TENS, warm bath, massage therapy, breathing and relaxation exercises, thermotherapy and positioning during labor and delivery).

Postoperative Physiotherapy in Women Undergoing Pelvic Floor Reconstructive Surgery: A Randomized Controlled Clinical Trial.

Purpose: Postoperative physiotherapy in conjunction with pelvic organ prolapse (POP) surgery is still under-investigated and controversial. In this randomized controlled trial, pelvic floor muscle training (PFMT) and abdominal training were compared with a control condition (standard in-hospital treatment). Method: Eighty-one women were randomized to one of three groups. The Prolapse Quality of Life questionnaire, two-dimensional ultrasound, Pelvic Organ Prolapse Quantification System scale, the PERFECT (power, endurance, repetitions, fast contractions, every contraction timed) scheme, electromyography, Sahrmann scale, and pressure biofeedback unit (PBU) were used to measure quality of life (QOL), POP, and pelvic floor and abdominal muscle function. A mixed-model analysis of variance and the Kruskal-Wallis test was used for analysis. Results: Beneficial effects (p<0.05) were found for the PFMT group - increased power, number of fast contractions, amount of movement, endurance, and Sahrmann and PBU measures - compared with the control group. Abdominal training led to a significant (p<0.05) increase in bulging and discomfort, number of pelvic floor muscle contractions, and Sahrmann and PBU measures compared with the control condition; both groups showed significantly increased urinary frequency (p<0.05). Conclusions: Postoperative physiotherapy did not have a beneficial effect on QOL or POP symptoms. PFMT and abdominal training had beneficial effects on pelvic floor muscle function and abdominal muscle measures. Additional abdominal training led to increased symptoms.

Fractional CO 2 Laser Versus Urogynecological Physiotherapy in Women With Stress Urinary Incontinence: Study Protocol for a Randomized Clinical Trial

Background: Stress urinary incontinence (SUI) is recognized as an involuntary loss of urine during physical exertion or a sudden increase in intra-abdominal pressure, such as sneezing and coughing. It is a condition that affects 15% to 30% of women and can negatively impact quality of life, including professional, social, psychological and sexual aspects. Although surgical treatment is considered the gold standard for SUI, it is necessary to offer non-invasive treatments for women with this condition. Pelvic floor muscle training (PFMT) is a physiotherapy modality with proven effectiveness for SUI. The carbon dioxide (CO 2 ) laser is a new tool that has been offered to women with urogenital atrophy, but its effectiveness for SUI is not yet known. We present a study protocol for a prospective non-inferiority randomized clinical trial, comparing the efficacy and safety of CO 2 laser versus physiotherapy for treatment in women with SUI. Methods: Participants recruited for this study (n = 94) will be randomly assigned to two groups. The laser group will receive three vaginal CO 2 laser applications at monthly intervals. The physiotherapy group will undergo 12 weeks of PFMT, twice a week. The impact on SUI, colorectal-anal, pelvic organ prolapse and sexual function will be assessed using validated questionnaires. The response rate to interventions will also be measured. Patients will be assessed at baseline, 3 and 6 months after the intervention. As this is a study protocol, the study is ongoing with an expected end of recruitment and analysis date of 2022. Discussion: The results of this trial will make it possible to evaluate the efficacy and safety of a non-invasive method for the treatment of women with SUI, and offer it as a conservative alternative and a potential option for doctors before making the surgical decision. To date, such evaluation has not been performed, and this intervention we will evaluate is the impact of laser therapy on SUI, quality of life, and sexual dysfunction. J Clin Gynecol Obstet. 2021;10(1):4-10 doi: https://doi.org/10.14740/jcgo713

Fractional Co2 Laser Versus Urogynecological Physiotherapy in Women With Stress Urinary Incontinence: Study Protocol for a Randomized Clinical Trial

Fractional Co₂ Laser Versus Urogynecological Physiotherapy in Women With Stress Urinary Incontinence: Study Protocol for a Randomized Clinical Trial

A guide to physiotherapy in urogynecology for patient care during the COVID-19 pandemic.

Introduction and aimPhysiotherapy in urogynecology faces challenges to safely continuing its work, considering the adoption of social distancing measures during the COVID-19 pandemic. Some guidelines have already been published for urogynecology; however, no specific documents have been produced on physiotherapy in urogynecology. This article aimed to offer guidance regarding physiotherapy in urogynecology during the COVID-19 pandemic.MethodsA group of experts in physiotherapy in women’s health performed a literature search in the Pubmed, PEDro, Web of Science and Embase databases and proposed a clinical guideline for physiotherapy management of urogynecological disorders during the COVID-19 pandemic. This document was reviewed by other physiotherapists and a multidisciplinary panel, which analyzed the suggested topics and reached consensus. The recommendations were grouped according to their similarities and allocated into categories.ResultsFour categories of recommendations (ethics and regulation issues, assessment of pelvic floor muscle function and dysfunction, health education and return to in-person care) were proposed. Telephysiotherapy and situations that need in-person care were also discussed. Regionalization is another topic that was considered.ConclusionThis study provides some guidance for continuity of the physiotherapist's work in urogynecology during the COVID-19 pandemic, considering the World Health Organization recommendations and the epidemiological public health situation of each region. Telephysiotherapy can also be used to provide continuity of the care in this area during the COVID-19 pandemic, opening new perspectives for physiotherapy in urogynecology.

PERCEPÇÃO DISCENTE FRENTE À ESTRATÉGIA DE TELEMONITORAMENTO EM TEMPOS DE PANDEMIA, 2020

A partir do cenário de isolamento social pela pandemia do coronavírus, as universidades começaram a adotar estratégicas diferentes. O estudo objetivou relatar a experiência de discentes de graduação em fisioterapia com uma nova estratégia de atendimento. Trata-se de um trabalho descritivo, tipo relato de experiência, referente ao telemonitoramento em fisioterapia na saúde da mulher, por extensão universitária. Participaram 5 discentes, 2 docentes, atendendo 6 mulheres com disfunções uroginecológicas e funcionais. Ocorreu via chamadas de vídeos em tempo real, por aplicativo de comunicação virtual, durante 1 mês, 1 sessão por semana. A estratégia fortaleceu vínculos entre comunidade, discentes e docentes, enriqueceu os estudantes tanto no âmbito profissional de forma prática, como na produção de conteúdos teóricos, além de beneficiar mulheres com a continuidade do cuidado.&#x0D; Palavras-chaves: Coronavirus. Universidades. Estudantes.&#x0D;

Physiotherapy in women after breast cancer treatment – review

&lt;br/&gt;&lt;b&gt;Introduction:&lt;/b&gt; Breast cancer is the most common malignant tumor in women in the Polish region. Surgery is a basic method of breast cancer treatment. Surgery often carries a lot of unwanted changes as follows: limitation of mobility in the shoulder joint on the operated side, secondary lymphoedema, post mastectomy pain syndrome (PMPS), reduction of muscle strength or disorders in body posture. Therefore, the implementation of physiotherapeutic activities that are designed to prevent and eliminate postoperative complications seems very important. The main aim of this work was to present physiotherapeutic management in women after mastectomy based on the analysis of available literature. The physiotherapeutic process can be divided into three periods: early hospital, early ambulatory and the late ambulatory period. In the first period, active slow exercises, self-support of the upper limb on the operated side and breathing exercises on the thoracic track are used to prevent circulatory disorders, pulmonary complications, and edema. The early ambulatory period includes corrective exercises, general improvement exercises, stretching and learning of automatic massage of the upper limb of the operated side. The last period should be enriched by recreational methods of physical activity such as swimming, cycling or Nordic walking to maintain physical fitness, proper mobility of the shoulder girdle and improve the patient's psychophysical state. It is very important the patient regular continues the rehabilitation program after curing of breast cancer as well. In the case of secondary lymphoedema of the upper limb, comprehensive rehabilitation physiotherapy is used, consisting of manual lymphatic drainage, healing exercises, compression therapy, and skin care. &lt;br/&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Physiotherapy in women after breast cancer surgery is a complex and long-term process. Physiotherapeutic methods are effective in treating complications after surgery of breast cancer surgery. It is necessary to constantly update the physio-therapy knowledge in women after breast cancer surgery.

Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study

ObjectivesTo develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy.DesignLongitudinal cohort study based on data...

Postępowanie fizjoterapeutyczne u kobiet z rozstępem mięśni prostych brzucha

Postępowanie fizjoterapeutyczne u kobiet z rozstępem mięśni prostych brzucha

The beneficial effects of rehabilitation on hand function in patients with rheumatoid arthritis.

ObjectivesThe hand is one of the main elements of the rehabilitation of patients with rheumatoid arthritis (RA) due to deformities, which occur in approximately 90% of patients. It is a serious problem, both in the psychological and functional aspect, connected with muscle strength reduction, a limited range of motion and non-acceptance of the changes in the shape of the limb. The study aimed to assess the effect of rehabilitation on the function of the hand in rheumatoid arthritis.Material and methodsThe study group consisted of 40 women with RA. The patients had been previously treated at the Rehabilitation Department of the National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw. The study group underwent 3 weeks of rehabilitation involving individual therapy, exercises with equipment, patient education and physical therapy. The control group included women without a diagnosis of RA, hands pain-free and fully mobile. In both groups the hand was assessed for grip value, grip quality and manipulative ability. In the study group the basis of pain intensity was noted. The measurements were performed twice – prior to the rehabilitation and after 3 weeks of rehabilitation in women with RA and once in women without hand problems.ResultsThe results obtained revealed marked limitation of hand function in patients with rheumatoid arthritis. The treatment resulted in an improvement of all assessed parameters except cylindrical grip, in which only a part of the findings was statistically significant.ConclusionsThe analysis of the study material showed that appropriately adjusted and conducted hand physiotherapy in women with rheumatoid arthritis contributed to the improvement of its function by pain reduction, improved value and quality of grip, and also increased manipulative ability.