Assessment and Alleviation of Lumbopelvic Pain and Pelvic Floor Dysfunction
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 10, Issue 4
Abstract
Because of the time- and labor-intensive nature of the proposed study, a 5-week pilot test consisting of 10 subjects was implemented to determine if protocol modifications were necessary and if the full 60-subject study was warranted. Low back pain (LBP) is a condition of localized pain to the lumbar spine whose etiology is commonly unknown [1]. Pelvic floor disorders (PFD) occur when the muscles that comprise the pelvic floor fail to properly contract. This can cause urinary incontinence, pelvic organ prolapse, fecal incontinence, or other sensory and emptying abnormalities of the lower urinary and GI tracts [2]. Current evidence shows that individuals with low back pain have a significant decrease in pelvic floor function compared to individuals without LBP [3]. Over 25% of all women and more than a third over the age of 65 experience PFD. Even though it is a physiological problem, the psychosocial impact of PFD can be much more detrimental to the patient's quality of life. Over the next 30 years chronic health problems associated with PFD are projected to increase by 50% due to the increasing numbers of women reaching age 65 [4]. PFD does not typically have one specific cause. Pregnancy/childbirth, age, hormonal changes, obesity, lower UTI, and pelvic surgery are major risk factors. Additionally, anatomical, physiological, genetic, reproductive and lifestyle components are probably PFD developmental influences [1,4]. The pelvic floor forms the inferior border of the abdomino- pelvic cavity [4]. It supports the abdomino-pelvic organs. The pelvic floor muscles (PFM) function as a unit instead of individually contracting. They play an important role in maintaining and increasing intra-abdominal pressure during functional tasks such as lifting, sneezing, coughing, and laughing to prevent urinary and fecal incontinence [3,5]. Men can also have disorders of the pelvic floor, however due the anatomy of the male pelvis, it is less common [6]. Current evidence supports exercise protocol with the common goal of regaining neuromuscular control of the pelvic floor and deep abdominal muscles in a functional matter [7]. There is also strong evidence for PFM training as conservative treatment for stress urinary incontinence [5,8]. Treatment should also include education on healthy lifestyle habits to promote optimal functioning of the lumbopelvic stability system. Examples of these habits include good posture, maintenance of a healthy body weight, proper diet, routine exercise, and refraining from smoking [6]. This purpose of this study was to evaluate whether the implementation of lifestyle modifications as well as a specialized exercise program would improve the symptoms of pelvic floor dysfunction and mild pelvic organ prolapse in women. These symptoms include low back pain, hip pain, pelvic pressure, pelvic pain with intimacy and/or the use of tampons, bladder and/or bowel leakage with laughing, coughing, sneezing, jumping, bladder and/or bowel urgency and frequency. The research addressed whether the interventions proposed lead to improvements in pain levels and quality of life. The study evaluated the severity of the participants' symptoms pre and post intervention (Table 1).
Authors and Affiliations
Bonis M, Lormand J, Walsh C
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