Alappattu Meryl, Hilton Sandra, Bishop Mark
Department of Physical Therapy, University of Florida, Gainesville.
Entropy Physiotherapy, Chicago, Illinois.
J Womens Health Phys Therap. 2019 Apr-Jun;43(2):82-88. doi: 10.1097/jwh.0000000000000131.
Pelvic pain (PP) is a debilitating condition that is challenging to manage. Despite differences in suspected etiologies of different PP conditions, common clinical signs and symptoms make it appropriate to group these diagnoses. The presence of neuro-musculoskeletal impairments in PP suggests that physical therapists are ideally situated to be included as part of the health care team managing this condition; however, little information is available to guide physical therapist management of PP.
As a first step to developing management guidelines, we sought to determine common interventions currently used by physical therapists to manage PP.
Descriptive survey.
A modified Delphi approach was used to identify broad categories of interventions that were then used to build a survey. Purposeful selection with snowball recruiting methods was used to collect responses from practitioners. Frequency data were collected for survey responses. Chi-square analysis determined associations among responses based on practitioner training.
A total of 984 responses from 17 different countries were analyzed. The primary responses were from physical therapists in the USA and Canada. The majority of respondents were board-certified clinical specialists. More than 80% of physical therapist respondents indicated that they "frequently used" education, exercise, and manual therapy for patients with PP. The most common interventions considered effective but not frequently used were cognitive-behavioral therapy, dry needling, acupuncture, topical medications, and internal pelvic manual therapy techniques. Geographical differences in patterns of usespecific manual therapy and exercise interventions were noted. Differences were also noted on the basis of the levels of advanced postprofessional training.
Physical therapists routinely use education, manual therapy, and exercise to manage pelvic pain conditions.
盆腔疼痛（PP）是一种使人衰弱的病症，其治疗颇具挑战性。尽管不同PP病症的疑似病因存在差异，但常见的临床体征和症状使得对这些诊断进行归类是合理的。PP中存在神经肌肉骨骼损伤，这表明物理治疗师作为管理该病症的医疗团队的一部分，处于理想的位置；然而，几乎没有信息可指导物理治疗师对PP的管理。
作为制定管理指南的第一步，我们试图确定物理治疗师目前用于管理PP的常见干预措施。
描述性调查。
采用改良的德尔菲法确定广泛的干预类别，然后用于构建调查。采用有目的选择和滚雪球招募方法收集从业者的回复。收集调查回复的频率数据。卡方分析确定基于从业者培训的回复之间的关联。
共分析了来自17个不同国家的984份回复。主要回复来自美国和加拿大的物理治疗师。大多数受访者是获得委员会认证的临床专家。超过80%的物理治疗师受访者表示，他们“经常使用”教育、运动和手法治疗来治疗PP患者。最常见的被认为有效但不常使用的干预措施是认知行为疗法、干针疗法、针灸、局部用药和盆腔内部手法治疗技术。注意到在特定手法治疗和运动干预使用模式上的地理差异。在高级专业后培训水平的基础上也注意到了差异。
物理治疗师常规使用教育、手法治疗和运动来管理盆腔疼痛病症。
