The results concluded in this review are important to both the field of physiotherapy and patients. PFMT is an exercise method that many physiotherapists are familiar with, which can be used and instructed in order to help and improve QoL for many women.
PFMT is a training intervention used by many physiotherapists for varying conditions – from lower back pain to urine incontinence. The review strengthens the evidence for PFMT and adds POP to the list of conditions that can be treated through this intervention.
Not all physiotherapists are specialized in women’s health, but can often come across POP patients within the healthcare system. Midwifes on the other hand work with women’s health daily but may lack the adequate knowledge when it comes to rehabilitative training. Cross-disciplinary cooperation between physiotherapists and midwifes can increase the ability to reach patients in need for help and treatment.
One of the main reasons to invest more time on research for POP treatment is that POP affects many women (15). It can lead to difficulties performing activities such as heavy lifting during daily duties. On top of this, POP is often attached to stigma and decreased levels of physical activity, which can lead to decreased QoL and health (2). Typically people who are the most exposed to this come from groups with low socioeconomic status. Women constitute a large portion of the population in these groups (27). Having access to healthcare facilities that offer adequate care can be a luxury. SIM with PFMT programs can be used to reach and safely treat many suffering women without the presence of a clinician (21). By making PFMT accessible to women worldwide and improving their health, health gaps may decrease.
We believe future studies need to include a wider demographic selection (e.g. varying socioeconomic and ethnic backgrounds), extended study time and standardized methods for collecting data. They should compare different treatments – both conservative and surgical. Furthermore, from the perspective of physiotherapy, including level of physical activity at baseline and throughout the study period could be interesting in order to investigate the relationship between physical activity and pelvic floor hyper- or hypotrophy. It can give clues to the correlation between the two factors. Finally, we believe that QoL should be considered and discussed in future studies. QoL gains as a result of treatment alongside cost-effectiveness may be important motivators for clinicians when choosing treatment.
Based on data from existing research, this review concludes that PFMT was an effective method when treating and managing POP. However, it could draw no conclusions with regards to prevention or compare mainstream recommendations and PFMT programs due to lacking research.
To make an appointment with Anna Wallin specialist in women’s health please call the clinic on 020 8546 6464.