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Klahsen O, Thibault-Gagnon S, McLean L. A theoretical model for brisk walking- and running-induced lower urinary tract symptoms (BRUTS) and the development of the BRUTS-questionnaire (BRUTS-Q): A focus group and Delphi study. Neurourol Urodyn 2024. [PMID: 39032104 DOI: 10.1002/nau.25523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 02/06/2024] [Accepted: 05/28/2024] [Indexed: 07/22/2024]
Abstract
AIMS Existing questionnaires provide limited information on the nature, severity and context surrounding lower urinary tract symptoms (LUTS) experienced during running, jogging and brisk walking. The aims of this study were to develop a theoretical model of the experience of LUTS by females participating in gait-based exercise activities and to use this model to generate a questionnaire to evaluate the presence, symptoms and bother associated with LUTS experienced by females during gait-based activities. METHODS A theoretical model was developed through a review of the literature and refined through a focus group consultation including pelvic health physiotherapists, females who experienced leakage during exercise and academic researchers who studied female LUTS. A draft questionnaire was developed using key constructs identified in the model by the focus group. A new expert panel was recruited, which included physiotherapists, women with self-reported gait-induced LUTS and urogynecologists. This panel followed a DELPHI process to evaluate the relevance and completeness of the constructs within the questionnaire. RESULTS Two rounds of consultation were required to reach consensus on the completeness of included constructs as well as the inclusion and wording of questions. The resulting questionnaire contains questions related to five key constructs: physical activity characteristics, symptoms of urgency, urgency urinary incontinence, stress urinary incontinence experienced during exercise and management/mitigation strategies adopted by respondents. CONCLUSIONS The content validity of the brisk walking- and running-induced lower urinary tracts symptoms questionnaire has been established. The next steps are to ensure that the questionnaire has adequate comprehensibility, followed by adequate measurement properties.
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Affiliation(s)
- Olena Klahsen
- Department of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Linda McLean
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Bø K, Lillegård RH, Skaug KL. Pelvic Floor Muscle Training on Stress Urinary Incontinence in Power- and Weightlifters: a Pilot Study. Int Urogynecol J 2024; 35:1291-1298. [PMID: 38758455 PMCID: PMC11245411 DOI: 10.1007/s00192-024-05801-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/06/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Stress urinary incontinence (SUI) is defined as involuntary leakage of urine on physical effort and is prevalent among power- and weightlifters. However, there is scant knowledge on treatment options for this population. The aim of this pilot study was to evaluate the potential outcomes and feasibility of a pelvic floor muscle training (PFMT) program on SUI in nulliparous female power- and weightlifters. METHODS This was a case-series study, including one weightlifter and two powerlifters aged 21-32 years. The participants conducted 12 weeks of PFMT at home, with weekly follow-up by a physiotherapist. Change in total score of the International Consensus of Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF) was the primary outcome. Secondary outcome was perceived change assessed by the Patient Global Impression of Improvement (PGI-I) Scale and impact on sport participation. PFM strength, endurance, and resting pressure was measured using vaginal manometry. Feasibility was evaluated as adherence to training and self-efficacy (Self Efficacy Scale for Practicing Pelvic Floor Exercises). RESULTS One athlete reduced their ICIQ-UI-SF score and experienced improvement in symptoms. One athlete reported no change, and one reported a worsening of symptoms. All three participants improved PFM strength and endurance, completed the testing, and 12 weeks of PFMT, but adherence varied between 40 and 80%. Participants reported a lack of time and energy and forgetting to perform the exercises, as reasons for low adherence. CONCLUSION There were varying effects of a 12-week PFMT program on SUI in three strength athletes. The results can create the basis for a future randomized controlled trial.
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Affiliation(s)
- Kari Bø
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.
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Newark RL, Thompson R. Urinary Incontinence in Active Female Young Adults: Healthcare Preferences, Priorities and Experiences. Int Urogynecol J 2024; 35:1191-1200. [PMID: 38713238 PMCID: PMC11245447 DOI: 10.1007/s00192-024-05786-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/21/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION AND HYPOTHESIS There is a paucity of evidence on the healthcare preferences of active female young adults with urinary incontinence (UI). This research is aimed at examining the population's healthcare preferences and priorities and their characteristics and experiences to improve access to and use of services. METHODS This cross-sectional online survey study used a convenience community sample. Participants resided in Australia, were 18-30 years old, had self-reported engagement in physical activity of any frequency and self-reported urine leakage in the previous 4 weeks and met other eligibility criteria. Data were analysed using descriptive analyses. RESULTS Thirty-nine participants took part in the study. The majority engaged in recreational exercise (74.2%) and experienced UI of slight to moderate severity (82.9%). Participants preferred to access information and support anonymously online (71.4%) from general practitioners (58.8%), medical specialists (50.0%) or physiotherapists (44.1%). All participants wanted to be involved in the UI management decision-making process. Participants prioritised knowing information over cost (38.2%), changes to daily habits (35.3%) and potential risks or side effects (23.5%) when making decisions about management of UI. CONCLUSION The results highlight the diversity among active female young adults with UI. They emphasise the need for shared decision making and highlight key information needs, providing the basis for the development of decision-making tools and protocols specific to this population. They demonstrate the need for anonymous online information and support, and draw attention to the presence of UI among young recreational exercisers, highlighting the importance of ensuring that information and support is available within this demographic.
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Affiliation(s)
- Rebecca L Newark
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Rachel Thompson
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Skaug KL, Engh ME, Bø K. Pelvic floor muscle training in female functional fitness exercisers: an assessor-blinded randomised controlled trial. Br J Sports Med 2024; 58:486-493. [PMID: 38413133 PMCID: PMC11103308 DOI: 10.1136/bjsports-2023-107365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE Stress urinary incontinence (SUI) is common among females during functional fitness training, such as CrossFit. The aim of this study was to assess the effect of pelvic floor muscle training (PFMT) on SUI in female functional fitness exercisers. METHODS This was an assessor-blinded randomised controlled trial with a PFMT group (n=22) and a control group (n=25). The PFMT group followed a 16-week home-training programme with 3 sets of 8-12 maximum pelvic floor muscle (PFM) contractions daily and weekly follow-up/reminders by phone. The primary outcome was change in a total score of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). The secondary outcomes were perceived change of symptoms of SUI, change of PFM strength measured by vaginal manometry and symptoms of anal incontinence (AI) and pelvic organ prolapse (POP). RESULTS 47 women, mean age of 33.5 years (SD: 8.1), participated. At 16 weeks, there was a mean difference between groups of -1.4 (95% CI: -2.6 to -0.2) in the change of the ICIQ-UI-SF score in favour of the PFMT group. The PFMT group completed a mean of 70% (SD: 23) of the prescribed protocol. 64% in the PFMT group versus 8% in the control group reported improved symptoms of SUI (p<0.001, relative risk: 7.96, 95% CI, 2.03 to 31.19). There were no group differences in the change of PFM strength or AI/POP symptoms. CONCLUSION A 16-week home-training programme of the PFM led to improvements in SUI in female functional fitness exercisers. However, PFM strength and AI and POP symptoms did not improve significantly in the PFMT group compared with the control group.
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Affiliation(s)
| | - Marie Ellström Engh
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lorenskog, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lorenskog, Norway
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Dakic JG, Hay-Smith EJC, Lin KY, Cook JL, Frawley HC. Women's preferences for pelvic floor screening in sport and exercise: a mixed-methods study integrating survey and interview data in Australian women. Br J Sports Med 2023; 57:1539-1549. [PMID: 37648412 DOI: 10.1136/bjsports-2023-107017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES One in two women experiencing pelvic floor (PF) symptoms stop playing sport or exercising. The study examines the perspective of women with PF symptoms to inform acceptable screening practices within sport and exercise settings. METHODS Explanatory, sequential, mixed-methods design. Phase 1: survey of 18-65 years, symptomatic, Australian women (n=4556). Phase 2: semistructured interviews with a subset of survey participants (n=23). Integration occurred through connection of phases (study design, sampling) and joint display of data. RESULTS Findings are represented in three threads: (1) 'women (not) telling'; a majority of women had told no-one within a sport or exercise setting about their PF symptoms due to shame/embarrassment, lack of pelvic health knowledge and not wanting to initiate the conversation, (2) 'asking women (screening for PF symptoms)'; women endorsed including PF symptom questions within existing sport and exercise screening practices but only when conducted in a respectful and considered manner and (3) 'creating safety'; professionals can assist women to disclose by demonstrating expertise, trustworthiness and competency. If health and exercise professionals are provided with appropriate training, they could raise pelvic health awareness and promote a supportive and safe sport and exercise culture. CONCLUSION Women with PF symptoms support health and exercise professionals initiating conversations about PF health to normalise the topic, and include PF symptoms among other pre-exercise screening questions. However, women should be informed on the relevance and potential benefits of PF screening prior to commencing. Safe screening practices require building trust by providing information, gaining consent, displaying comfort and genuine interest, and being knowledgeable within one's scope of practice to the provision of advice, exercise modifications and referral as appropriate.
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Affiliation(s)
- Jodie G Dakic
- Department of Physiotherapy, Monash University, Clayton, Victoria, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - E Jean C Hay-Smith
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Kuan-Yin Lin
- Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
- School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan
| | - Jill L Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Helena C Frawley
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Allied Health Research, The Royal Women's Hospital, Melbourne, Victoria, Australia
- Allied Health Research, Mercy Hospital for Women, Melbourne, Victoria, Australia
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Campbell KG, Batt ME, Drummond A. Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey. Int Urogynecol J 2023; 34:2429-2437. [PMID: 37162534 PMCID: PMC10590299 DOI: 10.1007/s00192-023-05548-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/07/2023] [Indexed: 05/11/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Pelvic floor dysfunction (PFD) affects many women and participation in elite sport and high-impact exercise has been reported as a potential risk. However, few studies have investigated the effects of exercising at recreational levels on PFD. Our aim was to investigate levels of PFD in women exercising at, or above, UK guidelines for health and compare them with levels in non-exercisers. METHOD Data on levels of PFD and potential risk factors (age, hormonal status, body mass index, constipation, parity, forceps delivery, and recreational exercise) were collected using a cross-sectional survey distributed via social media. The International Consultation Incontinence Questionnaire (ICIQ) Urinary Incontinence Short Form was used to estimate prevalence of urinary incontinence (UI). Selected questions from the ICIQ vaginal symptom and bowel symptom questionnaires were used to estimate prevalence of anal incontinence (AI) and pelvic organ prolapse (POP). Logistic regression analysis was used to compare exercisers and non-exercisers after adjusting for potential confounders. RESULTS We recruited 1,598 adult women (1,141 exercisers and 457 non-exercisers). The majority were parous. High prevalence of UI (70%), AI (52%) and POP (18%) was reported. No significant association was found between recreational exercise and PFD despite adjustment for confounders, or further investigation regarding exercise involving impact, although some increased reporting of AI was seen in those exercising for over 10 hours per week. CONCLUSION High levels of all PFD were reported but no significant association was found between recreational exercise and symptoms. However, data suggest that women modify their exercise regimes as required. Few symptomatic women sought professional help.
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Affiliation(s)
- K Gillian Campbell
- Faculty of Medicine and Health Sciences, Queens Medical Centre, University of Nottingham, Room B302, B Floor, Queens Medical Centre, Nottingham, NG7 2HA, UK.
| | - Mark E Batt
- Faculty of Medicine and Health Sciences, Queens Medical Centre, University of Nottingham, Room B302, B Floor, Queens Medical Centre, Nottingham, NG7 2HA, UK
| | - Avril Drummond
- Faculty of Medicine and Health Sciences, Queens Medical Centre, University of Nottingham, Room B302, B Floor, Queens Medical Centre, Nottingham, NG7 2HA, UK
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Dakic JG, Hay-Smith J, Lin KY, Cook J, Frawley HC. Experience of Playing Sport or Exercising for Women with Pelvic Floor Symptoms: A Qualitative Study. SPORTS MEDICINE - OPEN 2023; 9:25. [PMID: 37097457 PMCID: PMC10127961 DOI: 10.1186/s40798-023-00565-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/09/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Women participate in sport at lower rates than men, and face unique challenges to participation. One in three women across all sports experience pelvic floor (PF) symptoms such as urinary incontinence during training/competition. There is a dearth of qualitative literature on women's experiences of playing sport/exercising with PF symptoms. The purpose of this study was to explore the lived experience of symptomatic women within sports/exercise settings and the impact of PF symptoms on sports/exercise participation using in-depth semi-structured interviews. RESULTS Twenty-three women (age 26-61 years) who had experienced a breadth of PF symptom type, severity and bother during sport/exercise participated in one-one interviews. Women played a variety of sports and levels of participation. Qualitative content analysis was applied leading to identification of four main themes: (1) I can't exercise the way I would like to (2) it affects my emotional and social well-being, (3) where I exercise affects my experience and (4) there is so much planning to be able to exercise. Women reported extensive impact on their ability to participate in their preferred type, intensity and frequency of exercise. Women experienced judgement from others, anger, fear of symptoms becoming known and isolation from teams/group exercise settings as a consequence of symptoms. Meticulous and restrictive coping strategies were needed to limit symptom provocation during exercise, including limiting fluid intake and careful consideration of clothing/containment options. CONCLUSION Experiencing PF symptoms during sport/exercise caused considerable limitation to participation. Generation of negative emotions and pain-staking coping strategies to avoid symptoms, limited the social and mental health benefits typically associated with sport/exercise in symptomatic women. The culture of the sporting environment influenced whether women continued or ceased exercising. In order to promote women's participation in sport, co-designed strategies for (1) screening and management of PF symptoms and (2) promotion of a supportive and inclusive culture within sports/exercise settings are needed.
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Affiliation(s)
- Jodie G Dakic
- Department of Physiotherapy, Monash University, 47 - 49 Moorooduc Highway Frankston, Victoria, 3199, Australia.
- Department of Physiotherapy, The University of Melbourne, 161 Barry St, Parkville, 3010, Australia.
| | - Jean Hay-Smith
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, PO Box 7343, Wellington South, 6242, New Zealand
| | - Kuan-Yin Lin
- Department of Physical Therapy, National Cheng Kung University, No. 1, Ta-Hsueh Road, Tainan, 701, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, Ta-Hsueh Road, Tainan, 701, Taiwan
| | - Jill Cook
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Plenty Rd &, Kingsbury Dr, Bundoora, VIC, 3086, Australia
| | - Helena C Frawley
- Melbourne School of Health Sciences, The University of Melbourne, 161 Barry St., Parkville 3010, VIC, Australia
- Allied Health Research, The Royal Women's Hospital, Parkville, VIC, 3052, Australia
- Allied Health Research, Mercy Hospital for Women, Studley Rd, Heidelberg, VIC, 3084, Australia
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Johnston CL, Negus MF, Rossiter MA, Phillips CG. A national survey of urinary incontinence in professional Team England female athletes. Eur J Obstet Gynecol Reprod Biol 2023; 282:12-16. [PMID: 36608453 DOI: 10.1016/j.ejogrb.2022.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/06/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To investigate the prevalence of urinary incontinence in Team England female athletes participating in the 2018 Commonwealth Games, the self-imposed lifestyle modifications used to manage symptoms in training and competition and the impact on performance. STUDY DESIGN This was a Cross-Sectional Survey. All Team England female athletes participating in 2018 Commonwealth Games were asked to complete a structured questionnaire regarding symptoms and management of urinary incontinence. Chi-squared statistical analysis was applied to relevant data. RESULTS 103 athletes were included. 52 % reported experiencing urinary incontinence (38 % in training vs 27 % in competition X2 = 2.68, p0.13). Highest rates of incontinence were seen in cycling and gymnastics, with lowest rates of incontinence in swimming and rugby. In sports requiring form fitting garments, 64 % did not feel they could wear a pad in training, compared with 19 % in sports with less form-fitting clothing. In competition, 75 % of athletes wearing form-fitting clothing did not feel they could wear a pad, compared with 24 % of those with less form-fitting attire (X2 = 16.9, p < 0.001 in training; X2 = 24.04, p = <0.001 in competition). 11 % of athletes reported reducing fluid intake to reduce urinary incontinence in training and 8 % reported doing this in competition. Only 3 % of athletes reported that their performance is affected by urinary incontinence. CONCLUSION Prevalence of urinary incontinence is higher in athletes than in the general population. Tight-fitting sportswear is a barrier to athletes using pads to manage urinary incontinence. Athletes may reduce fluid intake to reduce urinary leakage in training and competition, which may affect performance. However, few athletes report that urinary incontinence has an impact overall.
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Affiliation(s)
- Catherine L Johnston
- Hampshire Hospitals NHS Foundation Trust, Gynaecology, Basingstoke and North Hampshire Hospital, Aldermaston Road, Basingstoke, UK.
| | | | - Michael A Rossiter
- North Hampshire Hospitals NHS Trust, Department of Sport & Exercise Medicine, Basingstoke, Hampshire, UK; Commonwealth Games England, London, UK.
| | - Christian G Phillips
- Basingstoke and North Hampshire Hospital, Urogynaecology, Basingstoke, Hampshire, UK.
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Strenuous physical activity, exercise, and pelvic organ prolapse: a narrative scoping review. Int Urogynecol J 2023:10.1007/s00192-023-05450-3. [PMID: 36692525 DOI: 10.1007/s00192-023-05450-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023]
Abstract
INTRODUCTION AND HYPOTHESIS High-intensity physical activity and exercise have been listed as possible risk factors for pelvic organ prolapse (POP). The aim of the present study is to conduct a literature review on the prevalence and incidence of POP in women who engage in regular physical activity. In addition, we review the effects of a single exercise or a single session of exercise on pelvic floor support. Finally, the effect of exercises on POP in the early postpartum period is reviewed. METHODS This is a narrative scoping review. We searched PubMed and Ovid Medline, the Physiotherapy Evidence Database (PEDro), and the Cochrane Database of Systematic Reviews up to May 2022 with the following MeSH terms: "physical activity" AND "exercise" AND "pelvic floor" AND "pelvic organ prolapse". RESULTS Eight prevalence studies were retrieved. Prevalence rates of symptomatic POP varied between 0 (small study within different sports) and 23% (Olympic weightlifters and power lifters). Parity was the only factor associated with POP in most studies. Three studies evaluated the pelvic floor after a single exercise or one session of exercise and found increased vaginal descent or increased POP symptoms. One prospective cohort study reported the development of POP after 6 weeks of military parashot training, and one randomized trial reported increased POP symptoms after transverse abdominal training. There is scant knowledge on exercise and POP in the postpartum period. CONCLUSIONS Prevalence of POP in sports varies widely. Experimental and prospective studies indicate that strenuous exercise increased POP symptoms and reduced pelvic floor support.
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Giagio S, Salvioli S, Innocenti T, Gava G, Vecchiato M, Pillastrini P, Turolla A. PFD-SENTINEL: Development of a screening tool for pelvic floor dysfunction in female athletes through an international Delphi consensus. Br J Sports Med 2022:bjsports-2022-105985. [DOI: 10.1136/bjsports-2022-105985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
To develop a screening tool for pelvic floor dysfunction (PFD) in female athletes for use by sports medicine clinicians (eg, musculoskeletal/sports physiotherapists, sports and exercise medicine physicians), which guides referral to a PFD specialist (eg, pelvic floor/women’s health physiotherapist, gynaecologist, urogynaecologist, urologist).Between February and April 2022, an international two-round modified Delphi study was conducted to assess expert opinion on which symptoms, risk factors and clinical and sports-related characteristics (items) should be included in a screening tool. We defined consensus a priori as >67% response agreement to pass each round.41 and 34 experts participated in rounds 1 and 2, respectively. Overall, seven general statements were endorsed as relevant by most participants highlighting the importance of screening for PFD in female athletes. Through consensus, the panel developed the Pelvic Floor Dysfunction-ScrEeNing Tool IN fEmale athLetes (PFD-SENTINEL) and agreed to a cluster of PFD symptoms (n=5) and items (risk factors, clinical and sports-related characteristics; n=28) that should prompt specialist care. A clinical algorithm was also created: a direct referral is recommended when at least one symptom or 14 items are reported. If these thresholds are not reached, continuous monitoring of the athlete’s health is indicated.Despite increasing awareness and clinical relevance, barriers to identify PFD in female athletes are still present. The PFD-SENTINEL is a new resource for sports medicine clinicians who regularly assess female athletes and represents the first step towards early PFD identification and management. Further studies to validate the tool are needed.
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Culleton-Quinn E, Bø K, Fleming N, Mockler D, Cusack C, Daly D. Elite female athletes' experiences of symptoms of pelvic floor dysfunction: A systematic review. Int Urogynecol J 2022; 33:2681-2711. [PMID: 36040507 PMCID: PMC9477953 DOI: 10.1007/s00192-022-05302-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/10/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND AIMS Pelvic floor dysfunction (PFD) is a collection of signs, symptoms and conditions affecting the pelvic floor and urinary incontinence (UI) is the most common type of PFD. Recent systematic reviews have indicated a higher prevalence of UI among female athletes compared to their non-athletic counterparts. To date, no review has been undertaken to investigate female athletes' experiences of PFD. This review aims to offer insight and understanding, through aggregation, summary, synthesis and interpretation of findings from studies that report elite female athletes' experiences of symptoms of PFD. METHODS The review protocol was registered in PROSPERO in August 2020. A systematic search was conducted in Embase, MEDLINE (OVID), Cochrane Library, CINAHL, PsycINFO and Web of Science for studies published in the English language reporting elite female athletes' experiences of symptoms of PFD. This review included primary research studies that involved elite female athletes of any age or ethnicity. RESULTS Of the 1922 citations retrieved in the search, 32 studies met the methodological criteria for data extraction and analysis. Five main themes emerged: (1) triggers for symptoms of PFD; (2) strategies adopted by athletes to manage/mitigate symptoms of PFD; (3) impact on QOL/daily life; (4) impact on performance; (5) impact on emotions. CONCLUSIONS The findings of this review suggest a need to further explore the experiences of PFD among elite female athletes and it is suggested that future research should adopt qualitative methods or incorporate a qualitative component.
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Affiliation(s)
- Elizabeth Culleton-Quinn
- School of Medicine, Trinity College, Dublin, Ireland ,Discipline of Physiotherapy and Discipline of Occupational Therapy, Trinity College, Dublin, Trinity Centre for Health Sciences, James’s St., Dublin, D08W9RT Ireland
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway ,Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway
| | - Neil Fleming
- School of Medicine, Trinity College, Dublin, Ireland
| | | | - Cinny Cusack
- Physiotherapy Department, Rotunda Hospital, Dublin, Ireland
| | - Déirdre Daly
- School of Nursing and Midwifery, Trinity College, Dublin, Ireland
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