Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome and pelvic floor tenderness

PURPOSE

We determined the efficacy and safety of pelvic floor myofascial physical therapy compared to global therapeutic massage in women with newly symptomatic interstitial cystitis/painful bladder syndrome.

MATERIALS AND METHODS

A randomized controlled trial of 10 scheduled treatments of myofascial physical therapy vs global therapeutic massage was performed at 11 clinical centers in North America. We recruited women with interstitial cystitis/painful bladder syndrome with demonstrable pelvic floor tenderness on physical examination and a limitation of no more than 3 years' symptom duration. The primary outcome was the proportion of responders defined as moderately improved or markedly improved in overall symptoms compared to baseline on a 7-point global response assessment scale. Secondary outcomes included ratings for pain, urgency and frequency, the O'Leary-Sant IC Symptom and Problem Index, and reports of adverse events. We compared response rates between treatment arms using the exact conditional version of the Mantel-Haenszel test to control for clustering by clinical center. For secondary efficacy outcomes cross-sectional descriptive statistics and changes from baseline were calculated.

RESULTS

A total of 81 women randomized to the 2 treatment groups had similar symptoms at baseline. The global response assessment response rate was 26% in the global therapeutic massage group and 59% in the myofascial physical therapy group (p=0.0012). Pain, urgency and frequency ratings, and O'Leary-Sant IC Symptom and Problem Index decreased in both groups during followup, and were not significantly different between the groups. Pain was the most common adverse event, occurring at similar rates in both groups. No serious adverse events were reported.

CONCLUSIONS

A significantly higher proportion of women with interstitial cystitis/painful bladder syndrome responded to treatment with myofascial physical therapy than to global therapeutic massage. Myofascial physical therapy may be a beneficial therapy in women with this syndrome.

Event Perception and Social Skills in Undergraduates with ADHD Symptoms

BACKGROUND

Event perception provides a promising, novel approach for investigating underlying cognitive mechanisms of the social impairment associated with symptoms of ADHD.

AIMS

The goal of this study was to establish the relationship among event perception, symptoms of ADHD, and social skills.

METHODOLOGY

Eighty-three undergraduates were recruited from the University of Ottawa first year psychology courses (38 with ADHD, 45 without ADHD). They performed an event perception task and completed self-report questionnaires assessing social functioning and symptoms of ADHD (The Social Skills-Improvement System and the Conner's CBRS-SR).

RESULTS

Bootstrapping mediation analyses revealed that symptoms of inattention and hyperactivity mediated the relationship between event perception and social skills. A model with predictor and mediator reversed was also tested, and was not significant, providing strength to the directionality of the relationships. Results highlight the applicability of event perception to understanding the association between social impairment and symptoms of ADHD.