Objective: To describe the process by which available evidence was critically assessed and findings were integrated with patient preferences and clinical expertise to determine whether soft tissue mobilization or biofeedback would be most effective in the management of a middle-aged woman experiencing dyspareunia and incontinence.
Study Design: Systematic review.
Background: A lack of consensus regarding the most effective treatments for pelvic floor dysfunctions currently exists. Use of evidence based-practice and outcome measures is encouraged; however, very few studies compare physical therapy interventions for dyspareunia and incontinence. Therapists must not only locate applicable literature but also consider clinical expertise and client preferences when selecting ideal interventions.
Methods and Measures: The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and MEDLINE were searched. Studies selected for review included those with subjects, interventions, and outcome measures similar to the question under investigation.
Results: A critical analysis of the relevant studies indicated that both biofeedback and soft tissue mobilization significantly reduced pain and improved sexual function for middle-aged women with dyspareunia. Gains were maintained up to 12 months.
Conclusions: When treating middle-aged women with dyspareunia, treatment including both soft tissue mobilization and biofeedback is recommended. Because of the paucity of studies on this topic, additional research investigating biofeedback and comparing the effects of biofeedback and soft tissue mobilization for the treatment of middle-aged women experiencing dyspareunia is warranted. In addition, client preferences and clinical expertise must be considered when determining management strategies.
1Doctor of Physical Therapy Program, Bellarmine University, Louisville, Kentucky.
2Transitional Doctor of Physical Therapy Program, A.T. Still University, Mesa, Arizona.
3Department of Physical Therapy, A.T. Still University, Mesa, Arizona.
4Department of Physical Therapy, Temple University, Philadelphia, Pennsylvania.
The lead author thanks Tony Brosky, PT, DHS, SCS, for his contribution to this manuscript.
The authors declare no conflicts of interest.