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Abstract
Importance: Pelvic floor disorders affect an estimated 86% of pregnancies, leading to decreased quality of life and negative health outcomes for postpartum women (Palmieri et al., 2022; Dasikan et al., 2020). Functional challenges including urinary incontinence, and difficulty with sexual activity and exercise are also frequently reported (Burkhart et al., 2020).
Objective: The objective of this review is to provide occupational therapists with evidence-based interventions for postpartum women with pelvic floor dysfunction.
Study Selection and Data Collection: Inclusion criteria were as follows: published in English within the last 10 years, postpartum women, RCTs, systematic reviews and meta-analysis.
Data Sources: The search, performed by a medical librarian, found 262 articles from PubMed, CINHAL, and Embase, of which 26 were included in this review.
Findings: Three themes emerged: exercise-based, physical agent modalities, and education-based interventions. Two level 1A and eight level 1B research studies provided strong evidence for exercise-based interventions improving pelvic floor function, while two level 1A and eight level 1B studies showed moderate evidence. One level 1A and three level 1B studies showed strong evidence for use of physical agent modalities such as electrical stimulation and biofeedback, while one level 1A, 1 level 1B, and one level 2B studies showed moderate evidence. Two level 1B studies provided strong evidence for educational intervention on pelvic floor strength, whereas two level 1B studies provided a moderate strength of evidence.
Conclusions and Relevance: Occupational therapists should consider routine use of pelvic floor muscle exercise training, educational intervention, electrostimulation, and biofeedback to improve pelvic floor function in postpartum women.
What this study adds: This study adds knowledge of evidence-based interventions within the scope of OT practice that can be used to improve pelvic floor dysfunction among postpartum women. Examples of interventions include pelvic floor muscle training, education and demonstration of Kegel exercises, and use of electrical stimulation of the pelvic floor muscles
References:
Burkhart, R., Couchman, K., Crowell, K., Jeffries, S., Monvillers, S., & Vilensky, J. (2020). Pelvic floor dysfunction after childbirth: Occupational impact and awareness of available treatment. OTJR: Occupation, Participation and Health, 41(2), 108–115. https://doi.org/10.1177/1539449220970881
Dasikan Z., Ozturk R., & Ozturk A. (2020). Pelvic floor dysfunction symptoms and risk factors at the first year of postpartum women: A cross-sectional study. Contemporary Nurse, pp. 132-135. DOI: 10.1080/10376178.2020.1749099
Palmieri, S., De Bastiani, S. S., Degliuomini, R., Ruffolo, A. F., Casiraghi, A., Vergani, P., Gallo, P., Magoga, G., Cicuti, M., Parma, M., Frigerio, M. (2022). Prevalence and severity of pelvic floor disorders in pregnant and postpartum women. International Journal of Gynecology Obstetrics, 158(2), 346–351. doi:10.1002/ijgo.14019
Publication Date
2024
Keywords
occupational therapy, postpartum, interventions, pelvic floor
Disciplines
Occupational Therapy
Recommended Citation
Novak, Kelsey; Wallace, Jaycee; Rutt, Emma; Delkamiller, Lydia; Westmark, Danielle; Smallfield, Stacy; and Whitlow, Molly, "Evidence-based Interventions for Postpartum Women with Pelvic Floor Dysfunction: A Systematized Review" (2024). Student Systematic Reviews: Occupational Therapy. 20.
https://digitalcommons.unmc.edu/cahp_ot_sysrev/20