Autore: Baccini Silvia

  • “Una survey per fisioterapisti per indagare il management riabilitativo delle pazienti con POP e confrontarlo con la letteratura”

    “Una survey per fisioterapisti per indagare il management riabilitativo delle pazienti con POP e confrontarlo con la letteratura”

    “A survey for physiotherapists to investigate the rehabilitation management of patients with POP and compare it with the literature

    Autori

    Dott.ssa Silvia Baccini, fisioterapista, Master riabilitazione del pavimento pelvico

    Dott.ssa Cantù Daniela

    Introduction

    A questionnaire based on the most recent evidence about pelvic organs prolapse has been
    created and issued to a pool of physiotherapists specialised in pelvic floor rehabilitation.
    The final goal is to compare all of the data available in literature with the actual
    professional clinical execution.

    Methods

    Research on the latest POP rehabilitation revisions has been performed, together with
    analysing guidelines and RCT which have been published on the PubMed platform
    between the years 2020 and 2023. Based on its results, a list of 22 questions, subdivided
    into 4 main topics, has been drawn up: 1) competencies, training and clinical experience of
    the physiotherapist; 2) profile of the patient with POP who receives the physiotherapeutic
    treatment; 3) treatment tools and techniques; 4) outcome and modality of its achievement;
    5) pre and post surgery physiotherapy. The data gathered has finally been discussed and
    compared to the relevant evidence outlined in specialised literature.

    Results

    The questionnaire has been filled out by 86 physiotherapists who are either expert or
    specialised in pelvic floor rehabilitation. The collected data has been compared both with
    guidelines and the most recent articles issued in relation to the physiotherapeutic treatment
    of patients affected by POP. The data concerning the choices of treatment has come out to
    be different compared to what it would have been expected based on the evidence in
    literature. The choice to use PFMT as a treatment technique for POP patients’
    rehabilitation, has involved 67% of the physiotherapists. This percentage has been rather
    unexpected considering that popular guidelines such as NICE 2019 recommend it as an
    option for patients affected by POP. Also, other figures emerged to be in disagreement
    with the current literature: this is the case of hypopressive exercise and the use of pessary.

    Discussion and Conclusion

    The future objective would be to implement qualitative and meaningful studies and
    research in order to recognise the effectiveness of physical rehabilitative techniques for
    POP patients, including radiofrequency and hypopressive exercise, for which there is not
    much evidence still.
    It is necessary to strengthen studies and scientific evidence of the rehabilitative treatment
    applied in prevention of post-surgery relapse. Currently, there are no studies that can
    compare the long-term outcome preservation within groups of patients with prolapse
    setbacks, who have been treated with physiotherapy both before and after surgery, versus
    similar patients who have not undergone a physiotherapeutic cycle. Another relevant piece
    of data is about physiotherapists proposing pessary as a treatment option: only a very
    minimal percentage of colleagues do so. It is crucial to identify the reasons behind this, in
    light of the large amount of literature in support of the many benefits and advantages of
    this therapy option.

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