Physiotherapy and pelvic floor health within a contemporary biopsychosocial model of care: From research to education and clinical practice

Abstract

Background: Pelvic floor dysfunction (PFD) is a common problem in both men and women. Despite the high prevalence and negative effects on quality of life, there is still a lack of research in this area which translates into clinical practice and education.Objectives: My study discusses how gaps and controversies in current research and evidence on PFD might be addressed by positioning PFD within a contemporary biopsychosocial model of care (BPSM).Method: Various databases were searched for relevant studies published between 2010 and 2020 to support hypotheses and statements.Results: My study focuses on the available evidence of PFD in both men and women as related to the themes and sub-themes of the BPSM, and how this available evidence might translate into education and clinical practice. It highlights areas of research, education and clinical practice that need to be explored and how the different components of healthcare may influence one another.Conclusion: Biomedical aspects regarding pelvic health are mostly investigated and taught, whilst psychological, cognitive, behavioural, social and occupational factors, individualised care, communication and therapeutic alliances are still under-investigated and not integrated or translated at a sufficient level into research, education and clinical practice.Clinical implications: Incorporating the integration of all factors of the BPSM into research is important for effective knowledge translation and enhancement of a de-compartmentalised approach to management. The interaction between the different components of the BPSM should be investigated especially in a South African population.

Hard Flaccid Syndrome: A Biopsychosocial Management Approach with Emphasis on Pain Management, Exercise Therapy and Education

“…The therapeutic management approach undertaken, which was based on a holistic strategy, utilizing three therapeutic axes (pelvic floor muscle management, pain management and lifestyle/stress-related modifications) followed a biopsychosocial management approach, and it seemed to interrupt the vicious cycle of symptoms being described [1,2]. Indeed, such an approach is compatible with current evidence on various pelvic syndromes and chronic pain states [2,[15][16][17]27]. Although the HFS-specific outcomes and overall quantitative outcomes are limited, the aforementioned approach proved favourable for the patient.…”

Multimodal therapies and strategies for the treatment of interstitial cystitis/bladder pain syndrome in Taiwan

“…Furthermore, alterations in the urinary microbiota composition may contribute to inflammation and initiation of central sensitization 36,65 . A biopsychosocial model also correlated pelvic floor dysfunction with LUTS, 66 and autonomic nervous system sympathovagal imbalance was found to be associated with chronic pelvic pain syndrome and psychological stress severity 67 …”