scholarly journals Psychometric Properties and Practicability of the Self-Report Urinary Incontinence Questionnaire in Patients With Pelvic-Floor Dysfunction Seeking Outpatient Rehabilitation

2013 ◽  
Vol 93 (8) ◽  
pp. 1116-1129 ◽  
Author(s):  
Ying-Chih Wang ◽  
Dennis L. Hart ◽  
Daniel Deutscher ◽  
Sheng-Che Yen ◽  
Jerome E. Mioduski
Keyword(s):  
Urinary Incontinence ◽  
Physical Therapy ◽  
Pelvic Floor ◽  
Psychometric Properties ◽  
Pelvic Floor Dysfunction ◽  
Outpatient Rehabilitation ◽  
Local Independence ◽  
Therapy Services ◽  
Urine Leakage ◽  
Discriminating Ability

BackgroundPelvic-floor dysfunction (PFD) affects a substantial proportion of individuals, mostly women. In responding to the demands in measuring PFD outcomes in outpatient rehabilitation, the Urinary Incontinence Questionnaire (UIQ) was developed by FOTO in collaboration with an experienced physical therapist who has a specialty in treating patients with PFD.ObjectiveThe purpose of this study was to evaluate psychometric properties and practicability of the 21-item UIQ in patients seeking outpatient physical therapy services due to PFD.DesignThis was a retrospective analysis of cross-sectional data from 1,628 patients (mean age=53 years, SD=16, range=18–91) being treated for their PFD in 91 outpatient physical therapy clinics in 24 states (United States).MethodsUsing a 2-parameter logistic item response theory (IRT) procedure and the graded response model, the UIQ was assessed for unidimensionality and local independence, differential item functioning (DIF), discriminating ability, item hierarchical structure, and test precision.ResultsFour items were dropped to improve unidimensionality and discriminating ability. Remaining UIQ items met IRT assumptions of unidimensionality and local independence. One item was adjusted for DIF by age group. Item difficulties were suitable for patients with PFD with no ceiling or floor effect. Item difficulty parameters ranged from −2.20 to 0.39 logits. Endorsed items representing highest difficulty levels were related to control urine flow, impact of leaking urine on life, and confidence to control the urine leakage problem. Item discrimination parameters ranged from 0.48 to 1.18. Items with higher discriminating abilities were those related to impact on life of leaking urine, confidence to control the urine leakage problem, and the number of protective garments for urine leakage.LimitationsBecause this study was a secondary analysis of prospectively collected data, missing data might have influenced our results.ConclusionsPreliminary analyses supported sound psychometric properties of the UIQ items and their initial use for patients with PFD in outpatient physical therapy services.

scholarly journals Characteristics of Patients Seeking Outpatient Rehabilitation for Pelvic-Floor Dysfunction

2012 ◽  
Vol 92 (9) ◽  
pp. 1160-1174 ◽  
Author(s):  
Ying-Chih Wang ◽  
Dennis L. Hart ◽  
Jerome E. Mioduski
Keyword(s):  
Physical Therapy ◽  
Pelvic Floor ◽  
Pelvic Pain ◽  
Pelvic Floor Dysfunction ◽  
Secondary Analysis ◽  
Outpatient Rehabilitation ◽  
Therapy Services ◽  
Bowel Disorders ◽  
Prospective Longitudinal ◽  
Physical Therapy Services

BackgroundPelvic-floor dysfunction (PFD) affects a substantial proportion of individuals, especially women.ObjectiveThe purposes of this study were: (1) to describe the characteristics of individuals with disorders associated with PFD who were seeking outpatient physical therapy services and (2) to identify the prevalence of specific pelvic-floor disorders in the group.DesignThis was a prospective, longitudinal, cohort study of 2,452 patients (mean age=50 years, SD=16, range=18–91) being treated in 109 outpatient physical therapy clinics in 26 states (United States) for their PFD.MethodsThis study examined patient demographic variables and summarized patient self-reported responses to questions related to urinary and bowel functioning at admission prior to receiving the therapy for their PFD disorders.ResultsPatients primarily were female (92%), were under 65 years of age (39%: 18 to <45 years; 39%: 45 to <65 years; 21%: 65 years or older), and had chronic symptoms (74%). Overall, 67% of the patients reported that they had urinary problems, 27% reported bowel problems, and 39% had pelvic pain. Among those who had urinary or bowel disorders, 32% and 54% reported leakage and constipation, respectively, as their only problem. Among patients who had pelvic pain, most (56%) reported that the pain was in the abdominal area. Combinations of urinary, bowel, or pelvic-floor pain disorders occurred in 31% of the patients.LimitationsBecause this study was a secondary analysis of data collected prospectively, the researchers were not in control of the data collection procedure. Missing data were common.ConclusionsData suggested most patients with PFD receiving outpatient physical therapy services were female, younger than 65 years, and had disorders lasting for more than 90 days. Combinations of urinary, bowel, or pelvic-floor pain disorders were not uncommon.

scholarly journals The Self-Report Fecal Incontinence and Constipation Questionnaire in Patients With Pelvic-Floor Dysfunction Seeking Outpatient Rehabilitation

2014 ◽  
Vol 94 (2) ◽  
pp. 273-288 ◽  
Author(s):  
Ying-Chih Wang ◽  
Daniel Deutscher ◽  
Sheng-Che Yen ◽  
Mark W. Werneke ◽  
Jerome E. Mioduski
Keyword(s):  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Item Difficulty ◽  
Pelvic Floor Dysfunction ◽  
Self Report ◽  
Outpatient Rehabilitation ◽  
Rehabilitation Services ◽  
Local Independence ◽  
Floor Effect ◽  
Cross Sectional

Background Fecal incontinence and constipation affect men and women of all ages. Objective The purpose of this study was to psychometrically analyze the Fecal Incontinence and Constipation Questionnaire (FICQ) in patients seeking outpatient rehabilitation services due to pelvic-floor dysfunction (PFD). Design This was a retrospective analysis of cross-sectional data from 644 patients (mean age=52 years, SD=16, range=18–91) being treated for PFD in 64 outpatient rehabilitation clinics in 20 states (United States). Methods We assessed the 20-item FICQ for unidimensionality and local independence, differential item functioning (DIF), item fit, item hierarchical structure, and test precision using an item response theory model. Results Factor analyses supported the 2-factor subscales as originally defined; items related to severity of leakage or constipation. Removal of 2 leakage items improved unidimensionality and local independence of the leakage scale. Among the remaining items, 2 items were suggestive of adjustment for DIF by age group and by number of PFD comorbid conditions. Item difficulties were suitable for patients with PFD with no ceiling or floor effect. Mean item difficulty parameters for leakage and constipation subscales ranged from 38.8 to 62.3 and 28.1 to 63.3 (0–100 scale), respectively. Endorsed leakage items representing highest difficulty levels were related to delay defecation and confidence to control bowel leakage. Endorsed constipation items representing highest difficulty levels were related to the need to strain during a bowel movement and the frequency of bowel movements. Limitations A limitation of this study was the lack of medical diagnostic criteria to classify patients. Conclusions After removing 2 items and adjusting for DIF, the results supported sound psychometric properties of the FICQ items and its initial use for patients with PFD in outpatient rehabilitation services.

scholarly journals PELVIC FLOOR REHABILITATION IN MALES…. AN IGNORED DOMAIN

2017 ◽  
Vol 6 (2) ◽  
pp. 3
Author(s):  
Sadia Shafaq
Keyword(s):  
Urinary Incontinence ◽  
Physical Therapy ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Asian Population ◽  
Pelvic Floor Rehabilitation ◽  
Prostate Hyperplasia ◽  
Age Related ◽  
Male Patients

y writing in Pakistan Journal of Rehabilitation, I would like to draw attention of the readers toward the ignorance on the need of physical therapy in pelvic floor rehabilitation among males. Urinary incontinence is prevalent by 1.8-30.5% in Europe, 1.7-36.4% in USA and is 1.5-15.2% in Asian population due to pelvic floor muscle dysfunction. By recent studies, it has been observed that urinary incontinence in males has less emphasis when compared with females. Urinary incontinence among males is possibly an outcome of prostatitis, trauma, chronic infection, obesity, heavy lifting, benign prostate hyperplasia, prostatectomy4, and many other age-related diseases. Globally, pelvic pain and dysfunction influence millions of males worldwide and till date little evidence is present regarding pelvic floor rehabilitation among males. A major concern is the lack of awareness in male patients regarding pelvic floor dysfunction. Moreover, other issues include unfamiliarity with physical therapy, hesitation to discuss genital issues, referral issues by physicians and less number of available pelvic floor physiotherapist. Pelvic floor rehabilitation utilizes the concept of physical therapy to contribute in an organized program for strengthening pelvic floor muscles

scholarly journals Quo Vadis Urogynecology 2020 – Innovative Treatment Concepts for Urinary Incontinence and Pelvic Organ Prolapse

2021 ◽  
Vol 81 (02) ◽  
pp. 183-190
Author(s):  
Gert Naumann
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Professional Training ◽  
Pelvic Floor Dysfunction ◽  
Estrogen Therapy ◽  
Pelvic Organ ◽  
Alloplastic Materials ◽  
Wide Range ◽  
Quo Vadis

AbstractThe current treatment for urinary incontinence and pelvic organ prolapse includes a wide range of innovative options for conservative and surgical therapies. Initial treatment for pelvic floor dysfunction consists of individualized topical estrogen therapy and professional training in passive and active pelvic floor exercises with biofeedback, vibration plates, and a number of vaginal devices. The method of choice for the surgical repair of stress urinary incontinence consists of placement of a suburethral sling. A number of different methods are available for the surgical treatment of pelvic organ prolapse using either a vaginal or an abdominal/endoscopic approach and autologous tissue or alloplastic materials for reconstruction. This makes it possible to achieve optimal reconstruction both in younger women, many of them affected by postpartum trauma, and in older women later in their lives. Treatment includes assessing the patientʼs state of health and anesthetic risk profile. It is important to determine a realistically achievable patient preference after explaining the individualized concept and presenting the alternative surgical options.

scholarly journals Sexual function in women with pelvic floor disorders

2013 ◽  
Vol 7 (9-10) ◽  
pp. 199 ◽  
Author(s):  
Rebecca G. Rogers
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Stress Urinary Incontinence ◽  
Sexual Function ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
The Impact

Pelvic floor disorders (PFDs) can impact sexual function. This summary provides an overview of the impact of stress urinary incontinence and pelvic organ prolapse and their treatments on sexual function. In general, interventions that successfully address PFDs will generally improve sexual function as well. However, there are patients whose sexual function will remain unchanged despite treatment, and a small but significant minority who will report worsened sexual function following treatment for their pelvic floor dysfunction.

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