Date Presented 04/22/2023

This study is a qualitative, retrospective case series used to provide a description of the experience of women who received OT for pelvic floor health conditions. OT changed the course of women’s journey with pelvic health, women experienced relief through discovering OT, and occupation-based therapy empowered women to be the experts on their own bodies. This research is important in advocating for and supporting OT’s role in pelvic floor and women’s health.

Primary Author and Speaker: Johanna R. Schmitz

Additional Authors and Speakers: Kelsey Mathias

Contributing Authors: Hannah Schoener, Karen Atler, Christine A. Fruhauf, Delaney Pearce, Arlene Schmid

PURPOSE: Pelvic floor dysfunction (PFD) is a condition that affects one third of women, greatly impacting their quality of life. There is limited research on occupational therapy (OT) and pelvic floor health as pelvic floor therapy is a relatively new topic in the field of OT. Currently there is no research on women’s perception of the OT intervention they received for PFD. It is important to understand the role and skills OT has to contribute to the field of pelvic floor health as PFD limits everyday occupations. The question this research seeks to answer is, ‘What is the experience of women receiving occupational therapy for pelvic floor health issues?' The objective of this study is to explore the experiences of women who received OT for PFD.

DESIGN: This study was a qualitative, retrospective case series used to provide a detailed description of the experience and perspective of women who received OT for pelvic floor health conditions. Eligibility criteria included: ≥18 years old; biologically female participants; self-reported pelvic floor health issue; English speaking; completed OT intervention for PFD within the past two years. The researchers worked with a local pelvic floor occupational therapist (OTR), who owned her own private practice and focused on occupation-based therapy. Participants were recruited once they completed OT treatment with this OTR. The OTR encouraged current and past clients through social media and word of mouth to participate in the study. Once the clients showed interest, the OTR introduced potential participants to the lead interviewer via email and they were then screened for inclusion criteria via email.

METHOD: Four participants completed a semi-structured interview about their treatment and qualitative analyses were completed using inductive coding techniques. Participants’ electronic medical records were reviewed. The Pelvic Floor Distress Inventory Questionnaire-20 (PFDI-20) was completed to assess changes in PFD symptoms and impact on quality of life (QoL).

RESULTS: Qualitatively, three main themes emerged from the data across participants: 1) Occupation-based therapy changed the course of women’s ongoing journey with pelvic health, 2) Women experienced relief through discovering OT, and 3) Occupation-based therapy empowered women to be the experts of their own bodies. There were clinically significant changes in participants PFDI-20 scores indicating a decrease in PFD symptoms and impact of PFD symptoms on QoL following OT intervention.

CONCLUSION: In conclusion, it appears that OT interventions and being occupation-based may play an important role in positively impacting women’s life with PFD. The women in this study experienced: empowerment to understand their bodies, a return to occupations they enjoyed, reduced PFD symptoms, and a changed journey with their pelvic health. This research is important in supporting and advocating for OT’s role in women’s health and pelvic floor health. More research is needed to investigate the mechanisms of what makes OT interventions effective in treating PFD.

References

Blacker, J., Mathias, K., Lee, T., Peek, H., & Podvey, M. (2020). Occupational therapy’s role in the treatment of pelvic organ prolapse. SIS Quarterly Practice Connections, 5(4), 27-29. https://www.aota.org/Publications-News/SISQuarterly/rehabilitation-disability-participation-practice-connections/RDSIS-11-20.aspx

Daniels, J. P., & Khan, K. S. (2010). Chronic pelvic pain in women. British Medical Journal, 341, 772–775. https://doi.org/10.1136/bmj.c4834

Frota, I. P. R., Rocha, A. B. O., Neto, J. A. V., Karbage, S. A. L., Augusto, K. L., Nascimento, S. L. D., . . . Bezerra, L. R. P. S. (2018). Pelvic floor muscle function and quality of life in postmenopausal women with and without pelvic floor dysfunction. Acta Obstetricia et Gynecologica Scandinavica, 97, 552–559. https://doi.org/10.1111/aogs.13305

Lawson, S., & Sacks, A. (2018). Pelvic floor physical therapy and women’s health promotion. Journal of Midwifery & Women’s Health, 63(4), 410-417. https://doi.org/10.1111/jmwh.12736