The Evaluation of Pelvis Girdle Musculoskeletal Dysfunction in Female patients with IC/BPS (Interstitial Cystitis/ Bladder Pain Syndrome). A Preliminary Study

Lee M1, Chen Y2, Wu H3

Research Type

Clinical

Abstract Category

Pelvic Pain Syndromes

Abstract 179
ePoster 3
Scientific Open Discussion Session 12
On-Demand
Painful Bladder Syndrome/Interstitial Cystitis (IC) Pelvic Floor Pain, Pelvic/Perineal Physiotherapy Quality of Life (QoL)
1. Department of Urology, Miao-Li Hospital, Ministry of Health and welfare, Taiwan. Central Taiwan University of Science and Technology, Taichung, Taiwan, 2. Department of Physical Therapy, Chung-Shan Medical University, 3. Department of Urology, Miao-Li Hospital, Ministry of Health and welfare, Taichung, Taiwan. Central Taiwan University of Science and Technology, Taichung, Taiwan
Presenter
M

Ming Huei Lee

Links

Abstract

Hypothesis / aims of study
Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS) is a chronic disease characterized by urinary urgency, frequency, and pain. Many IC/BPS patients also suffer from pelvic floor spasm or pelvic girdle musculoskeletal dysfunction, which causes pelvic pain, dyspareunia, and urinary hesitancy. The purposes of this study is to investigate the correlation of pelvic girdle musculoskeletal disorders in women with different symptom/ problem severity of female patients with IC/PBS.
Study design, materials and methods
Thirty four women aged from 20 y/o to 65 y/o who diagnosed with IC/PBS by urologists were recruited in this study. The pelvic girdle musculoskeletal disorder assessments, including muscle strength (rectus abdominis, gluteus medius and pelvic floor muscle), muscle flexibility (tensor fascia lata, rectus femoris and piriformis), myofascial tender point pain level (rectus abdominis, iliacus, tensor fascia lata, piriformis and pelvic floor muscle), screening examination of sacroiliac joint and hip joint, were conducted in this study. The subjects were divided into two groups according to their clinical symptom and problem severity which was defined by their self-reported total scores of The Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI). The range of total scores is 0-36, with the higher scores the higher risk of having IC. The subjects with the total scores smaller than/ or equal to 23 were referred to group I (mild-moderate group, n=17), the total scores greater than 23 were referred to group II (severe group, n=17).  Independent-sample T test and Chi Square test were used to compare the differences between two groups. The correlation between symptom/ problem questionnaire scores and pelvic girdle musculoskeletal disorder assessments were also analysed for all subjects by Spearman's rho. Significance was set at p < 0.05.
Results
The results shown significant differences between groups in abdominal muscle strength, as well as the myofascial tender point pain level of tensor fascia lata and puborectalis. The significant positive correlation was found between symptom/ problem sub-scores/ or total scores and sacroiliac joint screening examination, and myofascial tender point pain level (piriformis, puborectalis, and pubococcygeus). Whereas significant negative correlation was found between symptom/ problem sub-scores/ or total scores and abdominal muscle strength, abdominal muscle endurance, and piriformis flexibility.
Interpretation of results
Subjects with more severe self-reported IC/PBS related symptoms/ problems tended to have poorer abdominal muscle strength, more noticeable myofascial tender point pain level on tensor fascia lata, pirirformis and pelvic floor muscles, and more common abnormal finding on musculoskeletal exam.
Concluding message
Women with IC/PBS may also have pelvic girdle musculoskeletal dysfunction. As part of a multimodality approach to treating IC/PBS, pelvic girdle musculoskeletal assessment is recommended. The understanding of the pelvic musculoskeletal disorders in subjects with interstitial cystitis would be beneficial to provide a complete advice in treatment prescription.
Figure 1 <Table 1> The contrast of manual muscle test of retus abdomins and myofacial tender point pain level between group I (mild-moderate group) and group II (severe group)
Figure 2 <Table 2> The results of correlation between scores of The Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI) and pelvic girdle musculoskeletal disorder assessments
References
  1. de Oliveira, I. O., Pilz, B., Junior, R. L. S., Vasconcelos, R. A., Mello, W., & Grossi, D. B. (2018). Reference values and reliability for lumbopelvic strength and endurance in asymptomatic subjects. Brazilian journal of physical therapy, 22(1), 33-41.
  2. Rahmani, N., & Mohseni-Bandpei, M. A. (2011). Application of perineometer in the assessment of pelvic floor muscle strength and endurance: a reliability study. Journal of bodywork and movement therapies, 15(2), 209-214
  3. Bassaly, R., Tidwell, N., Bertolino, S., Hoyte, L., Downes, K., & Hart, S. (2011). Myofascial pain and pelvic floor dysfunction in patients with interstitial cystitis. International Urogynecology Journal, 22(4), 413-418.
Disclosures
Funding Nothing to disclosure Clinical Trial Yes Registration Number No RCT No Subjects Human Ethics Committee Institutional Review Board of Tsaotun Psychiatric Center -107028 Helsinki Yes Informed Consent Yes
18/04/2024 14:21:05