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Pelvic floor physical therapy and mindfulness: approaches for chronic pelvic pain in women—a systematic review and meta-analysis

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Abstract

Purpose

Chronic pelvic pain (CPP) in women is a complex syndrome and symptoms are associated with sexual dysfunction, musculoskeletal and myofascial disorders, and comorbid psychiatric disorders. Its widespread prevalence results in substantial expense due to therapy and lost productivity, and it is perhaps one of the most urgent and neglected medical needs. This systematic review and meta-analysis aimed to estimate the role of mindfulness and pelvic floor physical therapy (PFPT) in the treatment or management of women with CPP.

Methods

This systematic review (CRD42020204987) searched for relevant publications between January 2000 and November 2020 on MEDLINE/PubMed, Web of Science, One File GALE, and Technology Research databases using the following search terms: chronic pelvic pain, pelvic floor physical therapy/physiotherapy, mindfulness, and their variants. Risk of bias and quality of evidence were evaluated.

Results

Seven clinical trials (n = 279) were included in the review, and five in the meta-analysis (n = 225). For the pain outcome and its catastrophizing, there was a statistical difference for the Pain Catastrophizing Scale after treatment and during follow-up with mindfulness and PFPT (MD = − 3.82 [− 6.97, − 0.68], p = 0.01, and MD = − 4.49 [− 7.61, − 1.37], p = 0.00, respectively). Sexual function, assessed by the female sexual function index, differed significantly during follow-up between PFPT and mindfulness (MD = − 0.72 [− 1.38, − 0.05], p = 0.03).

Conclusion

The small number of studies applying both PFPT and mindfulness to CPP suggests that a multidisciplinary approach is required to treat women with CPP, and further studies involving these therapeutic techniques throughout the CPP cycle are needed.

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All relevant data are within the paper.

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Authors and Affiliations

  1. Department of Clinical Surgery, Universidade Federal do Paraná (UFPR), Rua José Naves da Cunha, 51, Curitiba, PR, 80310080, Brazil

    Cleima Coltri Bittelbrunn

  2. Department of Clinical Surgery, UFPR, R. Angelo Durigan, 1199/01, Curitiba, PR, 82025100, Brazil

    Rogerio de Fraga

  3. UFPR, Rua Marechal Deodoro, 1650/51, Curitiba, PR, 80045090, Brazil

    Camilli Martins

  4. Department of Clinical Surgery, UFPR, Alameda Augusto Stellfeld 1274/23, Curitiba, PR, 80430-140, Brazil

    Ricardo Romano

  5. Department of Clinical Surgery, UFPR, Rua Diogo Pinto de Azevedo Portugal 115, Curitiba, PR, 82130460, Brazil

    Thomaz Massaneiro

  6. Pontifícia Universidade Católica do Paraná (PUCPR), Rua Benedito Cotolengo, 710/9, Curitiba, PR, 81220310, Brazil

    Glauco Vinicius Pauka Mello

  7. Systems and Production Engineering Department (PPGEPS), PUCPR, R. Amazonas, 642/34, Curitiba, PR, 80610-030, Brazil

    Matheus Canciglieri

Authors
  1. Cleima Coltri Bittelbrunn
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  2. Rogerio de Fraga
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Contributions

CCB: protocol/project development; data collection or management; data analysis; manuscript writing/editing. RF: protocol/project development. CM: protocol/project development. R: data collection or management; data analysis; manuscript writing/editing. TM: data analysis. GVPM: data collection or management; data analysis; manuscript writing/editing. MC: data collection.

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Correspondence to Cleima Coltri Bittelbrunn.

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Bittelbrunn, C.C., de Fraga, R., Martins, C. et al. Pelvic floor physical therapy and mindfulness: approaches for chronic pelvic pain in women—a systematic review and meta-analysis. Arch Gynecol Obstet 307, 663–672 (2023). https://doi.org/10.1007/s00404-022-06514-3

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