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Low-Value Practices for Pelvic Floor Dysfunction—Choosing Wisely Recommendations from the Brazilian Association of Physiotherapy in Women’s Health: Observational Study

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Abstract

Introduction and Hypothesis

The Choosing Wisely campaign is an international initiative that is aimed at promoting a dialog between professionals, helping the population to choose an evidence-based, truly necessary and risk-free care. The aim of the study was to develop the Choosing Wisely Brazil list on Women's Health Physiotherapy in the area of the pelvic floor.

Methods

A observational study was carried out between January 2022 and July 2023, proposed by the Brazilian Association of Physiotherapy in Women's Health, and developed by researchers working in the area of the pelvic floor. The development of the list consisted of six stages: a panel of experts, consensus building, national research, a review by the Choosing Wisely Brazil team, preparation of the list, and publication of the recommendations. Descriptive and content analyses were carried out in order to include evidence-based recommendations with over 80% agreement by physiotherapists in Brazil.

Results

The expert panel was made up of 25 physiotherapists who submitted 63 recommendations. Seven physiotherapists/researchers carried out a critical analysis of the literature and refined the recommendations, resulting in 11 recommendations that were put to a national vote, in which 222 physiotherapists took part. After a review by the Choosing Wisely Brazil team, five recommendations with an average agreement of 88.2% agreement were chosen for publication.

Conclusions

The Choosing Wisely Brazil team in Physiotherapy in Women's Health/Pelvic Floor proposed a list of five recommendations that showed a high agreement among Brazilian physiotherapists working in the area.

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Data Availability

We declare that the data will be available to all those who request the corresponding author.

Abbreviations

ABRAFISM:

Brazilian Association of Physiotherapy in Women's Health

AUA:

American Urological Association

AUGS:

American Urogynecologic Society

COFFITO:

Federal Council of Physiotherapy and Occupational Therapy

FI:

Fecal incontinence

ICS:

International Continence Society

IFRJ:

Federal Institute of Rio de Janeiro

IUGA:

International Urogynecological Association

PFD:

Pelvic floor dysfunction

PFM:

Pelvic floor muscles

PFMT:

Pelvic floor muscle training

POP:

Pelvic organ prolapse

SGO:

Society of Gynecologic Oncology

UFSCar:

Federal University of São Carlos

UI:

Urinary incontinence

UNICAMP:

University of Campinas

UNIFAL-MG:

Federal University of Alfenas

USP-RP:

University of São Paulo—Ribeirão Preto

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Acknowledgements

This work was supported by the Coordination for the Improvement of Higher Education Personnel—Brazil (CAPES)—Finance Code 001 and the Fundação de Amparo à Pesquisa do Estado de Minas Gerais—FAPEMIG (PPM-00471-18), in partnership with ABRAFISM and the University Research Laboratories UNICAMP, UNIFAL-MG, UFSCar, USP-RP, and IFRJ.

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Authors and Affiliations

Authors

Contributions

L.P.: project development, data analysis, and manuscript writing; P.D.: project development and data analysis; F.J.J.R.: project development and data analysis; J.C.R.: project development and data collection; C.C.C.: project development and data collection; C.R.: project development and manuscript writing; C.H.J.: project development and data analysis; S.B.: project development, data analysis, and manuscript writing.

Corresponding author

Correspondence to Simone Botelho.

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Ethical/Institutional Review Board Approval

Research Ethics Committee of Federal University of São Carlos (UFSCar) under CAAE number 51932321.0.0000.5504 and opinion number 5.165.999 in accordance with Resolution 466/12 of the National Health Council.

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None.

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Pasqualotto, L., Driusso, P., dos Reis, F.J.J. et al. Low-Value Practices for Pelvic Floor Dysfunction—Choosing Wisely Recommendations from the Brazilian Association of Physiotherapy in Women’s Health: Observational Study. Int Urogynecol J (2024). https://doi.org/10.1007/s00192-024-05828-x

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