Impact of a Holistic Educational Self-Led OT Intervention on Pelvic Floor Dysfunction Among Postpartum Women

Pelvic floor dysfunction (PFD) following childbirth is common and impacts quality of life (QoL) and participation in activities of daily living (Burkhart et al., 2021). The literature suggests pelvic floor muscle training to be an effective treatment for PFD (Singh et al., 2016), however, a more holistic approach to account for the complexity of PFD in postpartum women is needed (Xu et al., 2023). The purpose of this study was to determine the impact of a holistic educational self-led occupational therapy (OT) intervention on PFD symptoms, occupational participation, and QoL in postpartum women. Pre-menopausal women who were at least 3 months postpartum, experiencing at least 1 PFD symptom, and not currently receiving PFD therapy were eligible to participate. Ten healthy women ages 30 to 43 participated in a 90-minute educational session followed by an 8-week structured program to complete at home. The program addressed physical, psychosocial, and behavioral components offering a flexible, low-cost alternative that addresses barriers to traditional care (Xu et al., 2023). In this repeated measure design, the Pelvic Floor Disability Index (PFDI)-20 and Pelvic Floor Impact Questionnaire (PFIQ)-7 were administered prior to the intervention (pre), at 4 weeks (middle), and after 8 weeks (post). The Friedman test (α=0.05) showed differences in both PFDI-20 (p=0.038) and PFIQ-7 (p<0.001) scores between the three points of data collection. Wilcoxon post hoc test demonstrated a significant improvement in PFDI-20 scores between pre to post (p=0.019) and middle to post (p=0.066). It also showed improvements in PFIQ-7 scores between pre to post (p=0.007), pre to middle (p=0.02), and middle to post (p=0.007). In conclusion our holistic educational self-led OT intervention may improve activity participation and QoL in 4 weeks. Continuing the intervention for 8 weeks may decrease PFD symptoms in postpartum women.

References

Burkhart, R., Couchman, K., Crowell, K., Jeffries, S., Monvillers, S., & Vilensky, J. (2021). Pelvic Floor Dysfunction After Childbirth: Occupational Impact and Awareness of Available Treatment. OTJR: Occupation, Participation and Health, 41(2), 108–115. https://doi.org/10.1177/1539449220970881

Singh, N., Arya, K. N., & Perveen, A. (2016). Effectiveness of pelvic floor (PF) rehabilitation by recruiting abdominals (global) vs kegels in the management of stress urinary incontinence in women. Indian Journal of Physiotherapy and Occupational Therapy - An International Journal. https://doi.org/10.5958/0973-5674.2016.00074.5

Xu, P., Jin, Y., Guo, P., Xu, X., Wang, X., Zhang, W., Mao, M., & Feng, S. (2023). Barriers and enablers of pelvic floor rehabilitation behaviours in pregnant women with stress urinary incontinence: A qualitative analysis using the theoretical domains framework. BMC Pregnancy and Childbirth, 23(1), 300. https://doi.org/10.1186/s12884-023-05633-2