Purpose: To accurately and precisely evaluate the validity and reliability of the English-language Pelvic Floor Inventories (PelFIs) administered questionnaire. Participants: Fifty female patient volunteers (ages 24 to 82 years) plus fifty female control volunteers (ages 21 to 83 years) completed the 149-item questionnaire. Results: Construct validity of the English-language PelFIs was established by quantifying the differences in prevalence of pfm dysfunction between the patient population and the control population. Very significant findings of F=10.83, p<0.0001 were found for the document as a whole. Content validity was attained by experts, and additional information gathered for further improvement of this tool. Test-retest reliability for all domains was established with ICC=0.905 and no significant differences were found between time-one and time-two. Internal consistency was obtained with significant Pearson's Correlation noted between the domains. The prevalence of co-occurrence of pfm disorders with patients presenting for treatment of a single pfm dysfunction was quantified and 100% of the patients reported symptoms in domains additional to the domain they sought treatment for. The presence of pfm dysfunction was also quantified in the control population and 94% were found to display symptoms of pelvic floor dysfunction. Conclusions: The English-language PelFIs was shown to be valid and reliable. Co-occurrence of pfm dysfunction was found to be highly prevalent.

Purpose: To accurately and precisely evaluate the validity and reliability of the English-language Pelvic Floor Inventories (PelFIs) administered questionnaire. Participants: Fifty female patient volunteers (ages 24 to 82 years) plus fifty female control volunteers (ages 21 to 83 years) completed the 149-item questionnaire. Results: Construct validity of the English-language PelFIs was established by quantifying the differences in prevalence of pfm dysfunction between the patient population and the control population. Very significant findings of F=10.83, p<0.0001 were found for the document as a whole. Content validity was attained by experts, and additional information gathered for further improvement of this tool. Test-retest reliability for all domains was established with ICC=0.905 and no significant differences were found between time-one and time-two. Internal consistency was obtained with significant Pearson's Correlation noted between the domains. The prevalence of co-occurrence of pfm disorders with patients presenting for treatment of a single pfm dysfunction was quantified and 100% of the patients reported symptoms in domains additional to the domain they sought treatment for. The presence of pfm dysfunction was also quantified in the control population and 94% were found to display symptoms of pelvic floor dysfunction. Conclusions: The English-language PelFIs was shown to be valid and reliable. Co-occurrence of pfm dysfunction was found to be highly prevalent.

Bakgrund Bäckenbottendysfunktion (BBD) är vanligt hos personer som genomgått förlossning, och kan påverka den hälsorelaterade livskvaliteten. Fysioterapeutisk behandling av BBD kan både symptomlindra och förbättra den hälsorelaterade livskvaliteten (HRQoL). Syfte Att beskriva hur personer 1-5 år postpartum skattar sina bäckenbottenbesvär och sin hälsorelaterade livskvalitet, samt att utreda sambandet mellan BBD och HRQoL. Att utreda hur många av deltagarna som fått behandling av fysioterapeut. Metod I tvärsnittsstudien deltog 205 personer med bäckenbottendysfunktion (medelålder 33,56 år, SD=±4,7). En webbenkät publicerades på fyra Facebooksidor. För korrelationerna användes icke-parametrisk statistik och beräknades med Spearmans korrelationskoefficient. Resultat Medianvärdet för deltagarnas skattade BBD med PFDI-20 var 95. Högst skattat av deltagarnas HRQoL mätt med RAND-36 var delskalan fysisk funktion med medianvärde 80, lägst var vitalitet med 35. Korrelationerna mellan BBD och olika delar av HRQoL varierade mellan delskalan smärta (r= -0,550) som högst, emotionell rollfunktion (r= -0,358) som lägst, och alla korrelationer hade p&lt;0.001. Starkast negativ korrelation mellan sexuell dysfunktion och HRQoL hittades inom dimensionen fysisk funktion (r= -0,517), och svagast för vitalitet (r=-0,235). Samtliga korrelationer hade p&lt;0,001. Av samtliga deltagare har 40% träffat fysioterapeut/sjukgymnast. Konklusion Deltagarna skattade sin BBD högre än en normalpopulation. Studien påvisar en negativ korrelation både mellan BBD mätt med PFDI-20, en egenformulerad fråga om sexuell dysfunktion och skattad HRQoL mätt med RAND-36. Trots upplevd BBD har enbart hälften av deltagarna fått vård för sina besvär. / Background Pelvic floor dysfunction (BBD) is common among people post partum, and it can affect the health-related quality of life (HRQoL). Physiotherapy for the pelvic floor can both ease symptoms and improve HRQoL. Purpose To describe how people 1-5 years postpartum estimate their BBD and their HRQoL, and to investigate the correlation between BBD and HRQoL. To investigate how many of the participants that have received treatment from a physiotherapist. Method In this cross-sectional study 205 people with BBD participated (mean age 33.56 years, SD=± 4.7). A web survey was published on four Facebook pages. Non-parametric statistics were used, and calculated with Spearman's correlation coefficient. Results The median value for the participants' estimated BBD with PFDI-20 was 95. The highest of the participants' HRQoL measured with RAND-36 was the subscale physical function with a median value of 80 and the lowest was vitality with 35. The correlations between BBD and the various subscales for HRQoL varied between pain (r = -0.550) as the highest, and emotional role function (r = -0.358) as the lowest, and all correlations had p &lt;0.001. The strongest negative correlation between sexual dysfunction and HRQoL was physical function (r = -0.517), and the weakest was vitality (r = -0.235). All correlations had p &lt;0.001. Of all participants, 40% have seen a physiotherapist. Conclusion The participants rated their BBD higher than an average population. The study shows a negative correlation between BBD measured with PFDI-20, a question about sexual dysfunction and estimated HRQoL measured with RAND-36. Despite perceived BBD, only half of the participants have received care for their problems.

Bakgrund Urininkontinens är ett av de vanligaste kroniska hälsoproblemen i samhället, där få söker vård för sina besvär, vilket innebär en försämrad livskvalitet. Resultatet huruvida träning påverkar urinläckage varierar i tidigare forskningsstudier.  Syfte Att undersöka punktprevalensen av ansträngningsinkontinens hos fysiskt aktiva nulliparous totalt och uppdelat på olika träningsformer, samt analysera korrelationen mellan upplevd besvärsgrad av urininkontinens och volymen av måttlig till hög aktivitetsnivå bland fysiskt aktiva nulliparous med ansträngningsinkontinens.  Metod Kvantitativ observationsstudie som utfördes via en webbaserad enkät baserad på IPAQ-SF och PFIQ-7. Fysiskt aktiva kvinnor mellan 16–55 år, som var födda med kvinnligt kön, ej fått barn eller varit gravida efter vecka 13 samt ej var elitidrottare inkluderades. Resultat 215 personer besvarade enkäten, 61 exkluderades. Av 154 deltagare upplevde 37 kvinnor besvär av ansträngningsinkontinens (prevalens 24%). De vanligaste aktiviteterna var löpning (prevalens 26%) och gym/styrketräning (prevalens 18%). Högintensiv träning hade en prevalens av ansträngningsinkontinens på 31–38%. Lågintensiv träning hade en prevalens på 19%. Ingen korrelation kunde påvisas mellan upplevda besvär av urininkontinens och volym av måttlig till hög aktivitetsnivå bland kvinnor med ansträngningsinkontinens (r = -0,0489) (p = 0,8). Konklusion Ansträngningsinkontinens är vanligt hos tränande nulliparous. Det är vanligare med ansträngningsinkontinens vid högintensiva aktiviteter jämfört med lågintensiva. Ingen korrelation kunde påvisas mellan upplevd besvärsgrad av urininkontinens hos kvinnor med ansträngningsinkontinens och aktivitetsnivå. Mer forskning kring träning som eventuell riskfaktor och som eventuell behandlingsmetod krävs. / Background Urinary incontinence is one of the most common chronic health issues in society where few seek care meaning a decreased quality of life. Research regarding how exercise affects urinary incontinence varies.  Purpose On one occasion examine the prevalence of stress urinary incontinence (SUI) in physically active (PA) nulliparous in total and divided by activity, and the correlation between perceived level of discomfort of urinary incontinence (UI) and volume of moderate to high activity level amongst PA nulliparous with SUI. Method Quantitative observational study conducted via a web-based survey based on IPAQ-SF and PFIQ-7. PA women, age 16-55, who were born with a female gender, hadn’t given birth or been pregnant after week 13 and weren’t elite athletes were included.  Result 215 women responded to the survey, 61 were excluded. Of 154 participants 37 women experienced SUI (prevalence 24%). Strength training (prevalence 18%) and running (prevalence 26%) were the most common activities. High-intensity training had a prevalence of 31–38%. Low intensity training had a prevalence of 19%. No correlation between experienced level of discomfort of UI and volume of moderate to high level of physical activity amongst women with SUI could be revealed. (r = -0,0489, p = 0,8).   Conclusion  SUI is common amongst exercising women without known risk factors. It is more common with SUI during high-intensity activities compared with low-intensity. No correlation was demonstrated between UI amongst women with SUI and activity level. Research regarding exercise as risk factors and treatment for UI is required.

No description available.

Sammanfattning Bakgrund Urininkontinens är ett av de vanligaste kroniska hälsoproblemen i samhället, där få söker vård för sina besvär, vilket innebär en försämrad livskvalitet. Resultatet huruvida träning påverkar urinläckage varierar i tidigare forskningsstudier.  Syfte Att undersöka punktprevalensen av ansträngningsinkontinens hos fysiskt aktiva nulliparous totalt och uppdelat på olika träningsformer, samt analysera korrelationen mellan upplevd besvärsgrad av urininkontinens och volymen av måttlig till hög aktivitetsnivå bland fysiskt aktiva nulliparous med ansträngningsinkontinens.  Metod Kvantitativ observationsstudie som utfördes via en webbaserad enkät baserad på IPAQ-SF och PFIQ-7. Fysiskt aktiva kvinnor mellan 16–55 år, som var födda med kvinnligt kön, ej fått barn eller varit gravida efter vecka 13 samt ej var elitidrottare inkluderades. Resultat 215 personer besvarade enkäten, 61 exkluderades. Av 154 deltagare upplevde 37 kvinnor besvär av ansträngningsinkontinens (prevalens 24%). De vanligaste aktiviteterna var löpning (prevalens 26%) och gym/styrketräning (prevalens 18%). Högintensiv träning hade en prevalens av ansträngningsinkontinens på 31–38%. Lågintensiv träning hade en prevalens på 19%. Ingen korrelation kunde påvisas mellan upplevda besvär av urininkontinens och volym av måttlig till hög aktivitetsnivå bland kvinnor med ansträngningsinkontinens (r = -0,0489) (p = 0,8). Konklusion Ansträngningsinkontinens är vanligt hos tränande nulliparous. Det är vanligare med ansträngningsinkontinens vid högintensiva aktiviteter jämfört med lågintensiva. Ingen korrelation kunde påvisas mellan upplevd besvärsgrad av urininkontinens hos kvinnor med ansträngningsinkontinens och aktivitetsnivå. Mer forskning kring träning som eventuell riskfaktor och som eventuell behandlingsmetod krävs. / Abstract Background Urinary incontinence is one of the most common chronic health issues in society where few seek care meaning a decreased quality of life. Research regarding how exercise affects urinary incontinence varies.  Purpose On one occasion examine the prevalence of stress urinary incontinence (SUI) in physically active (PA) nulliparous in total and divided by activity, and the correlation between perceived level of discomfort of urinary incontinence (UI) and volume of moderate to high activity level amongst PA nulliparous with SUI. Method Quantitative observational study conducted via a web-based survey based on IPAQ-SF and PFIQ-7. PA women, age 16-55, who were born with a female gender, hadn’t given birth or been pregnant after week 13 and weren’t elite athletes were included.  Result 215 women responded to the survey, 61 were excluded. Of 154 participants 37 women experienced SUI (prevalence 24%). Strength training (prevalence 18%) and running (prevalence 26%) were the most common activities. High-intensity training had a prevalence of 31–38%. Low intensity training had a prevalence of 19%. No correlation between experienced level of discomfort of UI and volume of moderate to high level of physical activity amongst women with SUI could be revealed. (r = -0,0489, p = 0,8).   Conclusion SUI is common amongst exercising women without known risk factors. It is more common with SUI during high-intensity activities compared with low-intensity. No correlation was demonstrated between UI amongst women with SUI and activity level. Research regarding exercise as risk factors and treatment for UI is required.

Thesis (MScPhysio (Interdisciplinary Health Sciences. Physiotherapy))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The pelvic floor muscles (PFM) contribute to urinary continence and overactive PFM seem to be associated with pelvic pain syndrome (PPS). The literature indicates that ethnic differences regarding symptoms of urinary incontinence may exist. Research is needed to establish relationships between PFM function and symptoms reported by women of different ethnic groups. Objectives: To compare the PFM strength and endurance in black, white and coloured women. To investigate relationships between PFM strength, vaginal resting pressures, risk factors and symptoms associated with PFM dysfunction and PPS. Method: A cross-sectional study assessed the PFM strength and vaginal resting pressures of 122 nulliparous black (n=44), white (n=44) and coloured (n=34) university students. A self-developed questionnaire determined inclusion, demographic variables, factors affecting/factors associated with PFM strength and symptoms related to PPS. Maximum voluntary contraction pressure (cmH2O) and vaginal resting pressure (cmH2O) were measured with the Peritron TM 9300 (Cardio Design, Australia) used with the Camtech AS vaginal balloon sensor (Sandvika, Norway). Two sets of 3 maximum voluntary contractions of the PFM were recorded. Results: The mean age of the group was 22 ± 3.54 years and mean BMI of 23± 4.16 kg/m2. Black women (25 cmH2O ± 13.5) had significantly stronger PFM than white (p=0.02) or coloured (p<0.01) women, but no significant difference (p=0.78) in PFM strength existed between white (18.4 cmH2O ± 9.8) and coloured (15.6 cmH2O ± 8) women. In black women, PFM strength decreased significantly (p=0.02) between the sets, whereas no significant difference between sets was noted in the other ethnic groups. Increased PFM strength was associated with SUI (p=0.03) and amenorrhoea (p=0.01) and decreased PFM strength was associated with decreased frequency of bowel motion (p=0.01). In this sample, increased vaginal resting pressure was associated with menorrhagia (p=0.04). Conclusion: Black nulliparous women had stronger PFM than white and coloured women. There was no difference in PFM strength between white and coloured women. Endurance, as measured in this study, indicates that black women have decreased endurance of the PFM compared to white and coloured women. These findings inform the current research on ethnic differences in the prevalence of urinary incontinence. Preliminary data suggest that there was no relationship between vaginal resting pressures and symptoms of PPS and risk factors for PFM dysfunction, except for menorrhagia. / AFRIKAANSE OPSOMMING: Die bekkenvloer spiere (BVS) dra by tot urinêre kontinensie en ooraktiewe BVS kan moontlik geassosieer wees met pelviese pyn sindroom (PPS). Uit die literatuur blyk dit of daar etniese verskille bestaan in die simptome van urinere inkontinensie gerapporteer deur vroue. Navorsing is nodig om die verwantskap tussen BVS funksie en simptome wat deur pasiënte van verskillende etniese groepe gerapporteer word vas te stel. Doel: Om „n vergelyking te tref tussen BVS sterkte in swart, wit en kleurling vroue. Om vas te stel of daar assosiasies bestaan tussen BVS sterkte, rustende vaginale druklesings en risiko faktore en simptome geassosieer met bekkenvloer disfunksie en PPS. Metodologie: „n Dwarssnit studie het die BVS sterkte en rustende vaginale drukke van 122 nullipareuse swart (n=44), wit (n=44) en kleurling (n=34) universiteit studente geëvalueer. Insluiting, uitsluiting, demografiese veranderlikes, faktore wat kan affekteer/faktore geassosieer met BVS sterkte en simptome geassosier met PPS is deur „n self ontwikkelde vraelys geëvalueer. Maksimale willekeurige spiersametrekking drukke (cmH2O) en rustende vaginale drukke (cmH2O) was gemeet met „n Peritron™9300 perineometer (Cardio Design, Australië) wat saam „n vaginale ballon sensor (Camtech AS, Sandvika, Noorweë) gebruik is. Twee stelle van 3 maksimale willekeurige sametrekkings van die BVS was gemeet. Resultate: Die groep se gemiddelde ouderdom was 22±3.54 jaar en die gemiddelde liggaamsgewig indeks was 23±4.16kg/m2. Swart vroue (25 cmH2O ±13.5) het beduidend sterker BVS gehad as wit (p=0.02) en kleurling (p<0.01) vroue, maar daar was geen beduidende verskil (p=0.78) in BVS sterkte tussen wit (18.4 cmH2O ± 9.8) en kleurling (15.6 cmH2O ± 8) vroue nie. Die BVS sterkte in swart vroue het beduidend (p=0.02) verminder tussen die stelle, maar geen beduidende verskille was waargeneem in die ander etniese groepe tussen stelle. Verhoogde BVS sterkte was geassosieer met druklek (p=0.03), amenorrhoea (p=0.01) en verminderde BVS sterkte was geassosieer met verminderde frekwensie van opelyf (p=0.01). Verhoogde rustende vaginale drukke was geassosieer met menoragie in hierdie steekproef. Gevolgtrekking: Swart nullipareuse vroue het sterker BVS gehad as wit en kleurling vroue, Daar was geen verskil in BVS sterkte tussen wit en kleurling vroue nie. Uithouvermoë soos in hierdie studie getoets toon dat swart vroue verminderde uithouvermoë het i.v.m. wit en kleurling vroue. Hierdie bevindings dra by tot die huidige navorsing oor etniese verskille in die prevalensie van urinêre inkontinensie. Daar was geen verwantskap tussen vaginale rustende drukke en simptome van PPS en risiko faktore vir die ontwikkeling van bekkenvloer disfunksie, behalwe vir menoragie.

Résumé : Introduction : Parmi les structures anatomiques impliqués dans la statique pelvienne, la continence urinaire et anale, le muscle élévateur de l’anus (MEA), le sphincter urétral (SU) et son innervation ont un rôle déterminant. Au cours de la grossesse, de l’accouchement par voie vaginale, de la chirurgie radicale pelvienne, des lésions des muscles du plancher pelvien ou de son innervation peuvent survenir. Ces lésions sont à l’origine de dysfonctions du plancher pelvien telle que le prolapsus uro-génital ou l’incontinence urinaire. Une meilleure connaissance de l’anatomie musculaire et nerveuse pelvi-périnéale est nécessaire pour diminuer la survenue et traiter ces troubles fonctionnels. Classiquement les muscles du plancher pelvien sont décrits comme entièrement striés sous contrôle somatique (nerf du MEA et/ou nerf pudendal (NP)). La dissection Anatomique Assisté par Ordinateur (DAAO) en utilisant des marqueurs nerveux et musculaires spécifiques peut aujourd’hui compléter les données établies par la dissection conventionnelle classique de sujets anatomiques.Objectif : L’objectif était de décrire l’innervation (origine, topographie, trajet, rapports, fonction) et la structure musculaire du MEA, de décrire l’innervation (origine, topographie, trajet, rapports, fonction) du sphincter urétral pour mettre en perspective les implications potentielles dans les dysfonctions du plancher pelvien.Méthodes : Nous avons étudié 9 fœtus humains (6 féminins et 3 masculins). Des coupes histologiques sériées de 5 µm d’épaisseur ont été effectuées dans les régions pelviennes de 7 fœtus âgés de 18 à 40 semaines de gestation. Pour chaque niveau de coupe, des lames ont été colorées puis traitées en immunohistochimie pour détecter : l’ensemble des fibres nerveuses (anticorps anti-protéine S100), les fibres autonomes cholinergiques (anti-VAChT), les fibres autonomes adrénergiques (anti-TH), les fibres autonomes nitrergiques (anti-nNOS), les fibres somatiques (anti-PMP 22), les fibres sensorielles (anti-CGRP), les fibres musculaires lisses (anti-SMA) et les fibres musculaires striées (anti-MYOG). Les coupes ont ensuite été numérisées par un scanner de haute résolution optique et les images ont été reconstruites en 3D avec le logiciel Winsurf®. Un fœtus additionnel a été entièrement destiné à réaliser de la microscopie électronique afin de confirmer nos résultats au niveau architectural musculaire.Résultats : Nous avons observé une innervation à la fois autonome (plexus hypogastrique inférieur (PHI)) et somatique (nerf du MEA et NP) du MEA. Nous avons individualisé des zones de cellules musculaires lisses au sein du plancher pelvien notamment de la partie médiane sous contrôle autonome (PHI) que nous nommons « compartiment médian musculaire lisse ».Nous avons systématisé le plancher pelvien musculaire en une zone médiale lisse sous contrôle nerveux autonome réalisant une interface entre les viscères pelviens, et une zone musculaire striée latérale sous contrôle nerveux somatique.Enfin, nous avons mis en évidence une double innervation à la fois somatique et autonome du sphincter urétral.Conclusion : La DAAO a permis de mettre en évidence une innervation pelvi-périnéale complexe avec l’intrication du système nerveux somatique et autonome. La fonction du contingent musculaire lisse pelvien reste à préciser. / Abstract : Levator ani muscle (LAM), urethral sphincter (US), and their innervation play a major role in pelvic status, urinary continence and anal continence. During pregnancy, vaginal delivery, pelvic radical surgery, damage of pelvic floor muscles or of their innervation may occur. These lesions are responsible for pelvic floor dysfunction such as urogenital prolapse or urinary incontinence. Better knowledge of pelvi-perineal muscle and nerve anatomy is needed to reduce the occurrence and treat these pelvic floor dysfunctions. Classically pelvic floor muscles are described as entirely striated under somatic control (levator ani nerve (LAN) and /or pudendal nerve (PN)). Computer Assisted Anatomical Dissection (CAAD) using specific nerve and muscle markers can nowadays complete data established by conventional dissection of anatomical subjects.The objective was to describe the innervation and the muscular structure of the levator ani muscle, to describe nerve supply of the urethral sphincter in order to better understand pelvic floor dysfunction.Methods : We studied nine human fetuses (6 female and 3 male). Serial histological sections of 5 μm of thickness were performed in the lumbar and pelvic regions of seven human fetuses aged 18 to 40 weeks of gestation. For each level, slides were stained and then treated in immunohistochemistry to detect: general nerve fibers (anti-protein S100), autonomic cholinergic fibers (anti-VAChT), autonomic adrenergic fibers (anti-tyrosine hydroxylase), autonomic nitrergic fibers (anti-nNOS), somatic nerve fibers (anti-peripheral myelin protein 22), sensory fibers (anti-CGRP), smooth muscle fibers (anti-SMA) and striated muscle fibers (anti-MYOG). The slides were then digitized by a high-resolution optical scanner and the images were reconstructed in 3D using the Winsurf® software. One fetus was entirely reserved for electronic microscopy in order to confirm our results.Results: We observed that LAM innervation is supplied by both autonomic (inferior hypogastric plexus (IHP)) and somatic (LAN and PN). We have individualized areas of smooth muscle cells in the pelvic floor, particularly the median part controlled by the autonomic system that we named “smooth muscle medial compartment”.We systematized within the pelvic floor muscle a smooth medial part under an autonomic nervous control as interface between the pelvic viscera and a lateral striated muscle part under somatic nervous control.Finally, we have demonstrated a dual innervation both somatic and autonomic sphincter urethral.Conclusion : CAAD has demonstrated complex pelvic-perineal innervation with the interaction of the somatic and autonomic nervous system. The function of the pelvic smooth muscle contingent remains to be clarified.

Bakgrund: Bäckenbottendysfunktion innebär onormal funktion i bäckenbottenmuskulaturen som orsakas av ökad eller minskad muskeltonus och nedsatt koordination av bäckenbottenmusklerna.  Det innefattar flera olika funktionella problem och delas upp i urologiska, gynekologiska eller kolorektala. Biofeedback är en apparat som kan användas som ett tillägg till vanlig bäckenbottenträning. Den är till för att lära sig använda rätt teknik och kontrollera och identifiera rätt muskler. Man kan använda biofeedback till att träna styrka, uthållighet, koordination samt avslappning. Syfte: Undersöka effekten av bäckenbottenträning med biofeedback på blås- och tarmtömningsbesvär (utöver urin- och fekalinkontinens), livskvalitet och sexuell funktion jämfört med bäckenbottenträning utan biofeedback/sedvanlig behandling/ingen träning alls. Metod: Systematisk litteraturstudie med databaserna PubMed och Web of Science. Studiernas kvalitet granskades med PEDro och resultatets tillförlitlighet granskades enligt Uppsala Universitets Fysioterapeutsprograms bedömningsmall för systematiska översikter.  Resultat: Sju randomiserade kontrollerade studier inkluderades. Alla studier visade signifikant förbättring hos interventionsgrupperna. Fyra studier undersökte tömningssvårigheter, tre undersökte livskvalitet och två studier undersökte sexuell dysfunktion. Fem studier undersökte biverkningar av biofeedback utan fynd. Alla studier hade god kvalitet enligt PEDro, men samtliga visade på mycket låg tillförlitlighet (+) enligt Uppsala Universitets Fysioterapeutsprograms bedömningsmall för systematiska översikter. Konklusion: Det tyder på att bäckenbottenträning med biofeedback har positiv effekter på blås- och tarmtömningssvårigheter, livskvalitet och sexuell funktion hos personer med bäckenbottendysfunktion. Inga fynd av biverkningar av bäckenbottenträning med biofeedback hittades. Studierna hade god kvalitet enligt PEDro och dess sammanvägda resultat hade mycket låg tillförlitlighet (+). Resultatet bör därför tas med försiktighet och fler randomiserade kontrollerade studier behövs för att kunna dra några slutsatser. / Background: Pelvic floor dysfunction means abnormal function of the pelvic floor muscles caused by increased or decreased muscle tone and reduced coordination of the pelvic floor muscles. It includes several different functional problems such as urological, gynecological or colorectal. Biofeedback is a device that can be used as an addition to regular pelvic floor training. It helps people to use the right technique and to control and identify the right muscles. Biofeedback can be used to train strength, endurance, coordination and relaxation. Objective: Investigate the effect of pelvic floor training with biofeedback on bladder- and bowel voiding difficulties (except for urinary- and fecal incontinence), quality of life and sexual function compared to pelvic floor training without biofeedback/usual care/no training. Method: Systematic literature study which used the databases PubMed and Web of Science. The quality of the studies was reviewed using PEDro and the reliability of the results were reviewed according to Uppsala University's Physiotherapy program assessment template for systematic reviews. Results: Seven randomized controlled trials were included in this study. All studies showed significant improvement in the intervention groups. Four studies examined voiding difficulties, three examined quality of life and two studies examined sexual dysfunction. Five studies investigated side effects of biofeedback with no findings. All studies had good quality according to PEDro, however all showed very low reliability (+) according to Uppsala University's Physiotherapy program assessment template for systematic reviews. Conclusion: It indicates that pelvic floor training with biofeedback has positive effects on bladder- and bowel voiding difficulties, quality of life and sexual function in people with pelvic floor dysfunction. There are no findings of side effects of pelvic floor training with biofeedback. The studies were of good quality according to PEDro and their combined results had very low reliability (+). The result should therefore be taken with caution and more randomized controlled trials are needed to reach more reliable conclusions.

Title: Sexual Dysfunction and Pelvic Floor Dysfunction in Patients with Systemic Rheumatic Diseases Objectives: To assess sexual functions, quality of life and pelvic floor function in female patients with Systemic Sclerosis (SSc) and Idiopathic Inflammatory Myopathies (IIM) compared to age-/sex-matched healthy controls (HC). Methods: In total, 41 women with SSc (mean age: 50.9, disease duration: 5.8 years), who fulfilled the ACR/EULAR 2013 classification criteria for SSc, 41 healthy controls (mean age: 50.9) without rheumatic diseases, 22 women with IIM [mean age: 55.1, disease duration: 7.9 years, dermatomyositis (DM, 8)/ polymyositis (PM, 10)/ necrotizing myopathy (IMNM, 3)/ inclusion body myositis (IBM, 1)], who fulfilled the Bohan/Peter 1975 diagnostic criteria for DM/PM, and 22 healthy controls (mean age: 55.1 years) filled in 12 well-established and validated questionnaires assessing sexual function/quality of life, pelvic floor function, fatigue, physical activity and depression. Results: Compared to HC, patients with SSc and IIM had significantly higher prevalence and greater severity of sexual dysfunction (FSFI, BISF-W: in all subscales as well as total scores), dysfunction of pelvic floor (PISQ-12), and worse sexual quality of life (SQoL-F). Worse scores in SSc patients were associated...