Pelvic floor physical therapy for female stress urinary incontinence: five years outcome

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lymphedema and a higher level of daily activities. Special attention should be paid to muscle strengthening, functional recovery and cardiopulmonary status during cancer treatment. Conclusion(s): Patients treated with ALND require special attention to detect and consequently address impairments in the arm and shoulder. Commencing physical therapy 5–7 days post-operatively proves to be the most efficacious. Implications: Patients with breast cancer at high risk for reduced range of motion and muscle strength, pain, lymphoedema and decreased degree of activities in daily living should be referred without delay for physical therapy. The physical therapist should pay attention to impairments in function as well as performance of daily activities and participation. Utilization of uniform validated measurement instruments for diagnosis and evaluation should be encouraged to compare outcomes of treatments and to enable meta-analyses. Keywords: Breast cancer; Impairments arm/shoulder; Daily activities Funding acknowledgements: – Ethics approval: Ethics approval was not required. http://dx.doi.org/10.1016/j.physio.2015.03.292 Research Report Poster Presentation Number: RR-PO-16-09-Mon Monday 4 May 2015 12:15 Exhibit halls 401–403 MEASURING JOINT HYPERMOBILITY USING THE HOSPITAL DEL MAR CRITERIA—A RELIABILITY ANALYSIS USING SECONDARY DATA ANALYSIS D.E. Bevilacqua Junior 1,2 , S. Maillard 3 , J. Ferrari 4 1 UFTM

Universidade Federal do Triangulo Mineiro, Patologia Geral, Uberaba, Brazil; 2 APAE Associa¸cão de Pais e Amigos dos Excepcionais, Fisioterapia, Uberaba, Brazil; 3 Great Ormond Street Hospital, Physiotherapy, London, United Kingdom; 4 UEL University of East London, School of Health, Sport and Bioscience, London, United Kingdom Background: Joint hypermobility (JH), also known as joint laxity, is a condition which most of an individual’s synovial joints present an excessive range of movement (ROM) during passive or active movements taking in consideration the age, gender and different ethnic group of the subject. While various sets of diagnostic criteria for hypermobility have been published, to date there is no recommended gold standard, and diagnosis of hypermobility in children is generally based on clinical judgement. Purpose: The aims of this study were to test the interrater reliability of the Hospital Del Mar criteria, assessing the

reliability of the total score as well as individual components of the score. Methods: Secondary analysis of data was carried out from a retrospective study on a cohort of children under the age of 16 years, presenting to a joint assessment clinic. Two raters examined those subjects using the Hospital Del Mar criteria (Bulbena et al., 1992) for diagnosing joint hypermobility (JH). Each rater also classified the subject as either hypermobile or normal based on their overall clinical findings. The Kappa statistic was used to calculate the level of agreement between the two raters. Results: Thirty subjects were included in the study ranging in age from 3 to 12 years (mean = 7.02, ±2.47 SD). Of the 30 subjects assessed, 21 (30%) were classified as hypermobile, 11 boys (52.3%) and 10 girls (47.6%). Nine children (30%) were classified as non-hypermobile. Overall, the prevalence of JH in this study was higher in boys than in girls. Conclusion(s): In this group of children, the Hospital Del Mar criteria appeared to be reliable tool for diagnosing hypermobility. Inter-rater reliability was good to excellent when assessing JH. Specific thresholds for diagnosis need to be set dependant on the age and ethnic group of the population being studied. Implications: Through comparison of the classifications, the Hospital Del Mar criteria were shown to have benefits over the already existent scoring systems. If replicated, these findings may give enhanced value to Joint Hypermobility assessment in clinical and general population studies. Keywords: Joint hypermobility; Inter-rater reliability; Children Funding acknowledgements: School of Health and Biosciences, University of East London (UEL) and Great Ormond Street Hospital, London. Ethics approval: The ethical application was not required because this paper work is a secondary data analysis. http://dx.doi.org/10.1016/j.physio.2015.03.293 Research Report Poster Presentation Number: RR-PO-99-23-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 PELVIC FLOOR PHYSICAL THERAPY FOR FEMALE STRESS URINARY INCONTINENCE: FIVE YEARS OUTCOME N. Beyar 1,2 , A. Groutz 3 1 Tel-Aviv

University, Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv, Israel; 2 Maccabi Health Services, Physical Therapy, Tel-Aviv, Israel; 3 Tel Aviv Medical Center, Lis Maternity Hospital, Tel-Aviv, Israel Background: Pelvic floor muscle training (PFMT) is a part of pelvic floor physical therapy (PFPT) and

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS26–eS426

recommended as first-line treatment of female stress urinary incontinence (SUI). However, up-to-date long-term outcomes of this treatment modality are scarce and controversial. Purpose: The aim of this study was to evaluate the clinical status, lower urinary tract symptoms (LUTS) and quality of life (QOL) parameters five years after completion of PFPT program for female SUI. Methods: 263 consecutive women who had undergone PFPT for SUI five years earlier were eligible and were invited to participate in the study. All patients had a history of symptoms of SUI prior to treatment. Patients with mixed urinary incontinence, concomitant significant pelvic organ prolapse (1 cm or more distal to the hymen), and those who previously underwent SUI surgery, were excluded. Baseline demographic and clinical data, as well as treatment parameters were taken from “Maccabi health services” computerized database. All patients underwent and completed a PFPT course conducted by pelvic floor physiotherapists. Treatment outcomes were measured by LUTS and QOL questionnaires (BFLUTS, ICIQ-UI, I-QOL), as well as demographic and clinical questionnaires. Primary outcome measures comprised of five-year adherence to PFMT, interval surgery for SUI, and patients’ self-assessment of LUTS and QOL. Secondary outcome measures were risk factors associated with severity of incontinence and impaired QOL. Results: 132 women who underwent PFPT for SUI five years earlier completed all study questionnaires (50% response rate). Of these, 75 (56.8%, mean age 49.8 + 10.8) had stopped PFMT, 55 women (41.7%, mean age 52.1 + 10.8) reported adherence to PFMT, and two others (1.5%) had undergone SUI surgery. Except for those who underwent surgery, almost all other women reported SUI, however their ICIQ-UI scores for frequency and amount of leakage were low (2.2 + 0.9, 1.18 + 1.04, respectively) and I-QOL score was high (96.2 + 13.6). Frequency and severity of LUTS, as well as QOL scores, were similar among all women regardless of adherence to PFMT. Positive correlation was found between lower back pain, BMI, age and parity and severity of symptoms. Further analysis of the 132 patients who did not complete the questionnaires revealed 6 more patients who underwent SUI surgery. Thus, overall, 8 patients (3%) of the original cohort underwent surgery for SUI within five years after completion of the PFMT program. Conclusion(s): (1) Up to 41.7% of women who underwent PFPT for SUI reported adherence to training five years later, and only 1.5% had undergone SUI surgery. It was noted that adherence to therapy per se was not found to be associated with better LUTS or QOL parameters but none of the women accurately followed the recommended training protocol. Further prospective studies are needed to establish the long term results of PFPT for SUI. (2) LBP, higher BMI, older age and parity increase severity of LUTS symptoms. Implications: Our studies reveal that although most women still suffered mild incontinence, their quality of life was reported to be very high. It is assumed that accurate

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adherence strategies to the training protocol will significantly improve incontinence. Keywords: Stress urinary incontinence; Pelvic floor physical therapy; Pelvic floor muscle training Funding acknowledgements: No funding. Ethics approval: Ethics approval-Helsinki committee of Maccabi health services, Israel, The Ethical Committee of Tel-Aviv University, Israel. http://dx.doi.org/10.1016/j.physio.2015.03.294 Research Report Poster Presentation Number: RR-PO-99-28-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 ROLE OF SHORT TERM EXERCISE INTERVENTION IN PELVIC GIRDLE PAIN IN PREGNANCY A. Bhandiwad 1 , S. Vaisravanath 1 , M.S. Sujatha 2 1 JSS College of Physiotherapy, Women’s Health, Mysore, India; 2 JSS Medical College & Hospital, Obstetrics & Gynaecology, Mysore, India

Background: Pregnancy related pelvic girdle pain is a disabling problem. Recent data suggests that during pregnancy, 25% of women experience serious pelvic pain, and 8% are severely disabled. Pregnancy places stress on a woman’s body affecting her hormonal levels, causing muscle and joint dysfunction and affecting her gait and posture. The hormonal changes cause ligaments to relax inducing joint hyper mobility and pain. As the weight progresses during pregnancy the center of gravity shifts, causing pelvic distortion to develop with gait disturbances and pain. Despite the fact that pregnancy-related pelvic girdle pain is a common ailment, it is still poorly described and understood. Studies have shown that it is a relatively common problem in many countries. It has been estimated that approximately 20–25% of all pregnant women suffer from pelvic girdle pain that is sufficiently serious to require medical help. Purpose: Pregnancy-related pelvic girdle pain is an ailment which is still poorly described and understood. Studies have shown that pelvic girdle pain is a relatively common problem in many countries, irrespective of their socioeconomic status. The treatment for pelvic girdle pain involves various techniques that have a distinctive effect in perceiving and modulating the pain behavior. The purpose of this study is to determine the role of pregnancy specific exercise intervention for short duration to minimize pelvic girdle pain, posture and improve their functional activity levels and posture during pregnancy. Methods: A total of 12 patients were selected who were diagnosed with pelvic girdle pain in their second and third trimesters (5, 6, 7 and 8), their informed consent was taken