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Pain characteristics, psychological variables and pelvic floor muscle function as predictors of treatment response to physical therapy in women with provoked vestibulodynia

Year: 2019
Type: dissertation
Abstract: Introduction: Physical therapy (PT) is recognized as a first-line treatment for women with provoked vestibulodynia (PVD), yet there are presently no validated predictors of treatment response. Objective: This study investigated whether pretreatment pain characteristics, psychological variables and pelvic floor muscle (PFM) function predict PT outcomes in women with PVD. Methods: One hundred-five women diagnosed with PVD underwent 10 weekly sessions of individual PT comprised of education, PFM exercises with biofeedback, manual therapy, and dilators use. Outcome measures were evaluated at pretreatment, post-treatment and 6-month follow-up and included pain intensity (numerical rating scale 0-10) and sexual function (Female Sexual Function Inventory). Multilevel analyses were used to examine the potential predictors of response over time including pain characteristics (PVD subtype, pain duration), psychological variables (fear of pain, pain catastrophizing) and PFM function assessed with a dynamometric speculum (tone, flexibility and strength). Results: Results showed that PVD subtype and PFM tone were significant predictors of greater treatment response for pain intensity reduction. Secondary PVD (i.e., pain developed after a period of pain-free intercourse) and lower PFM tone at baseline were both associated with greater reduction in pain intensity after PT and at follow-up. Among the psychological variables, fear of pain was the only significant predictor of better treatment response when assessed through improvement in sexual function, higher fear of pain at baseline was associated with greater improvement after PT. Conclusion: In conclusion, this study identified PVD secondary subtype, lower PFM tone and higher fear of pain as significant predictors of better treatment response to PT in women with PVD.
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W7201944792
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