Elizabeth E Painter1, Melissa D Ogle, Deydre S Teyhen. 1. Physical Therapy Clinic, General Leonard Wood Army Community Hospital, Fort Leonard Wood, MO 65473, USA. Elizabeth.painter@na.amedd.army.mil
Abstract
STUDY DESIGN: Case report. BACKGROUND: It has been suggested that altered neuromuscular control of the transversus abdominis and pelvic floor muscles may contribute to sacroiliac joint (SIJ) region pain and stress urinary incontinence. There are limited examples describing the evaluation and management of individuals with both SIJ region pain and stress urinary incontinence in the literature. This case report describes a patient with both conditions and details the integration of rehabilitative ultrasound imaging (RUSI) during physical therapy evaluation. 6 CASE DESCRIPTION: A 35-year-old female soldier presented with a 6-week history of left buttock pain and 4-year history of stress urinary incontinence during activities that involved running, jumping, and fast walking. RUSI was used to supplement the physical assessment process, revealing altered motor control strategies of the transversus abdominis and pelvic floor muscles, and as a form of biofeedback during the rehabilitation process. OUTCOMES: After completing a rehabilitation program that incorporated principles of lumbar stabilization and pelvic floor muscle re-education, this patient was able to complete all physical activities in basic combat training without SIJ region pain or urinary leakage. DISCUSSION: This case demonstrates the importance of considering pelvic floor muscle dysfunction and training in a patient with primary complaints of SIJ region pain. It also highlights the potential role of RUSI as both an evaluation and biofeedback tool for the deep abdominal and pelvic floor muscles.
STUDY DESIGN: Case report. BACKGROUND: It has been suggested that altered neuromuscular control of the transversus abdominis and pelvic floor muscles may contribute to sacroiliac joint (SIJ) region pain and stress urinary incontinence. There are limited examples describing the evaluation and management of individuals with both SIJ region pain and stress urinary incontinence in the literature. This case report describes a patient with both conditions and details the integration of rehabilitative ultrasound imaging (RUSI) during physical therapy evaluation. 6 CASE DESCRIPTION: A 35-year-old female soldier presented with a 6-week history of left buttock pain and 4-year history of stress urinary incontinence during activities that involved running, jumping, and fast walking. RUSI was used to supplement the physical assessment process, revealing altered motor control strategies of the transversus abdominis and pelvic floor muscles, and as a form of biofeedback during the rehabilitation process. OUTCOMES: After completing a rehabilitation program that incorporated principles of lumbar stabilization and pelvic floor muscle re-education, this patient was able to complete all physical activities in basic combat training without SIJ region pain or urinary leakage. DISCUSSION: This case demonstrates the importance of considering pelvic floor muscle dysfunction and training in a patient with primary complaints of SIJ region pain. It also highlights the potential role of RUSI as both an evaluation and biofeedback tool for the deep abdominal and pelvic floor muscles.
Authors: Vânia F Figueiredo; Juleimar S C Amorim; Aline M Pereira; Paulo H Ferreira; Leani S M Pereira Journal: Braz J Phys Ther Date: 2015-02-13 Impact factor: 3.377