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Somatocognitive therapy of women with gynecological unexplained chronic pelvic pain
Haugstad GK
Fysioterapeuten 2008 Sep;75(9):23-34
clinical trial
2/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Chronic pelvic pain (CPP) is a common cause of infirmity (an imperfection or weakness) among women. No effective treatment is available. Aims of this thesis were to (1) study the motor patterns of posture, movements and coordination, gate, sitting posture and respiration in women with chronic pelvic pain and (2) study the effect of Mensendieck somatocognitive therapy (MSGT) compared to gynecological therapy as usual to (3) develop an evaluation instrument designed to assess motor patterns. A standardized Mensendieck test (SMT) was developed to assess motor patterns. Inter-rater reliability and validity were tested in a sample of 15 women with CPP and 15 controls. 40 women with CPP were recruited. The patients were examined by a gynecologist, a psychologist and a physiotherapist using the SMT. A visual analogue score of pain (VAS) and a self-rating of distressing psychological symptoms, general well-being and function (GHQ-30) were obtained. The patients were randomized into two treatment group: (1) standard gynecological treatment (STGT) and (2) STGT plus Mensendieck somatocognitive therapy (MSCT). Group 1 received standard gynecological advice. Group 2 received 10 treatments sessions with MSCT. After the three months treatment periods was completed a new gynecological, psychological and a Mensendieck examination was conducted, including a second SMT and VAS: The same examination was performed one year after the inclusion adding GHQ-30. Good intra class correlations (ICC(1.1)) were found (0.83-0.97). SMT discriminated well between women with GPP and the healthy controls. After three months the STGT group had no significant change in performance of the SME MSCT group scored significantly higher after 90 days of treatment in all aspect of the SMT. In the STGT group VAS was reduced 7.8%. In the MSCT group the VAS was reduced by 50%. Nine months after treatment these effects of treatment remained and even improved. A reduction in GHQ-30 scores in the MSCT group was found, but not in the STGT group.

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