Screening for pelvic floor symptoms in exercising women: a survey of 636 health and exercise professionals

Jodie G Dakic; Jean Hay-Smith; Jill Cook; Kuan-Yin Lin; Helena C Frawley

doi:10.1016/j.jsams.2023.01.008

Screening for pelvic floor symptoms in exercising women: a survey of 636 health and exercise professionals

J Sci Med Sport. 2023 Feb;26(2):80-86. doi: 10.1016/j.jsams.2023.01.008. Epub 2023 Jan 21.

Authors

Jodie G Dakic¹, Jean Hay-Smith², Jill Cook³, Kuan-Yin Lin⁴, Helena C Frawley⁵

Affiliations

¹ Department of Physiotherapy, Monash University, Australia; Department of Physiotherapy, The University of Melbourne, 161 Barry St., Parkville VIC 3010, Australia. Electronic address: jodie.dakic@monash.edu.
² Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand. Electronic address: jean.hay-smith@otago.ac.nz.
³ La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Australia. Electronic address: J.Cook@latrobe.edu.au.
⁴ Department of Physical Therapy, National Cheng Kung University, Taiwan; Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan. Electronic address: 10802003@gs.ncku.edu.tw.
⁵ Melbourne School of Health Sciences, The University of Melbourne, Australia; Allied Health Research, The Royal Women's Hospital, Parkville, VIC 3052, Australia; Allied Health Research, Mercy Hospital for Women, Studley Rd, Heidelberg, VIC 3084, Australia. Electronic address: h.frawley@unimelb.edu.au.

PMID: 36739199
DOI: 10.1016/j.jsams.2023.01.008

Abstract

Objectives: This study aimed to establish health and exercise professionals' (i) current practice of screening for pelvic floor (PF) symptoms in women within sports/exercise settings (ii) between-professional group differences in screening practice (iii) confidence and attitudes towards screening for PF symptoms and (iv) barrier/enablers towards engagement in future screening practice.

Design: Observational, cross-sectional survey.

Methods: Australian health and exercise professionals (n = 636) working with exercising women participated in a purpose-designed and piloted, online survey about PF symptom screening in professional practice. Data were analysed descriptively and groups compared using Chi-square/Kruskal-Wallis tests.

Results: Survey respondents included physiotherapists (39%), personal trainers/fitness instructors (38%) and exercise physiologists (12%), with a mean of 12 years of practice (SD: 9.7, range: 0-46). One in two participants never screened women for PF symptoms; 23% screened when indicated. Pregnant/recently post-natal women (44%) were more commonly screened for PF symptoms than younger women (18-25 years:28%) and those competing in high-impact sports (32%). Reasons for not screening included waiting for patients to disclose symptoms (41%) and an absence of PF questions on screening tools (37%). Most participants were willing to screen PF symptoms but cited a lack of knowledge, training and confidence as barriers.

Conclusions: Screening for PF symptoms in exercising women is not common practice, especially in at-risk groups such as young, high-impact athletes. Including PF questions in existing pre-exercise questionnaires and providing professional development to improve knowledge of indications for screening and evidence-based management options may facilitate early symptom identification and prevent secondary exercise cessation.

Keywords: Clinical practice; Exercise; Female; Pelvic floor; Screening; Urinary incontinence.

MeSH terms

Australia
Cross-Sectional Studies
Exercise Therapy
Female
Humans
Pelvic Floor*
Pregnancy
Surveys and Questionnaires
Urinary Incontinence*