Abstract
Background and purpose: Pelvic Floor Disorders (PFD) have gained recognition in the health care arena, not only due to rising incidence, but also due to rising health care costs and economic burdens. Because of the diverse and multifactorial nature of both impairments and symptoms of pelvic floor disorders, successful treatment outcomes have been difficult. The purpose of this case report was to demonstrate the application of an encompassing physical therapy approach to the treatment of pelvic floor dysfunction and demonstrate functional outcomes towards return to optimal pain free function. Case Description: The patient was an otherwise healthy, ectomorphic 63-year-old female with insidious onset of diverse pelvic symptoms including left groin/hip pain, bilateral thigh pain, low back pain, dyspareunia, urinary urgency, and irregular defecation. Symptoms were moderate to severe, with patient reporting functional and leisure activity level at 10% to that of her normal level. Physical therapy evaluation and interventions focused on areas of involvement including the pelvic floor, the pelvic girdle, and the diaphragm and integrated various treatment techniques including manual therapy and exercise prescription with patient preference direction. Functional outcomes were determined through objective measures of involved tissues, subjective measure tools including Lower Extremity Functional Score (LEFS) and pelvic floor questionnaire (short form 7), and patient subjective input. Following physical therapy interventions and Total Hip Arthroplasty, the patient reported achieving pain free function with dissipation of all subjective complaints and improved objective measures of all components contributing to measures of pelvic girdle stabilization, strength, mobility, and coordinated functioning.