Efficacy of Rehabilitative Techniques on Pain Relief in Patients With Vulvodynia: A Systematic Review and Meta-Analysis.

Autor:	Calafiore D; Department of Neurosciences, ASST Carlo Poma, Physical Medicine and Rehabilitation Unit, Mantova, Italy., Marotta N; Department of Experimental and Clinical Medicine, University of Catanzaro 'Magna Graecia', Catanzaro, Italy.; Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro 'Magna Graecia', Catanzaro, Italy., Curci C; Department of Neurosciences, ASST Carlo Poma, Physical Medicine and Rehabilitation Unit, Mantova, Italy., Agostini F; Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy.; Department of Neurological and Rehabilitation Science, IRCCS San Raffaele, Rome, Italy., De Socio RI; Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, Catanzaro, Italy., Inzitari MT; Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, Catanzaro, Italy., Ferraro F; Department of Neurosciences, ASST Carlo Poma, Physical Medicine and Rehabilitation Unit, Mantova, Italy., Bernetti A; Department of Biological and Environmental Sciences and Technologies (DiSTeBA), University of Salento, Lecce, Italy., Ammendolia A; Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro 'Magna Graecia', Catanzaro, Italy.; Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, Catanzaro, Italy., de Sire A; Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro 'Magna Graecia', Catanzaro, Italy.; Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro Magna Graecia, Catanzaro, Italy.
Jazyk:	angličtina
Zdroj:	Physical therapy [Phys Ther] 2024 Jul 02; Vol. 104 (7).
DOI:	10.1093/ptj/pzae054
Abstrakt:	Objective: Vulvodynia is a chronic clinical condition characterized by provoked or non-provoked vulvar pain for at least 3 months of unknown etiology. The onset of vulvodynia involves a complex interplay of peripheral and central pain mechanisms, such as pelvic floor muscle and autonomic dysfunction, and interpersonal factors. A stepwise approach of pelvic floor physical therapy as medical management is suggested. In this scenario, by this meta-analysis of randomized controlled trials, we aimed to evaluate the efficacy of rehabilitation interventions in patients with vulvodynia. Methods: On October 13, 2022, PubMed, Scopus, and Web of Science were systematically searched for randomized controlled trials that assessed the efficacy of the rehabilitative approach to pain during intercourse in patients with vulvodynia. The quality assessment was performed with the Cochrane risk-of-bias tool for randomized trials. The trial registration number is CRD42021257449. At the end of the search, 9 studies were included for a total of 332 patients. A pairwise meta-analysis was performed to highlight the efficacy of rehabilitative approaches for reducing pain during intercourse, as measured with a visual analog scale or a numerical rating scale. Results: Meta-analysis showed that all these rehabilitative approaches had an overall effect size of -1.43 (95% CI = -2.69 to -0.17) in decreasing vulvodynia pain in terms of the visual analog scale. In the subgroup analysis, a significant effect size in acupuncture (effect size = -2.36; 95% CI = -3.83 to -0.89) and extracorporeal shockwave therapy (effect size = -2.94; 95% CI = -4.31 to -1.57; I2 = 58%) was observed. According to the Cochrane risk-of-bias tool, a low risk of bias for outcome selection in 89% of studies. Conclusion: Findings from this meta-analysis suggested that the physical agent modalities and complementary medicine techniques in people with vulvodynia appear to be more effective than placebo, sham, or waiting list. Further evidence on physical agent modalities and complementary therapies are warranted in the future. Impact: This was the first systematic review and meta-analysis of randomized controlled trials to provide evidence on the efficacy of rehabilitation interventions in patients with vulvodynia. (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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