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Spasm of pelvic floor muscles as a cause of its dysfunction
Hurt, Karel ; Zahálka, František (advisor) ; Martan, Alois (referee) ; Otčenášek, Michal (referee)
Background: Currently, there are no effective therapy strategies for idiopathic, non-organic vulvodynia and dyspareunia in women. ESWT (extracorporeal shock wave therapy) is a nonsurgical/noninvasive technique widely used to treat musculoskeletal diseases, muscle spasticity, hypertonia, renal, biliary calculi and urological disorders. Aim: The goal of our work is to investigate the possibility to eliminate chronic and acute forms of pelvic pain by a non-invasive physical method. We wanted to know if the extracorporeal shock wave technique could fulfill these requirements. Study design: The prospective, randomized, double-blind, placebo-controlled studies were conducted following feasibility studies. Methods: The study 1. included 62 women with vulvodynia for at least 3 months. The women were randomly assigned to either a treatment group (n=31) or a placebo group (n=31). The patients in the treatment group received perineally applied ESWT weekly (3000 pulses each for four consecutive weeks). The position of the shock wave transducer was changed six times after every 500 pulses. Patients in the placebo group underwent the same treatment procedure, but the handpiece was provided with a placebo stand-off that disabled energy transmission. Subjective pain was evaluated by a visual analogue scale (VAS,...
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Myofascial pain syndrome in the pelvic area
Hujová, Kateřina ; Bitnar, Petr (advisor) ; Langerová, Marie (referee)
Myofascial pain syndrome (MFBS) in the pelvic region is characterized by the presence of trigger points (TrPs) in the pelvic floor (PF) muscles and pain that is localized directly in the pelvis but simultaneously radiates to surrounding structures. This pain is often difficult to distinguish from internal complaints, which are often mimiced or accompanied by the pain. This bachelor's thesis addresses the subject of pain in the pelvic region and TrPs, which are related to myofascial structures, particularly PD. In the theoretical part, it aims to bring together the existing knowledge on MFBS with a narrower focus on the pelvic region and to present a comprehensive examination procedure and treatment options. The examination of PD in MFBS should be comprehensive, including history, palpation, dynamic tests and pelvic region specific tests. Therapy is initiated with manual techniques (MT), includes therapeutic physical education (TPE) methods to integrate the pelvis into global movement patterns. Training awareness of PD and the ability to relax it play an important role as well. The psychological side of the person should not be neglected, as pelvic difficulties are related to the intimate parts, in many cases reducing the quality of life and limiting the performance of daily activities. For five...
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