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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 28706

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Special Issue Editors

Prof. Dr. María Torres Lacomba

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Chief Guest Editor

Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Alcalá de Henares, Madrid, Spain
Interests: physiotherapy; women´s health; patient therapeutic education; health literacy; therapeutic adherence; pelvic health; sexual health; pain; breast cancer; gynecological cancer; lung cancer; COVID19; vascular diseases; sexual violence; abused women; women's health services; aging; menopause

Dr. Beatriz Navarro Brazález

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Assistant Guest Editor

Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Alcalá de Henares, Madrid, Spain
Interests: physiotherapy; women´s health; patient therapeutic education; health literacy; therapeutic adherence; pelvic health; sexual health; pain; breast cancer; gynecological cancer; vascular diseases; women's health services; therapeutic exercise; pregnancy; postpartum period

Dr. Virginia Prieto Gómez

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Assistant Guest Editor

Physiotherapy in Women’s Health (FPSM) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, 28805 Alcalá de Henares, Madrid, Spain
Head of the Oncological Physiotherapy Unit of the Spanish Association Against Cancer (AECC) of Madrid, Avenue Dr. Federico Rubio y Galí, 84, 28040 Madrid, Spain
Interests: physiotherapy; women´s health; patient therapeutic education; health literacy; therapeutic adherence; pelvic health; sexual health; pain; breast cancer; gynecological cancer; vascular diseases; women's health services; transgender persons; aging; menopause; plastic surgery; reconstructive surgery; therapeutic exercise; long term disability; shoulder movement impairments

Special Issue Information

Dear Colleagues,

Women and men face multiple health problems. However, biological, cultural, social and economic differences show diverse physiological responses to disease.

Some health processes are specific to women, such as pregnancy, childbirth, and menopause. In addition to other Special Issues within women´s health, such as female athletes and women´s exercise and aging, a number of health disorders affect women in a different way and level than men, such as osteoporosis, pelvic floor dysfunctions, breast cancer, anorexia, sexual violence and abuse, chronic pain, fibromyalgia, etc. In health conditions that affect both women and men similarly, sometimes women find it more difficult to access to health care (e.g., heart disease). The World Health Organization recognizes that sex and gender are determinants of health and that gender is one of the main causes of health inequity.

Physiotherapy in women's health aims to improve health care for women. Although many people relate it only to pelvic dysfunctions, physiotherapy in women's health practice has changed over the years and has included different health conditions that women may suffer throughout their lives.

This Special Issue aims to have a broad focus on the impact of Physiotherapy in Women's Health for specific women health needs. We welcome original research studies, systematic reviews, meta-analyses, clinical practice guidelines, case reports, qualitative studies and clinical commentaries that promote the integration of evidence into theory, education and research. We also consider studies with innovative research methods and technologies.

We cordially invite researchers and clinicians to submit their work to this Special Issue to improve and broaden Physiotherapy in Women's Health practice.

Prof. Dr. María Torres Lacomba
Dr. Beatriz Navarro Brazález
Dr. Virginia Prieto Gómez
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

physiotherapy
women´s health
up-to-date knowledge
health promotion
patient therapeutic education
therapeutic exercise
health literacy
therapeutic adherence
eHealth
pelvic health
sexual health
pain
breast cancer
gynecological cancer
plastic surgery
recovery surgery
lung cancer
COVID19
vascular diseases
heart disease
sexual violence
abused women
anorexia
mental health
long term disability
transgender persons
women's health services
aging
female athlete
pregnancy
postpartum period
breast feeding
menopause

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Published Papers (8 papers)

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Research

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16 pages, 1127 KiB

Open AccessArticle

Changes in Pain Sensitivity in Treatment for Breast Cancer: A 12-Month Follow-Up Case Series

by Laura Lorenzo-Gallego, Beatriz Arranz-Martín, Helena Romay-Barrero, Virginia Prieto-Gómez, Enrique Lluch and María Torres-Lacomba

Int. J. Environ. Res. Public Health 2022, 19(7), 4055; https://doi.org/10.3390/ijerph19074055 - 29 Mar 2022

Cited by 2 | Viewed by 2100

Abstract

This study aimed to investigate changes in the pain sensory profile of women with breast cancer. Five women with unilateral breast cancer were enrolled. Participants were assessed with direct (quantitative sensory testing, QST) and indirect measures of pain sensitization (self-reported central sensitization inventory, CSI) at baseline (before surgery), 1 week after surgery, and at 1, 6, 9, and 12 months post-surgery. In the event of pain occurrence, the Leeds Assessment of Neuropathic Symptoms and Signs was also used. Nociceptive pain was the predominant pain mechanism in the postoperative period, while an increase in sensitization predominated one year after breast cancer surgery, especially in those participants who had received more treatment procedures. The participants who received more therapies for breast cancer experienced persistent pain and a higher level of sensitization. An assessment protocol including direct measurements (QST) and indirect measurement (self-reported CSI) allows for detecting changes in pain sensitivity, which can be useful for characterizing and/or predicting pain before, during, and up to one year following surgical interventions for breast cancer. Full article

(This article belongs to the Special Issue Physiotherapy in Women's Health)

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15 pages, 965 KiB

Open AccessArticle

Online Information on Painful Sexual Dysfunction in Women: Quality Analysis of Websites in SPANISH about Dyspareunia, Vaginismus and Vulvodynia

by Andrea Vicente-Neira, Virginia Prieto-Gómez, Beatriz Navarro-Brazález, Cristina Lirio-Romero, Javier Bailón-Cerezo and María Torres-Lacomba

Int. J. Environ. Res. Public Health 2022, 19(3), 1506; https://doi.org/10.3390/ijerph19031506 - 28 Jan 2022

Cited by 4 | Viewed by 2973

Abstract

The objective of this study was to evaluate the content, quality, and readability of websites containing information on dyspareunia, vaginismus, and vulvodynia in Spanish. Web pages were retrieved entering the terms “dyspareunia”, “vaginismus”, and “vulvodynia” in Google, Yahoo!, and Bing search engines. Two researchers employed the DISCERN and Bermúdez-Tamayo questionnaires to analyze the content and quality of the websites, and the INFLESZ scale to evaluate their readability. IBM SPSS^® version 25 statistical software was employed for data analysis. The internet search yielded 262 websites, 91 of which were included after applying the selection criteria. Websites with information on dyspareunia obtained median scores of 24 (30–21) in the DISCERN, 38 (41.0–35.5) in the Bermúdez-Tamayo, and 55.3 (57.2–50.9) in the INFLESZ tools. The results for websites on vaginismus revealed median scores of 23.5 (30–20) in the DISCERN, 37 (42–35) in the Bermúdez-Tamayo, and 52.9 (55.6–46.4) in the INFLESZ. Finally, the median scores for vulvodynia sites was 25.5 (30–20) in the DISCERN, 38 (43–33.7) in the Bermúdez-Tamayo, and 54.2 (57.3–47.2) in the INFLESZ. These outcomes indicate that the quality of information in these websites is very low, while the overall quality of the web pages is moderate. Sites on vaginismus and vulvodynia were “somewhat difficult” to read, while readability was “normal” for websites on dyspareunia. Healthcare professionals should be aware of the shortcomings of these websites and address them through therapeutic education with resources containing updated, quality information. This raises the need for health professionals to generate these resources themselves or for experts and/or scientific societies in the field to check the quality and timeliness of the contents, regardless of whether or not the websites are endorsed with quality seals. Full article

(This article belongs to the Special Issue Physiotherapy in Women's Health)

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10 pages, 345 KiB

Open AccessArticle

New Motherhood Concepts, Implications for Healthcare. A Qualitative Study

by Esther Delgado-Pérez, Maria José Yuste-Sánchez, Yolanda Pérez-Martín, Vanesa Abuín-Porras and Isabel Rodríguez-Costa

Int. J. Environ. Res. Public Health 2021, 18(24), 13118; https://doi.org/10.3390/ijerph182413118 - 12 Dec 2021

Cited by 1 | Viewed by 2988

Abstract

The aim of this study was to explore the experience of women who take care of their children in postpartum and who desire to be understood by society, with no judgements. For this purpose, a qualitative methodology was followed. In-depth interviews, discussion groups, and an online forum were used for data collection. The participants were Spanish women that had given birth in the past 6 months, and their partners. Healthcare specialists with experience in the topic were also included. Results showed three main categories: lack of priority, self-demand, and self-esteem changes. As a conclusion, the concept of motherhood needs to be redefined, as women feel that they are living under the pressure of being a “perfect mother”. It is important that mothers allow themselves to fail in reaching the imposed requirements. Simple acceptance of motherhood boundaries could help in this transition. Full article

(This article belongs to the Special Issue Physiotherapy in Women's Health)

13 pages, 8681 KiB

Open AccessArticle

Differences in Inter-Rectus Distance and Abdominopelvic Function between Nulliparous, Primiparous and Multiparous Women

by Mercè Balasch-Bernat, Sofía Pérez-Alenda, Juan J. Carrasco, Begoña Valls-Donderis, Lirios Dueñas and Laura Fuentes-Aparicio

Int. J. Environ. Res. Public Health 2021, 18(23), 12396; https://doi.org/10.3390/ijerph182312396 - 25 Nov 2021

Cited by 7 | Viewed by 4123

Abstract

Widening of the inter-rectus distance (IRD) is highly prevalent among postpartum women and can lead to dysfunction of abdominopelvic muscles. The aim of this study was to evaluate the differences in IRD and abdominopelvic function between nulliparous, primiparous and multiparous women. A cross-sectional study was conducted on 75 women (25 nulliparous, 25 primiparous and 25 multiparous at 6 months postpartum). The participants underwent ultrasound assessment under three conditions (at rest, abdominal draw-in maneuver (ADIM) and curl-up) at two locations (2 cm above and 2 cm below the umbilicus). Furthermore, abdominopelvic muscle function was determined by prone, supine and side bridge tests. In all conditions and locations, the IRD were significantly higher (p < 0.05) in the primiparous and multiparous women than in the nulliparous. The multiparous women presented greater (p > 0.05) IRD at rest and during ADIM compared to the primiparous women. Regarding abdominopelvic muscle function, differences were only significant (p < 0.05) between the nulliparous with primiparous women in prone and supine conditions. These findings suggest that parity influences IRD: women at 6 months postpartum present greater IRD compared to nulliparous women; multiparous women present greater IRD at rest and during the activation of deep abdominal muscles than primiparous women; and primiparous women exhibit worse abdominopelvic muscle function than nulliparous women. Full article

(This article belongs to the Special Issue Physiotherapy in Women's Health)

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Review

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14 pages, 1422 KiB

Open AccessReview

Does the Contractile Capability of Pelvic Floor Muscles Improve with Knowledge Acquisition and Verbal Instructions in Healthy Women? A Systematic Review

by Lara Díaz-Álvarez, Laura Lorenzo-Gallego, Helena Romay-Barrero, Virginia Prieto-Gómez, María Torres-Lacomba and Beatriz Navarro-Brazález

Int. J. Environ. Res. Public Health 2022, 19(15), 9308; https://doi.org/10.3390/ijerph19159308 - 29 Jul 2022

Cited by 7 | Viewed by 2719

Abstract

Seventy percent of women with pelvic floor dysfunctions (PFDs) are estimated to present deficient consciousness of their pelvic floor muscles (PFMs) and poor ability to contract them. Improving the proprioception of PFMs, defined as the capacity to know the status and position of each body part, and adequately contracting them could be a protective factor to prevent the appearance of PFDs in the general female population. This study aimed to identify the effectiveness of educational interventions and verbal instructions on how to contract and exercise the PFMs to improve the proprioception of the PFMs in women. A systematic search of studies published in the last 20 years until March 2022 was conducted in the PubMed, Cochrane Library, Web of Science, Scopus, PEDro, Lilacs, and Dialnet databases. A meta-analysis could not be performed due to the heterogeneity in the types of studies and included populations. This review followed the PRISMA guidelines for the design, search, and reporting of studies. The methodological quality was analysed via the PEDro and the Newcastle–Ottawa scales in the case of randomised clinical trials and non-randomised studies, respectively, while the quality of evidence was determined using the SIGN grading system for evidence-based guidelines. Descriptive and experimental studies published in English, Spanish, or Portuguese that evaluated the contractile capability of the PFMs in healthy women or women without a previous diagnosis of PFD were included. Seven articles that included a total of 2507 women were found, three of which were clinical trials with PEDro scores between 5 and 9 points out of 10 and four of which were non-randomised studies with NOS scores between 6 and 8 points out of 10. The outcomes were measured through vaginal palpation, visual observation, questionnaires for PFD symptoms, and self-perception reports. This review discriminated between two types of intervention, educational programmes and verbal instructions, and evaluated the changes observed in PFM strength and knowledgeability and the symptoms of PFDs. The findings showed that educational interventions and verbal instructions improve the proprioception of PFMs in women of all ages that are healthy or without a previous diagnosis of PFDs as well as their knowledge about the pelvic floor, healthy lifestyle habits, and symptoms that are potentially indicative of PFDs. Further high-quality randomised clinical trials are warranted to draw definitive conclusions about the effectiveness of educational interventions to improve the proprioception of the PFMs in women considered healthy or with mild symptoms that may be indicative of PFDs. Full article

(This article belongs to the Special Issue Physiotherapy in Women's Health)

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12 pages, 1343 KiB

Open AccessReview

A Scoping Review of Available Tools in Measurement of the Effectiveness of Conservative Treatment in Lipoedema

by Monika Czerwińska, Jacek Teodorczyk and Rita Hansdorfer-Korzon

Int. J. Environ. Res. Public Health 2022, 19(12), 7124; https://doi.org/10.3390/ijerph19127124 - 10 Jun 2022

Cited by 8 | Viewed by 3221

Abstract

(1) Background: Due to insufficient knowledge of lipoedema, the treatment of this disease is undoubtedly challenging. However, more and more researchers attempt to incorporate the most effective lipoedema treatment methods. When assessing a new therapeutic method, choosing correct, objective tools to measure the therapeutic outcome is very important. This article aims to present possible instruments that may be used in the evaluation of therapeutic effects in patients with lipoedema. (2) Methods: The data on therapeutic outcome measurements in lipoedema were selected in February 2022, using the Medical University of Gdansk Main Library multi-search engine. (3) Results: In total, 10 papers on this topic have been identified according to inclusion criteria. The tools evaluating the therapeutic outcomes used in the selected studies were: volume and circumference measurement, body mass index, waist-to-hip ratio, ultrasonography and various scales measuring the quality of life, the level of experiencing pain, the severity of symptoms, functional lower extremity scales, and a 6 min walk test. (4) Conclusion: The tools currently used in evaluating the effectiveness of conservative treatment in women with lipoedema are: volume and circumference measurement, waist-to-hip ratio, body fat percentage, ultrasonography, VAS scale, quality of life scales (SF-36, RAND-36), symptom severity questionnaire (QuASiL), Lower Extremity Functional Scale and 6 min walk. Choosing a proper tool to measure the treatment outcome is essential to objectively rate the effectiveness of therapeutic method. Full article

(This article belongs to the Special Issue Physiotherapy in Women's Health)

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Other

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9 pages, 734 KiB

Open AccessProtocol

Vibration or Transcutaneous Tibial Nerve Stimulation as a Treatment for Sexual Dysfunction in Women with Spinal Cord Injury: Study Protocol for a Randomized Clinical Trial

by María del-Carmen Díaz-Ruiz, Rita-Pilar Romero-Galisteo, Beatriz Arranz-Martín, Rocío Palomo-Carrión, Sara Ando-Lafuente and Cristina Lirio-Romero

Int. J. Environ. Res. Public Health 2022, 19(3), 1478; https://doi.org/10.3390/ijerph19031478 - 28 Jan 2022

Cited by 3 | Viewed by 4086

Abstract

Background: Women with spinal cord injuries usually suffer from sexual dysfunction, such as alterations during arousal and an increase in the time to reach orgasm. However, little evidence has been found on its physiotherapeutic approach, as well as poor adherence to the latter. The aim of this study is to determine the effectiveness of two interventions to improve sexual dysfunction: the application of genital vibration and transcutaneous tibial nerve stimulation. Methods: This is a randomized clinical trial that will recruit 54 women who, one year after a spinal cord injury, suffer from sexual dysfunction associated with the latter. The participants will be randomized to three groups: (a) intervention group 1 treated with transcutaneous tibial nerve electrostimulation (n = 18), (b) intervention group 2 treated with genital vibration (n = 18), and (c) a control group (n = 18). The treatment time will be 12 weeks. Adherence to the treatment will be evaluated, as well as the effectiveness of the treatment, through the Female Sexual Function Index, the Sexual Quality of Life-Female questionnaire, quantitative sensory tests, and the improvement reported by the patient in terms of arousal and orgasm. The evaluations will be carried out before the treatment, at the end of the treatment and 3, 6 and 12 months after the end of the treatment. Full article

(This article belongs to the Special Issue Physiotherapy in Women's Health)

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17 pages, 687 KiB

Open AccessSystematic Review

Spanish Questionnaires for the Assessment of Pelvic Floor Dysfunctions in Women: A Systematic Review of the Structural Characteristics and Psychometric Properties

by Marina Guallar-Bouloc, Paloma Gómez-Bueno, Manuel Gonzalez-Sanchez, Guadalupe Molina-Torres, Rafael Lomas-Vega and Alejandro Galán-Mercant

Int. J. Environ. Res. Public Health 2021, 18(23), 12858; https://doi.org/10.3390/ijerph182312858 - 6 Dec 2021

Cited by 3 | Viewed by 3176

Abstract

Background: Pelvic floor dysfunctions affect a third of the adult female population, including a large number of clinical conditions, which can be evaluated through validated questionnaires that inform us of the status and perception of women both objectively and subjectively. The main objective of this study was to review and explain the topics of the validated questionnaires in Spanish on pelvic floor dysfunctions and to review their psychometric properties. Methods: A systematic review was carried out in the PUBMED and WOS databases. The keywords used were in PUBMED: ((((((((“Fecal Incontinence” [Mesh]) OR “Urinary Incontinence” [Mesh]) OR “Pelvic Organ Prolapse” [Mesh]) OR “Pelvic Floor Disorders” [Mesh]) OR “Sexual Dysfunction, Physiological” [Mesh]) OR “Pelvic Girdle Pain” [Mesh]) OR “sexual function” [Title/Abstract]) OR “Prolapse” [Title/Abstract]) AND “Surveys and Questionnaires” [Mesh] AND “Validation” [Title/Abstract] combined with the Boolean operators “AND”/“OR”. In contrast, in WOS, a segregated search was carried out with each of the terms of pelvic floor dysfunction together with “Validation” and “Surveys and Questionnaires”. All articles published up to 19 November 2021 were considered. Methodological quality was assessed with the COSMIN scale. Results: A total of 687 articles were identified, of which 13 were included. The evaluated questionnaires and the structural characteristics and psychometric properties of each of them were collected. Conclusion: The Spanish versions of the questionnaires show good basic structural and psychometric characteristics for the evaluation of patients with pelvic floor dysfunctions and that they resemble other versions of the same questionnaire published in other languages. Full article

(This article belongs to the Special Issue Physiotherapy in Women's Health)

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