scholarly journals Effectiveness of Physical Therapy in Addressing Sexual Dysfunction in Individuals with Multiple Sclerosis: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Arpita Gopal ◽  
Rebecca Sydow ◽  
Valerie Block ◽  
Diane D. Allen
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Physical Therapy ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Pelvic Floor ◽  
Sexual Satisfaction ◽  
Well Being ◽  
Current Evidence

Abstract Background: Individuals with multiple sclerosis (MS) frequently report sexual dysfunction, a condition that may result in low sexual satisfaction and decreased quality of life. Although sexual dysfunction is usually treated pharmacologically, physical therapists, especially those trained in pelvic floor physical therapy (PT), are well-equipped to address a variety of impairments that contribute to poor sexual function. The current evidence for effectiveness of PT interventions in improving sexual dysfunction, sexual satisfaction, and the emotional well-being aspect of quality of life was analyzed. Methods: The PubMed, CINAHL, and PEDro databases were searched through December 2019. Articles were included if participants had a clinical diagnosis of MS, reported sexual dysfunction or pain with intercourse, and had an intervention within the PT scope that addressed sexual dysfunction. Means and SDs were extracted from each study independently by two authors. Effect sizes (d) and 95% CIs were calculated within and across studies. Results: Eight studies met the inclusion criteria. Combined effects were significant and large across six studies for sexual function (d = 0.82, 95% CI, 0.57–1.06), moderate across seven studies for sexual satisfaction (d = 0.65, 95% CI, 0.43–0.87), and moderately large across two studies for emotional well-being (d = 0.78, 95% CI, 0.17–1.40). Between-group differences reached significance for sexual satisfaction (d = 0.29, 95% CI, 0.03–0.55). Conclusions: Sexual function, sexual satisfaction, and emotional well-being can all be effectively addressed with various PT interventions. Highly effective interventions included pelvic floor muscle training and mindfulness. Future research should compare PT interventions with non-PT controls to determine best practice in this population.

The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis

2008 ◽  
Vol 14 (8) ◽  
pp. 1131-1136 ◽  
Author(s):  
DK Tepavcevic ◽  
J Kostic ◽  
ID Basuroski ◽  
N Stojsavljevic ◽  
T Pekmezovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Health Distress ◽  
Pain Subscale ◽  
Related Quality ◽  
Vaginal Lubrication ◽  
The Impact

Objective Sexual dysfunction (SD) is a common but often overlooked symptom in multiple sclerosis (MS). The aim of this study was to estimate the frequency, type, and intensity of SD in our patients with MS and to investigate its influence on all the domains of quality of life. Methods The study population comprised a cohort of 109 patients with MS (McDonald's criteria, 2001). SD was quantified by a Szasz sexual functioning scale. Health-related quality of life was measured by a disease-specific instrument MSQoL-54 (Serbian version). Results The presence of at least one symptom of SD was found in about 84% of the men and in 85% of the women. The main complaints in women were reduced libido, difficulties in achieving orgasm, and decreased vaginal lubrication; in men, the main complaints were reduced libido, incomplete erections, and premature ejaculation. In women, statistically significant negative correlations between the presence and level of SD and quality of life domains were reached for all subscales ( P < 0.01), except for the Pain subscale ( P = 0.112). In men, negative correlations were also observed for all domains, but they were statistically significant for physical health, physical role limitations, social function, health distress, sexual function, and sexual function satisfaction ( P < 0.01). We found that the presence of all the analyzed types of sexual problems statistically significantly lowered scores on the sexual function and the sexual function satisfaction subscales in both men and women ( P < 0.01). The most prominent impact on both domains was observed for the total loss of erection in men and for anorgasmia in women. Conclusions Our results reveal that frequent occurrence of SD in MS patients prominently affects all aspects of their quality of life.

Sexual function in adult cancer survivors.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 123-123 ◽  
Author(s):  
Emily Jo Rajotte ◽  
K. Scott Baker ◽  
Leslie Heron ◽  
Karen Leslie Syrjala
Keyword(s):  
Quality Of Life ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Cancer Survivors ◽  
Sexual Satisfaction ◽  
Sexually Active ◽  
Clinic Appointment ◽  
Significant Difference ◽  
Adult Cancer Survivors

123 Background: Sexual dysfunction is a common treatment sequela across numerous cancer diagnoses and treatments, causing increased distress, discomfort and negatively impacting quality of life. Methods: Before their survivorship-focused clinic appointment, adult cancer survivors were asked to complete a comprehensive patient -eported outcomes survey that included detailed questions on their health status including sexual function. Results: Between April 2015 to July 2016, 94 patients completed the survey. They were 66% female, mean age 45 years (SD 16, range 21-82) and 34% leukemia/lymphoma, 18% breast cancer, and 12% genitourinary cancer survivors. Patients were a mean of 6.7 years (SD 7.9, range 0-42) from their cancer diagnosis at the time of clinic appointment. Nearly half (48%) were married or living with a partner and 49% were living alone (single, divorced, widowed). 70.2% reported being sexually active (alone or with a partner) in the last year: of these only half (55.3%) reported being sexually active in the last month. For those who were not sexually active the most commonly cited reasons included lack of interest (24.5%) and not having a partner (30.9%), with 12.8% reporting not being sexually active due to a physical problem. Survivors rated their sexual satisfaction in the past month as a 5.0 (SD 3.7; scale of 0-10, 0=not at all satisfying 10=extremely satisfying). An independent samples t-test revealed a statistically significant difference in sexual satisfaction between survivors under 45 years in age and ≥45 years in age (t=4.4, df=68.0, p < 0.05). Older survivors (mean=3.71, SD=3.7) reported significantly lower levels of sexual satisfaction than did younger survivors (mean=7.11, SD=2.8). The most commonly reported sexual function issues for women included vaginal dryness (23.4%) and for men included difficulty getting an erection (7.4%). Conclusions: Sexual dysfunction is a common long-term effect of cancer across diagnoses and most treatments, warranting widespread implementation of targeted interventions to manage sexual dysfunction and improve quality of life for these survivors.

Sexual Dysfunction in Patients with Neuropsychiatric Disorders: Challenges and Opportunities

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S9) ◽  
pp. 4-4
Author(s):  
Barry Gidal ◽  
John J. Barry
Keyword(s):  
Quality Of Life ◽  
Sexual Dysfunction ◽  
Adverse Effects ◽  
Sexual Function ◽  
Healthcare Providers ◽  
Well Being ◽  
Sexual Disorders ◽  
Functional Impairments ◽  
The Impact

Quality-of-life issues in healthcare have come to be of paramount importance for a population that increasingly expects healthcare not only to treat major illnesses but also to optimize normal levels of physical and psychosocial functioning and overall well-being. Healthcare providers have also increasingly appreciated the impact that adverse effects of treatment can have on quality of life, as well as on compliance with and the effectiveness of treatment.Many functional impairments and adverse treatment effects take the form of clinical complaints that patients and caregivers typically report to their healthcare providers without prompting. Other adverse effects are not so obviously clinical or treatment-related, and patients may not be inclined or may even be reluctant to bring them up when talking with the provider. Impairment of sexual function is a problem of this kind.Sexual dysfunction appears to be common and frequently underrecognized in certain patient populations. For example, it has been estimated that 25% to 63% of women and 10% to 52% of men with epilepsy have some form of sexual dysfunction, yet in clinical reviews of sexual disorders, epilepsy is not listed as one of the medical conditions commonly associated with impaired sexual function.

scholarly journals Do Physical Therapy Interventions Affect Urinary Incontinence and Quality of Life in People with Multiple Sclerosis?

2015 ◽  
Vol 17 (4) ◽  
pp. 172-180 ◽  
Author(s):  
Valerie Block ◽  
Monica Rivera ◽  
Marsha Melnick ◽  
Diane D. Allen
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Urinary Incontinence ◽  
Physical Therapy ◽  
Bladder Dysfunction ◽  
Meta Analysis ◽  
Group Analysis ◽  
Current Evidence ◽  
Level Of Evidence

Background: Multiple sclerosis (MS) presents with many debilitating symptoms, including urinary incontinence (UI), that physical therapy (PT) may address; UI is widely prevalent, but PT management of symptoms lacks consensus. A meta-analysis of long-term nonsurgical and nonpharmaceutical treatment options may supply this deficiency. We analyzed the current evidence for effectiveness of PT to decrease UI and improve quality of life (QOL) in people with MS. Methods: An electronic search conducted through November 26, 2013, included the following search terms: incontinence, bladder dysfunction, urinary incontinence, multiple sclerosis, MS, physical therapy, physiotherapy, therapy, and rehabilitation. Criteria for inclusion were as follows: MS diagnosis, intervention involved PT for UI or bladder dysfunction, outcomes assessed QOL or UI, and at least a 4 of 10 on the Physiotherapy Evidence Database scale or a 2b level of evidence. Outcomes were combined across studies, and effect sizes are depicted in forest plots. Results: Six studies met the inclusion criteria. Between-group analysis revealed statistically significant differences in incontinence episodes and QOL, but did not reach significance for functional control mechanisms (eg, electromyography data on strength of contraction, relaxation, and endurance). Incontinence leakage episodes and QOL participation improved within groups. Conclusions: Meta-analysis indicates support for PT for minimizing incontinence compared with pretreatment and affecting incontinence and QOL more than control in people with MS. Protocols were heterogeneous regarding duration and type of PT intervention and were applied in different types of MS. Further research may reveal the most effective combination and variety of PT interventions for people with MS.

Quality of life in multiple sclerosis patients in Spain

2002 ◽  
Vol 8 (6) ◽  
pp. 527-531 ◽  
Author(s):  
C-H Chang ◽  
D Cella ◽  
O Fernández ◽  
G Luque ◽  
P de Castro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Well Being ◽  
Cross Sectional Study ◽  
Self Report ◽  
Regression Analyses ◽  
Cross Sectional ◽  
Scale Scores ◽  
Multiple Sclerosis Patients

Objective: The cross-sectional study evaluated the psychometric properties of the Functional Assessment of Multiple Sclerosis (FAMS) Spanish version and its use in measuring quality of life (QOL) of multiple sclerosis (MS) patients in Spain. Methods: The FAMS is a factorially derived self-report scale designed to assess six primary aspects of QOL of patients with MS: Mobility, Symptoms, Emotional Well-Being, General Contentment, Thinking and Fatigue, and Family/Social Well-Being. Its Spanish translated version was used to assess QOL of 625 MS patients recruited in an outpatient clinic setting from 58 hospitals in Spain. Internal consistency of the Spanish FAMS was evaluated. Multiple regression analyses were performed to identify significant predictors from demographic, clinical and treatment characteristics, and Kurtzke Expanded Disability Status Scale (EDSS) scores in predicting FAMS scale scores. Results: Most of the patients are females (66%), and 74% were of the relapsing-remitting (RR) clinical subtype. Cronbach’s alpha coefficients were high (range=0.78-0.96), indicating subscale homogeneity comparable to that of the original English version. Linear multivariate regression analyses revealed that the EDSS is a dominant variable in predicting all the FAMS subscales, especially mobility (R2=0.51) and the total scores. Conclusions: The Spanish FAMS is a psychometrically valid instrument that allows clinicians and clinical researchers the ability to measure the QOL concerns of MS patients in Spain.

scholarly journals Health-Related Quality of Life of Patients with Multiple Sclerosis in Oman – A CrossSectional Study

2021 ◽  
Author(s):  
Jansirani Natarajan ◽  
Mickael Antoine Joseph ◽  
Abdullah Al Asmi ◽  
Gerald Amandu Matua ◽  
Jaber Al Khabouri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Disease Process ◽  
Well Being ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact ◽  
Disease Specific

Objectives: Multiple sclerosis is a disabling neurological disorder with significant negative effects on patients’ quality of life. Despite the increased prevalence of multiple sclerosis in Arabian Gulf countries in recent years, no study has assessed the impact of multiple sclerosis on the healthrelated quality of life of Omani patients. Therefore, the objectives of the current study was to assess the impact of multiple sclerosis on the health-related quality of life of Omani patients using the validated disease-specific self-administered MusiQoL instrument. Methods: A cross-sectional descriptive study was carried out between April and December 2019 on 177 Omani patients with multiple sclerosis attending two major hospitals in Oman. Patients’ health-related quality of life was assessed using the validated disease-specific self-administered MusiQoL instrument. Results: Majority (51.4%) of the patients had poor HRQOL and 48.6% had moderate HRQOL. We found that being older than 30 years, a female, married, separated, widowed, or divorced, and having visual and sleep problems had poorer health-related quality of life. Among the different health-related quality of life components, relationship with the healthcare system and relationship with family and friends were the most affected because of the disease process. Our results also showed that psychological well-being and coping domains of MusiQoL questionnaires are significantly reduced in females as compared to males. Conclusion: Understanding the health-related quality of life of Omanis with multiple sclerosis provides valuable knowledge that could help optimize the management of this disease.

scholarly journals eMSQOL-29: Prospective validation of the abbreviated, electronic version of MSQOL-54

2018 ◽  
Vol 25 (6) ◽  
pp. 856-866 ◽  
Author(s):  
Rosalba Rosato ◽  
Silvia Testa ◽  
Antonio Bertolotto ◽  
Francesco Scavelli ◽  
Ambra M Giovannetti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Sexual Function ◽  
Depression Scale ◽  
Social Function ◽  
Criterion Validity ◽  
Electronic Version ◽  
Ceiling Effect ◽  
Floor Effect

Background: We recently devised a shortened version of the 54-item Multiple Sclerosis Quality of Life (MSQOL-54) in paper (MSQOL-29, consisting of 25 items forming 7 subscales and 4 single items, and one filter question for 3 ‘sexual function’ items) and electronic format (eMSQOL-29). Objectives: To prospectively assess eMSQOL-29 psychometric properties, acceptability/equivalence versus MSQOL-29. Methods: Multiple sclerosis (MS) patients ( n = 623; Expanded Disability Status Scale (EDSS) range 0.0–9.0) completed eMSQOL-29, Hospital Anxiety and Depression Scale, Functional Assessment of MS (FAMS), European Quality of life Five Dimensions-3L, and received EDSS and Symbol Digit Modalities Test (SDMT). Equivalence versus MSQOL-29 was assessed in 242 patients (randomized cross-over design). Results: ‘Sexual function’ items were filtered out by 273 patients (47%). No multi-item scale had floor effect, while five had ceiling effect. Cronbach’s alpha range was 0.88–0.90. Confirmatory factor analysis showed good overall fit and the two-factor solution for composite scores was confirmed. Criterion validity was sub-optimal for ‘cognitive function’ (vs SDMT, r = 0.25) and ‘social function’ (vs FAMS social function, r = 0.38). eMSQOL-29 equivalence was confirmed and its acceptability was good. Conclusion: eMSQOL-29 showed good internal consistency, factor structure and no floor effect, while most subscales had some ceiling effect. Criterion validity was sub-optimal for two subscales. Equivalence and acceptability were good.

Physical Therapy in Rheumatoid Arthritis

2021 ◽  
Vol 63 (2) ◽  
pp. 81-87
Author(s):  
Włodzisław Kuliński ◽  
Jakub Skuza
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Physical Therapy ◽  
Joint Stiffness ◽  
Light Therapy ◽  
Well Being ◽  
Magnetic Field Therapy ◽  
Field Therapy ◽  
Global Population

Introduction: Rheumatoid arthritis (RA) is a chronic and progressive inflammatory process resulting in the destruction of articular and periarticular tissues and leading to the development of functional impairment, permanent deformities and disability. RA affects approximately 1% of the global population and is more common in women than men. Aim: To assess the effects of physical therapy in RA patients. Material and Methods: The study assessed 21 patients with stage III/IV RA. They were managed with physical therapy, including thermotherapy, electrotherapy, laser therapy, magnetic field therapy and light therapy. The data collected in the study were statistically analysed. Results: After treatment, all study patients showed pain reduction, improved well-being, reduced duration of morning joint stiffness, improved ranges of motion in the joints and a better quality of life. Conclusions: 1. Rheumatoid arthritis is a difficult clinical and social problem. 2. The physical therapy used in the study reduced the pain experienced by the patients and the duration of morning joint stiffness and improved the ranges of motion and quality of life. 3. Physical therapy and rehabilitation constitute the main method of treatment of this disorder.

Enhancing quality of life in progressive multiple sclerosis with powered robotic exoskeleton

2020 ◽  
pp. 135245852094308
Author(s):  
Seng Kwee Wee ◽  
Chiu Yi Ho ◽  
Si Lei Tan ◽  
Cheng Hong Ong
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Well Being ◽  
Gait Training ◽  
Self Esteem ◽  
Progressive Multiple Sclerosis ◽  
Robotic Exoskeleton ◽  
Lower Limb Strength ◽  
Training Post

Wearable powered robotic exoskeleton can provide high repetitions and high-intensity gait training. It can promote a sense of well-being when the user is in upright posture to walk around different environment. We present a case of a lady with progressive multiple sclerosis who received 15 sessions of robotic exoskeleton training. Post training, she demonstrated improvement in lower limb strength, sense of well-being and self-esteem that led to improved transfer ability, increased social outings and better quality of life (QOL). Previously, she was depressed and reluctant to go out for social activities. This case suggests the potential of robotic exoskeleton to enhance QOL in people with mobility challenges.

scholarly journals Well Being of Older Gay and Bisexual Men and Women in England: Results of a Cross-Sectional Population Based Study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I Grabovac ◽  
L Smith ◽  
D T McDermott ◽  
S Stefanac ◽  
L Yang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Life Satisfaction ◽  
Depressive Symptoms ◽  
Older People ◽  
Sexual Satisfaction ◽  
Well Being ◽  
Satisfaction With Life Scale ◽  
Cross Sectional ◽  
And Bisexual

Abstract Background Lesbian, gay, and bisexual (LGB) older people are an under-represented population in research, with limited research noting more depression, loneliness, rejection, overall poorer health and well-being outcomes. Our study compared well-being, defined as quality of life (QOL), life satisfaction, sexual satisfaction, and depression, among LGB people with their heterosexual peers’. Methods Cross-sectional data from the English Longitudinal Study of Aging, collected 2012-2013. A total of 5691 participants were included in the analysis, with 326 (5.7%) self-identifying as LGB. We used CASP-19 questionnaire for well-being; the Satisfaction with Life Scale for life satisfaction; and the Center for Epidemiologic Studies Depression Scale for depressive symptoms. The question “During the past three months, how satisfied have you been with your overall sex life?” was used for sexual satisfaction. T-test and chi-square tests were used for differences in sociodemographic characteristics between LGB and heterosexual participants. Regression models were used to test associations between sexual orientation and well-being outcomes. Results LGB participants reported significantly lower mean quality of life and life satisfaction, and had significantly lower odds of reporting satisfaction with their overall sex life and higher odds of reporting depressive symptoms in unadjusted models. After adjustment for sociodemographic and health-related covariates, there remained significant differences between groups in mean QOL scores (B= -0.96, 95% [CI] -1.87 to -0.06) and odds of sexual satisfaction (OR = 0.56, 95% CI 0.38-0.82). Conclusions LGB older people report lower quality of life and lower sexual satisfaction than their heterosexual counterparts, possibly associated with experiencing lifelong social discrimination. Main message: Older lesbian, gay and bisexual people in England report significantly lower QOL and sexual satisfaction in comparison to heterosexual counterparts.

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