3 Systematic review of treatment efficacy of PFPT 61 Outcome measures All outcome measures of included studies are listed in Table 1. Table 1. Outcome measures Muscle tone and function ◊ Modified Oxford-scale50 ◊ 7-point digital palpation scale muscle tone (-3 to +3)45 ◊ 4-point digital palpation score for muscle flexibility and muscle relaxation (0-4)45 ◊ Vulvalgesiometer 45 ◊ Rest s-EMG-values44,45,48 ◊ Modified Oxford-scale (0-5)45,46 ◊ The New PERFECT-scale 48 Pain ◊ Digital palpation of the pelvic floor muscles (levator, obturator internus, diaphragm urogenital) 51 ◊ Visual analog scales (VAS)35,46,47,49 ◊ the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI)35,44,49,51 ◊ Pelvic pain symptom scale (PPSS)35,49 ◊ Likert visual analog scale50-52 ◊ VAS-scores to assess vulvar pain45 ◊ Degree of pain during sexual intercourse48 Sexual Function ◊ Female Sexual Function Index (FSFI)46,48,51,52 ◊ Cervantes scale measuring sexual response cycle on Quality of Life (QoL)48 ◊ Sexual health domain of the PPSS35,49 ◊ Sexual Health Inventory for Men (SHIM)51 Pelvic floor symptoms ◊ O’Leary-Sant IC Symptom/Problem Index (ICSI/ICPI)50-52 ◊ NIH-CPSI 35,44,49,51 ◊ American Urological Association (AUA) symptom and bother score47 ◊ VAS-urgency47 ◊ Likert visual analog scale urgency50,52 ◊ Likert visual analog scale frequency52 ◊ Pelvic pain symptom scale (PPSS)35,49 Quality of life ◊ Cervantes QoL48 ◊ VAS-QoL45 ◊ NIH-CPSI domain QoL35,44,49,51 ◊ 12-item Short Form survey (SF-12)50-52 Patient’s perceived effect ◊ Global Response Assessment (GRA)35,49,51,52 Treatments The duration of treatment varied between 5-12 sessions, with sessions lasting between 30-75 minutes, over a period varying from 5 days to 3 months. PFPT protocols in the studies consisted of at least 3 of the following interventions: education about anatomy and function of the pelvic floor and related symptoms;44-47 digital vaginal palpation of the pelvic floor for proprioception and to guide home exercises;46,48 manual techniques to release MTrPs of the pelvic floor and soft-tissue massage, including stretching,
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