3 Systematic review of treatment efficacy of PFPT 65 a significant increase from pre- to post-treatment in pelvic floor muscle flexibility and in the ability to relax the pelvic floor muscles after contraction measured with 4-point digital palpation scale. S-EMG demonstrated a higher tonic rest activity at pretreatment in the superficial layer of pelvic floor muscles in the patient group compared to controls but not in the deeper layer of the pelvic floor muscles. The last prospective study50 in women with IC showed significant improvement in muscle tone after PFPT in all pelvic floor muscles except for the coccygeus, using the modified Oxford Scale. Pelvic floor muscle function was measured in 2 RCTs46,48 and one prospective study.45 One RCT48 involving patients with dyspareunia found that PFPT significantly increased sustained contractions from baseline to post-treatment and the number of peaks were significantly higher in the PFPT-group using s-EMG and compared to control who received heat applied to lower back and myofascial release of the abdominal diaphragm, piriformis and iliopsoas muscle. A significant improvement was found in post-treatment pelvic floor muscle function measured with New-PERFECT scores in the PFPT- group and relative to baseline. The second RCT46 involved patients with dyspareunia and found significant improvement in pelvic floor muscle strength and endurance in the PFPT group in comparison with a no-treatment control group using the modified Oxford-scale. One prospective cohort study45 found a significant increase in pelvic floor muscle strength from pre-to post-treatment but not compared to control measured with the modified Oxford scale. Pain Pain scores were assessed in all studies. In one RCT51 in patients with CP/CPPS and IC/PBS, PFPT resulted in significant relief of tenderness/pain in 4 muscle groups (levator ani posterior and anterior, obturator internus and urogenital diaphragm) from pre-to post-treatment in both groups measured with digital examination. In the IC/ PBS group a significant relief of tenderness/pain was found compared to controls who received full body global therapeutic massage. This study also found reduced pain scores measured with Likert pelvic pain score to be significantly reduced from pre-to post-treatment in both groups but not compared to controls. The second RCT48 found a significant reduction in post-treatment dyspareunia pain scores using VAS in the PFPT group relative to controls. The third RCT46 found post-treatment VAS pain scores in the genital area before, during, and after vaginal intercourse to be significantly decreased compared to no-treatment controls, which sustained after
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