ABSTRACT

Objectives

To prospectively evaluate a mindfulness protocol and pelvic floor physical therapy (PFPT) for women with chronic pelvic pain (CPP) who were otherwise physically and mentally healthy, comparing the effectiveness of the treatments separately and together.

Materials and Methods

Women with CPP were randomized into two groups. Each group initially underwent a mindfulness protocol or PFPT (including electrotherapy, biofeedback, trigger point massage, and basic pelvic kinesiotherapy guidance), being switched to the other therapy after the first intervention, so all participants underwent both interventions. Participants were evaluated at 4 time points: Baseline, after each intervention and 8 months after the final therapy using the SF-36, the Mindful Attention Awareness Scale (MAAS), the visual analog scale (VAS), pelvic assessment, and electromyography questionnaires.

Results

Of 49 included women, 38 participated in both interventions and completed all 4 evaluations. In 7 physical examination and biofeedback scores, the group performing PFPT first achieved significant gains (p<0.05) immediately after the first intervention, while the group starting with mindfulness achieved significant gains only after the second intervention. In other 6 physical examination and biofeedback scores, both groups achieved significant gains immediately after the first intervention. In the MAAS, VAS, and in 4 domains of the SF-36, the sum of the interventions showed progressively significant improvement. At follow-up, gains were sustained in more than 85% of the 29 domains.

Conclusion

The results suggest that performing both therapies simultaneously could optimize gains in quality of life, pain management, and pelvic floor health in women with CPP.