Dysfunction, activity limitations, participation restriction and contextual factors in South African women with pelvic organ prolapse.
Corlia Brandt, Elizabeth C Janse van Vuuren
PMID 30863799WHAT IT FOUND
South African women awaiting prolapse surgery reported poor quality of life mainly through emotional, social and sleep problems.
Physical activity limits were not the main issue. Many had heart disease or depression and rarely exercised, suggesting these lifestyle factors need addressing before pelvic floor therapy.
Key findings
01Quality of life was most impaired in prolapse impact, social limitations, emotional aspects and sleep/energy domains, while physical and role limitations were less affected.
02Participants reported low levels of exercise and sport participation, with only 15% playing sport and 21% doing cardiovascular exercise.
03A high proportion of participants had comorbidities relevant to general health, including 47% taking medication for hypertension and 14% having heart disease.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study is descriptive and cross-sectional, so it cannot prove that lack of exercise causes the observed quality of life issues or comorbidities. Participants were recruited from urogynaecology clinics and were scheduled for surgery, meaning they may not represent women with prolapse who manage conservatively or are asymptomatic. The sample was limited to white, Asian and mixed-race women, excluding black African women, which limits the generalisability of findings to the broader South African population. A custom questionnaire was used for demographic and exercise history, which has not been validated in the same way as the P-QOL.
Declared interests
The authors declared no conflicts of interest. The study was approved by the Ethics Committee of the Faculty of Health Sciences of the University of the Free State.
The easy way to misread this
Do not assume that physical exercise is the primary quality of life concern for these patients. The study found that emotional, social and sleep domains were more impaired than physical limitations, and that many patients had significant cardiovascular comorbidities that require medical clearance before starting an exercise programme.