Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial

Objective To explore feasibility in terms of delivering and evaluating a combination of physiotherapy and psychotherapy for patients with chronic pelvic pain syndrome (CPPS).Design Prospective non-randomised controlled pilot study.Setting Tertiary care facility with a specialised interdisciplinary o...

Full description

Saved in:
Bibliographic Details
Main Authors: Bernd Löwe, Margit Fisch, Christian A Brünahl, Susanne G R Klotz, Christoph Dybowski, Rebecca Albrecht, Johanna Höink, Gesche Ketels
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/12/e053421.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850104083269025792
author Bernd Löwe
Margit Fisch
Christian A Brünahl
Susanne G R Klotz
Christoph Dybowski
Rebecca Albrecht
Johanna Höink
Gesche Ketels
author_facet Bernd Löwe
Margit Fisch
Christian A Brünahl
Susanne G R Klotz
Christoph Dybowski
Rebecca Albrecht
Johanna Höink
Gesche Ketels
author_sort Bernd Löwe
collection DOAJ
description Objective To explore feasibility in terms of delivering and evaluating a combination of physiotherapy and psychotherapy for patients with chronic pelvic pain syndrome (CPPS).Design Prospective non-randomised controlled pilot study.Setting Tertiary care facility with a specialised interdisciplinary outpatient clinic for patients with CPPS.Participants A total of 311 patients was approached; 60 participated. 36 patients were included in the intervention group (mean age ±SD 48.6 years±14.8; 52.8% female) and 24 in the control group (mean age ±SD 50.6 years±14.5; 58.3% female). Fourteen participants were lost to follow-up.Interventions Participants were non-randomly allocated to the intervention group with two consecutive treatment modules (physiotherapy and cognitive behavioural therapy) with a duration of 9 weeks each or to the control group (treatment as usual).Main outcome measures Feasibility was operationalised in terms of delivering and evaluating the therapeutic combination. Regarding eligibility as the first aspect of feasibility, willingness to participate, dropout and satisfaction were assessed; for the second aspect, standardised self-report questionnaires measuring health-related quality of life, depression severity and pain were applied.Results Although eligibility and willingness-to-participate rates were low, satisfaction of the participants in the intervention group was high and dropout rates were low. Results indicated a small and non-significant intervention effect in health-related quality of life and significant effects regarding depression severity and pain.Conclusions The combination of physiotherapy and psychotherapy for patients with CPPS seems to be feasible and potentially promising with regard to effect. However, a subsequent fully powered randomised controlled trial is needed.Trial registration number German Clinical Trials Register (DRKS00009976) and ISRCTN (ISRCTN43221600).
format Article
id doaj-art-c7527f1bc7ea4308aeb3e0b9f2c3b5b5
institution DOAJ
issn 2044-6055
language English
publishDate 2021-12-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-c7527f1bc7ea4308aeb3e0b9f2c3b5b52025-08-20T02:39:24ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-053421Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trialBernd Löwe0Margit Fisch1Christian A Brünahl2Susanne G R Klotz3Christoph Dybowski4Rebecca Albrecht5Johanna Höink6Gesche Ketels74 Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Gynaecology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Physiotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyObjective To explore feasibility in terms of delivering and evaluating a combination of physiotherapy and psychotherapy for patients with chronic pelvic pain syndrome (CPPS).Design Prospective non-randomised controlled pilot study.Setting Tertiary care facility with a specialised interdisciplinary outpatient clinic for patients with CPPS.Participants A total of 311 patients was approached; 60 participated. 36 patients were included in the intervention group (mean age ±SD 48.6 years±14.8; 52.8% female) and 24 in the control group (mean age ±SD 50.6 years±14.5; 58.3% female). Fourteen participants were lost to follow-up.Interventions Participants were non-randomly allocated to the intervention group with two consecutive treatment modules (physiotherapy and cognitive behavioural therapy) with a duration of 9 weeks each or to the control group (treatment as usual).Main outcome measures Feasibility was operationalised in terms of delivering and evaluating the therapeutic combination. Regarding eligibility as the first aspect of feasibility, willingness to participate, dropout and satisfaction were assessed; for the second aspect, standardised self-report questionnaires measuring health-related quality of life, depression severity and pain were applied.Results Although eligibility and willingness-to-participate rates were low, satisfaction of the participants in the intervention group was high and dropout rates were low. Results indicated a small and non-significant intervention effect in health-related quality of life and significant effects regarding depression severity and pain.Conclusions The combination of physiotherapy and psychotherapy for patients with CPPS seems to be feasible and potentially promising with regard to effect. However, a subsequent fully powered randomised controlled trial is needed.Trial registration number German Clinical Trials Register (DRKS00009976) and ISRCTN (ISRCTN43221600).https://bmjopen.bmj.com/content/11/12/e053421.full
spellingShingle Bernd Löwe
Margit Fisch
Christian A Brünahl
Susanne G R Klotz
Christoph Dybowski
Rebecca Albrecht
Johanna Höink
Gesche Ketels
Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial
BMJ Open
title Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial
title_full Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial
title_fullStr Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial
title_full_unstemmed Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial
title_short Physiotherapy and combined cognitive-behavioural therapy for patients with chronic pelvic pain syndrome: results of a non-randomised controlled feasibility trial
title_sort physiotherapy and combined cognitive behavioural therapy for patients with chronic pelvic pain syndrome results of a non randomised controlled feasibility trial
url https://bmjopen.bmj.com/content/11/12/e053421.full
work_keys_str_mv AT berndlowe physiotherapyandcombinedcognitivebehaviouraltherapyforpatientswithchronicpelvicpainsyndromeresultsofanonrandomisedcontrolledfeasibilitytrial
AT margitfisch physiotherapyandcombinedcognitivebehaviouraltherapyforpatientswithchronicpelvicpainsyndromeresultsofanonrandomisedcontrolledfeasibilitytrial
AT christianabrunahl physiotherapyandcombinedcognitivebehaviouraltherapyforpatientswithchronicpelvicpainsyndromeresultsofanonrandomisedcontrolledfeasibilitytrial
AT susannegrklotz physiotherapyandcombinedcognitivebehaviouraltherapyforpatientswithchronicpelvicpainsyndromeresultsofanonrandomisedcontrolledfeasibilitytrial
AT christophdybowski physiotherapyandcombinedcognitivebehaviouraltherapyforpatientswithchronicpelvicpainsyndromeresultsofanonrandomisedcontrolledfeasibilitytrial
AT rebeccaalbrecht physiotherapyandcombinedcognitivebehaviouraltherapyforpatientswithchronicpelvicpainsyndromeresultsofanonrandomisedcontrolledfeasibilitytrial
AT johannahoink physiotherapyandcombinedcognitivebehaviouraltherapyforpatientswithchronicpelvicpainsyndromeresultsofanonrandomisedcontrolledfeasibilitytrial
AT gescheketels physiotherapyandcombinedcognitivebehaviouraltherapyforpatientswithchronicpelvicpainsyndromeresultsofanonrandomisedcontrolledfeasibilitytrial