Women's preferences for pelvic floor screening in sport and exercise: a mixed-methods study integrating survey and interview data in Australian women

Jodie G Dakic; E Jean C Hay-Smith; Kuan-Yin Lin; Jill L Cook; Helena C Frawley

doi:10.1136/bjsports-2023-107017

Women's preferences for pelvic floor screening in sport and exercise: a mixed-methods study integrating survey and interview data in Australian women

Br J Sports Med. 2023 Nov 30;57(24):1539-1549. doi: 10.1136/bjsports-2023-107017.

Authors

Jodie G Dakic^{1

2}, E Jean C Hay-Smith³, Kuan-Yin Lin^{4

5

6}, Jill L Cook⁷, Helena C Frawley^{8

9

10}

Affiliations

¹ Department of Physiotherapy, Monash University, Clayton, Victoria, Australia jodie.dakic@monash.edu.
² Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
³ Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington, New Zealand.
⁴ Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan.
⁵ Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan.
⁶ School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan.
⁷ La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.
⁸ Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
⁹ Allied Health Research, The Royal Women's Hospital, Melbourne, Victoria, Australia.
¹⁰ Allied Health Research, Mercy Hospital for Women, Melbourne, Victoria, Australia.

PMID: 37648412
DOI: 10.1136/bjsports-2023-107017

Abstract

Objectives: One in two women experiencing pelvic floor (PF) symptoms stop playing sport or exercising. The study examines the perspective of women with PF symptoms to inform acceptable screening practices within sport and exercise settings.

Methods: Explanatory, sequential, mixed-methods design. Phase 1: survey of 18-65 years, symptomatic, Australian women (n=4556). Phase 2: semistructured interviews with a subset of survey participants (n=23). Integration occurred through connection of phases (study design, sampling) and joint display of data.

Results: Findings are represented in three threads: (1) 'women (not) telling'; a majority of women had told no-one within a sport or exercise setting about their PF symptoms due to shame/embarrassment, lack of pelvic health knowledge and not wanting to initiate the conversation, (2) 'asking women (screening for PF symptoms)'; women endorsed including PF symptom questions within existing sport and exercise screening practices but only when conducted in a respectful and considered manner and (3) 'creating safety'; professionals can assist women to disclose by demonstrating expertise, trustworthiness and competency. If health and exercise professionals are provided with appropriate training, they could raise pelvic health awareness and promote a supportive and safe sport and exercise culture.

Conclusion: Women with PF symptoms support health and exercise professionals initiating conversations about PF health to normalise the topic, and include PF symptoms among other pre-exercise screening questions. However, women should be informed on the relevance and potential benefits of PF screening prior to commencing. Safe screening practices require building trust by providing information, gaining consent, displaying comfort and genuine interest, and being knowledgeable within one's scope of practice to the provision of advice, exercise modifications and referral as appropriate.

Keywords: exercise; pelvic floor; sport; women.

MeSH terms

Australia
Exercise
Exercise Therapy / methods
Female
Humans
Pelvic Floor*
Sports*