Introducing a Guide in Physical Therapy Addressing Sexual Function in Adults with Neuromuscular Disorders
Bibliographic record
Abstract
ABSTRACT Introduction Physical therapists are part of the rehabilitation team following individuals with neuromuscular disorders (NMD). Due to their impairments, people with NMD can have difficulties engaging in sexual activities. One study reported that 70% of people living with chronic disorders present difficulties related to sexuality and only 18% can overcome them by themselves [1]. Objective The guide has 3 main objectives: 1) To document interventions regarding sexual impairments in people with NMD that can be applied by physical therapists in clinical practice; 2) To propose approaches for addressing sexuality with their clients; 3) To highlight issues that require advanced physical therapy expertise in pelvic floor rehabilitation. Methods The guide is based on a review of the literature and the clinical experience of physical therapists with expertise in NMD or sexuality in Canada. It was developed using the “Rare knowledge mining methodological framework” [2]. Two frameworks were also followed: “Essential Competency Profile for Physiotherapists in Canada (2017)” [3] and the “EX-PLISSIT model” [4, 5]. Results A total of 75 articles retrieved were considered in our review. Twelve physical therapists and four other health professionals were consulted for this guide. It is recommended to introduce the topic of sexuality early in therapy and follow the steps of the EX-PLISSIT model [4, 5] before offering specific suggestions. Physical therapists should address different aspects in their assessment: interpersonal relationships, assistance required or not during sexual activities, urinary, vaginal or anorectal symptoms, erectile dysfunction, pain, fatigue and impact of the disease on sexuality. Some of the impairments or limitations that may be identified during an objective assessment can have an impact on sexual function and it is important to be aware of these issues: strength, grip, dexterity, sensibility, pain, bed mobility, motor control, etc. Interventions are presented in detail in the guide regarding physical activity, positioning, muscle weakness, fatigue, decreased mobility, erectile dysfunction, sensitivity disorders, lubrication, pain, incontinence, and cardio and respiratory implications. Conclusions To the best of our knowledge, this is the first guide on the role of physical therapists in sexuality. Physical therapists should integrate sexual function into their assessments and interventions. They are an essential part of the rehabilitation team, and they should collaborate with other health professionals to have a multidisciplinary approach, especially in NMD patients. More studies are needed to evaluate the effects of intervention on sexual function in this population. Disclosure No
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.022 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.014 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".