Postural Health in Women: The Role of Physiotherapy

Abstract Objective : To advise obstetric and gynaecology care providers of the physical, psychological, and environmental factors that affect women's posture throughout their lifespan, from adolescence to menopause. To outline the physiotherapy management of obstetrics, osteoporosis, and urinary incontinence in women and to identify recommendations for referral to a physiotherapist. Outcomes : Knowledge of abnormal postures, contributing factors and recommendations for physiotherapy management. Evidence : MEDLINE, PEDro, and Cochrane Library Search from 1992 to 2003 for English-language articles and references from current textbooks related to posture and women's health conditions that are managed by physiotherapists. Values : The evidence collected was reviewed by the authors and quantified using the evaluation of evidence guidelines developed by the Canadian Task Force on the Periodic Health Exam. Recommendations : 1.Pelvic floor muscle training with a physiotherapist is recommended to prevent urinary incontinence during pregnancy and after delivery(I-A). 2.Core stability training with a physiotherapist is recommended toprevent and treat back and pelvic pain during and followingpregnancy (I-B). 3.Physiotherapist-prescribed exercises are recommended for womento elicit positive changes in bone mass and to reduce fall andfracture risk (I-A). 4.Pelvic floor muscle training with a physiotherapist is recommendedfor women with stress urinary incontinence (I-A). The Canadian Physiotherapy Association and Society of Obstetricians and Gynaecologists of Canada have developed this joint policy statement regarding posture in women's health that highlights the physical, psychological, and environmental factors that affect women's posture throughout their lifespan, from adolescence to menopause. This statement outlines the role of physiotherapy in the assessment and treatment of women's posture; outlines the physiotherapy management of obstetrics, osteoporosis, and urinary incontinence; and identifies recommendations for referral to a physiotherapist. The quality of evidence and classification of recommendations havebeen adapted from the Report of the Canadian Task Force on the Periodic Health Exam (Table 1).1