Journal of Women’s Health Physical Therapy

The Official Journal of the Academy of Pelvic Health Physical Therapy

Research at your fingertips.

The Journal of Women’s Health Physical Therapy (JWHPT) is an enthusiastic proponent of advancing the science of women’s and men’s health, and we encourage authors to submit their research to the journal in accordance with this mission.

Despite the fact that it has been 20 years since research funding by the National Institutes of Health was required to include women, there is a still a large gender gap in biomedical research. Women remain underrepresented in all domains of health-related research impacting societal concerns and health care policy.

Viewing physical therapy research in this larger context, it is vital to maintain high standards of quality research regarding the health care needs of women.

Some of the topics the Journal covers:

  • Pre/post-partum
  • Manual Therapy
  • Women’s sports and health promotion
  • Women’s Musculoskeletal Concerns
  • Pelvic Pain
  • Menopause
  • Osteoporosis
  • Pediatric Pelvic Health
  • Bowel/Bladder Dysfunction
  • Post-Cancer Rehab/Breast Health
  • Chronic Pain

Access from anywhere.

Our journal is accessible in both digital and print formats allowing you to read it from anywhere. Free for APTA Pelvic Health members and costs USD $185 /year for non-members. Whether you are writing your CAPP Case Reflection, completing course work in a DPT program or want to advance your knowledge on the latest evidence available in the women’s health discipline, you will find peer-reviewed articles, book reviews and new research in women’s health physical therapy in our journal.

Facebook Journal Club

The Facebook JWHPT Journal Club is open to PTs, PTAs, SPTs and other medical health professionals who are interested in discussing the latest evidence and research.

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April/June 2021

April/June 2021 Highlights
Volume 45 – Issue 2

“In a survey of breastfeeding women, Synder and colleagues found low levels of physical activity and symptoms of urinary incontinence. The survey participants noted time constraints due to breastfeeding and childcare were barriers to activity.

Bernard and associates conducted a systematic review finding that the Protection Amount Frequency Adjustment Body Image Questionnaire provided the highest responsiveness to physical therapy intervention in women undergoing conservative care for urinary incontinence.

In a pilot study of women with pregnancy-related pelvic girdle pain, Guan and colleagues compared an individualized exercise program to education alone finding that both groups exhibited decreased pain and improved function.

In women with overactive bladder, Reisch, Zuniga, and Das found preliminary evidence that a mindfulness-informed group-based behavioral therapy was a useful intervention.

In a *free access* systematic review, Edie and associates found tiredness and/or lack of sleep, domestic chores and responsibilities, unpredictable schedule, lack of support, weather, and breastfeeding were the most reported barriers to exercise for postpartum women.”

Cynthia M. Chiarello, PT, PhD Editor-in-Chief

Jan/Mar 2021

Jan/March 2021 Issue

Volume 45 – Issue 1

This issue presents evidence for practice from original research and some interesting and important case reports. Kasitinon and colleagues present a novel case series in which pelvic pain with pudendal neuropathies is linked to repetitive or weighted squatting exercise. In a randomized controlled trial, Stone and colleagues found that a 6-week individualized physical therapy program could improve pain, patient satisfaction, and self-rated exercise ability in women recovering from a cesarean delivery. In a prospective descriptive study of NCAA Division III athletes, Tremback-Ball and colleagues examined the impact of their menstrual cycle on athletic performance. Interestingly, they found no difference between follicular and luteal phases. Divine and McVey present a case report describing physical therapy intervention for an adult with a history of uncomplicated recurrent urinary tract infection with pelvic pain, urinary urgency/frequency, and urinary incontinence. Fischer and colleagues illustrate the importance in recognizing that systemic disease can present as pregnancy-related musculoskeletal dysfunction. This case report on a woman with seemingly routine back pain during pregnancy is required reading for all clinicians working with this population. Please remember that this issue continues online with the platform and poster abstracts from the Academy of Pelvic Health for CSM 2021.”

—Cynthia M. Chiarello, PT, PhD Editor-in-Chief

Oct/Dec 2020

Oct/Dec 2020 Issue

Volume 44 – Issue 4

“In this issue, we have a thought-provoking mix of research exemplifying various aspects of women’s and pelvic health. Drs Siracusa and Gray lead us off with a clinical commentary and video abstract detailing fundamental background and the multisystem sequelae of COVID-19, with implications that respiratory issues can have on pelvic floor functioning for pelvic health therapists with advice for all physical therapists. In a retrospective analysis of medical records, Martins and colleagues present the clinical characteristics and determinants of obstetric palsy among patients with obstetric fistula. Dr Boissonnault and associates surveyed the chief delegates of the International Organization of Physical Therapists in Pelvic and Women’s Health from 30 countries regarding their impressions of professional focus and practice. Drs Maher and Iberle evaluated the concurrent validity of external coccyx motion to transabdominal ultrasound imaging to examine pelvic floor muscle function. The issue closes with an interesting study from Dr Hartigan’s group, who examined hip angles and moments at weight acceptance with motion analysis in women with and without stress urinary incontinence.” —Cynthia M. Chiarello, PT, PhD Editor-in-Chief 

Jul/Sept 2020

July/September 2020 Issue
Volume 44 – Issue 2

“The wide-ranging scope of women’s health physical therapy research is clearly represented in this issue of JWHPT. Dr Deja and colleagues examine whether there are associations between prior injury/stress fracture, disordered eating behaviors, menstrual health, and urogenital dysfunction among collegiate women dancers. Dr Hartigan and her group from the University of New England explored gait mechanics in women with and without stress urinary incontinence, specifically comparing hip motion, hip forces, and muscle activity during stance. Drs de Ruig and Watson present a thought-provoking case series with the novel approach of using quantitative ultrasound imaging to screen postmenopausal women for risk of fracture. We conclude this issue with a prospective controlled study by Dr Pawalia and associates who, contrary to societal norms, convinced women to participate in supervised exercise during pregnancy, finding that obesity markers were reduced postpartum.”  —Cynthia M. Chiarello, PT, PhD Editor-in-Chief 

Apr/Jun 2020

April/June 2020 Issue
Volume 44 – Issue 2

“In this issue, Dr Mannen and associates examined the biomechanics of holding infants under different conditions. Dr Bonis and colleagues performed a quantitative longitudinal study evaluating the effects of exercise and behavioral modifications on women with pelvic floor dysfunction and lumbopelvic pain. Dr Rudolphi’s group presented a retrospective case series on children with daytime incontinence who benefited from a comprehensive physical therapy program. In a qualitative study, Dr Happel-Parkins prompts us to be sensitive to the sociocultural and religious back- grounds of women with dyspareunia.” —Cynthia M. Chiarello, PT, PhD Editor-in-Chief 

Jan/Mar 2020

January/March 2020 Issue
Volume 44 – Issue 1

“This issue brings an interesting variety of scholarly products to consider for discussion. There are 2 research reports dealing with running. Drs Rothschild and Schellhase survey adult female endurance runners finding 2 components of the female athletic triad, low energy availability and menstrual dysfunction, to be an issue. Dr Deering and colleagues examined interrecti distance and abdominal muscle thickness before and after an 8-week training program, which used ultrasound imaging as a biofeedback tool in their intervention. Dr Reisch reviews the literature on behavioral training techniques for overactive bladder finding good support for the theoretical rationale of these techniques. Dr Stone shared a case report on intervening for Peyronie disease in a male to help with his female partner’s dyspareunia. Finally, Dr Bishop presents a thought-provoking clinical commentary on manual therapy for pelvic pain conditions.” Chiarello, Cynthia M. PT, PhD; Editor-in-Chief

Upcoming & Past Journal Club Webinars

The Journal Club is a member-led group sponsored by the Academy of Pelvic Health Physical Therapy and the Journal of Women’s Health Physical Therapy (JWHPT). It is open to PTs, PTAs, SPTs and other medical health professionals who are interested in discussing the latest evidence and research to advance practice.

The free webinars usually take place monthly and last about one hour. The format is typically a moderated discussion with a question and answer segment to allow for real-time engagement and clinical discussion. Registration is required and recordings are sent to registrants who cannot attend live. Archives of past events can be found here.

Disclaimer: The JWHPT promotes scholarly discussion and clinical dissemination of best available evidence; Journal Club presenters are responsible for the accuracy of the content. Ideas and opinions expressed may not be those of the Academy of Pelvic Health and JWHPT.

Submit a manuscript.

Our editorial team invites you to submit manuscripts on all aspects of women’s health as it pertains to physical therapy. The team is also looking for case studies or series that provide information on changes in treating women with COVID who are pregnant or post-partum that loop in the best available science of what is happening. 

We are seeking manuscripts for the following:

  • Pre/post-partum
  • Manual Therapy
  • Women’s sports and health promotion
  • Women’s Musculoskeletal Concerns
  • Pelvic Pain
  • Menopause
  • Osteoporosis
  • Pediatric Pelvic Health
  • Bowel/Bladder Dysfunction
  • Post-Cancer Rehab/Breast Health
  • Chronic Pain

Become a Manuscript Reviewer.

The Journal of Women’s Health Physical Therapy is seeking to expand its team of manuscript reviewers. Applicants must be able to:

  • Receive and review 1‐3 manuscripts per year for blinded peer review
  • Demonstrate that they have a good knowledge base of several clinical content areas in Women’s Health Physical Therapy with at least 2 years in specialty practice
  • Understand basic statistics required to evaluate the strength of the research for at least two of the following types of research.
  • Evaluate quality of the research and provide constructive criticism and suggestions to authors
  • Commitment to developing reviewer skills

Featured Free Article

Pelvic Floor Considerations of COVID-19
Siracusa, Carina PT, DPT; Gray, Amelia PT, DPT

Whether you are a physical therapist in acute care, rehabilitation, home health, or outpatient, this clinical commentary is for you. Dr’s Siracusa and Gray explain the systemic effects of coronavirus infection and set the stage to support physical therapists across the scope of practice. While there is not yet sufficient research on effects of COVID-19 on bowel and bladder, the authors extrapolate from existing related evidence of long-term hospitalization, neurologic insults, and respiratory diseases to help physical therapists identify screening, examination and intervention considerations for coronavirus survivors.

Screening guide from the authors:

“A simple 5-question screening tool may help pick up on bowel and bladder concerns in the general rehabilitation population:

  1. Are you experiencing any urinary incontinence? 
  2. Are you able to delay urination if you have the urge? If so, for how long?
  3. Are you experiencing any constipation?
  4. Are you experiencing any fecal incontinence?
  5. Are you experiencing any pain in the pelvic or abdominal region?

If the patient answers yes to any of these questions, it may be appropriate to at least refer to a pelvic floor  physical therapist for an educational consult. These questions could be asked in person or via telehealth to help determine whether a more robust evaluation and a plan of care are required.”

Read the FREE ACCESS clinical commentary to better understand and minimize sequelae of prolonged hospitalization inclusive of pelvic health considerations in coronavirus survivors.

Featured Highlight
Clinical Practice Guidelines

In a collaborative effort by the Academy of Orthopaedic Physical Therapy and the Academy of Pelvic Health Physical therapy of the APTA, the clinical practice guideline for physical therapy management for pelvic girdle pain in the antepartum population was published in 20171. This open access document offers recommendations for clinical reasoning in the management of females with prenatal pelvic girdle pain within the ICF framework, ranked by strength of supporting evidence. The recommendations also serve to guide future research to address areas in which evidence is sparse.

Pelvic Girdle Pain in the Antepartum Population – Physical Therapy Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health

Brief overview of findings:

  • “Risk factors. Based on strong evidence, risk factors for the development of PGP include previous pregnancy, orthopedic dysfunction (such as hip and/or leg dysfunction), increased body mass index, and smoking. Risk is also higher for patients with work dissatisfaction and those who don’t believe that their condition will improve.
  • Clinical course. Several factors can help to identify women who will have persistent problems. These include PGP developing early in pregnancy, multiple pain locations, and abnormal results on multiple physical therapy assessments.
  • Examination and diagnosis. The guideline highlights the importance of recognizing other pregnancy-related conditions that may appear similar to PGP. Important clinical tests and outcome questionnaires for assessing women with PGP are identified as well.
  • Physical therapy interventions. Physical therapy recommendations for PGP may include the use of a support belt, exercise programs, or manual therapy techniques. Yet so far there is only weak or conflicting evidence to support these recommendations. While strong evidence shows that women with PGP are at high risk of falls, there is little evidence on measures to assess balance or reduce the risk of falls, including activity limitations.”2

The Academy of Pelvic Health Physical Therapy continues to develop evidence-based practice guidelines following the APTA’s mission. The APTA states, “[Clinical prediction guidelines] are key to decreasing unwarranted variations in practice, decreasing the knowledge translation gap, and optimizing movement.3 The Academy of Pelvic Health Physical Therapy has the following evidence-based practice guidelines currently in development:

  • Functional Lower Gastrointestinal Disorders: Constipation
  • Pelvic Girdle Pain in the Postpartum Population
  • Pelvic Pain (in cooperation with the Academy of Orthopaedic Physical Therapy)
  • Physical Therapy Intervention for Adult Women With Urinary Incontinence
  • Inflammatory Bowel Disease: Physical Therapy and Exercise
  • See complete list of APTA clinical prediction guidelines in development

References:

  • Clinton S, Newell A, Downey P, Coleman-Ferreira K. Pelvic Girdle Pain in the Antepartum Population Physical Therapy Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Section on Women’s Health and the Orthopaedic Section of the American Physical Therapy Association. Journal of Women’s Health Physical Therapy. 2017; 41(2): 102-125.
  • Hughes, Connie. (2017, July 5). New guideline on pelvic girdle pain during pregnancy — Journal of Women’s Health Physical Therapy presents evidence-based recommendations. Retrieved from <https://eurekalert.org/pub_releases/2017-07/wkh-ngo070517.php>.
  • APTA. (2018). Clinical Practice Guidelines (CPGs). Retrieved from <http://www.apta.org/EvidenceResearch/EBPTools/CPGs/>.

Meet the Team

Cynthia M. Chiarello, PT, PhD

JWHPT Editor-in-Chief

2016-PRESENT
📍 New York, NY

Mary Dockter, PT, PhD

JWHPT Senior Editor

2017-PRESENT
📍 Bismarck, ND

Rebecca Reisch, PT, DPT, PhD, OCS

JWHPT Associate Editor

2017-PRESENT
📍 Portland, OR

Theresa M. Spitznagle, PT, DPT, Board-Certified Women's Health Clinical Specialist

JWHPT Associate Editor

PRESENT
📍 St. Louis, MO

Karen Abraham, PhD, PT

JWHPT Associate Editor

PRESENT
📍 Winchester, VA

Patricia Nelson, PT, ScD, FNAP, OCS

JWHPT Associate Editor

PRESENT
📍 Belton, TX

Rita Gillan, DPT

JWHPT Digital Media Coordinator

2019-PRESENT
📍 Netherlands

Ellen Meisner, PT

Social Media Committee Member

2019-PRESENT
📍 New Richmond, WI

Ellen Meisner, PT

Social Media Committee Member

2019-PRESENT
📍 Florissant, MO

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