Impact of Early Physiotherapy on Pain, Quality of Life, Pelvic Floor Function, and Sexual Health Post-Episiotomy

The Female Sexual Function Index (FSFI) is a standardized 19-item questionnaire used to assess various aspects of female sexual function, including desire, arousal, lubrication, orgasm, satisfaction, and pain. Each domain is scored separately, with higher scores indicating better sexual function, and the total score ranging from 2 to 36. The FSFI is widely used in clinical and research settings to diagnose female sexual dysfunction and monitor treatment outcomes, offering a comprehensive and validated tool for evaluating sexual health in women.

The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) is a standardized tool used to assess the severity and impact of urinary incontinence on quality of life. It consists of a few questions that evaluate the frequency, amount of leakage, and the overall impact of urinary incontinence on daily activities. Additionally, it includes a self-diagnostic item to help identify the type of incontinence. The ICIQ-UI SF is widely used in both clinical practice and research to quickly and effectively assess urinary incontinence and guide treatment decisions.

The Euro Quality of Life Five Dimensions (EQ-5D-5L) is a standardized questionnaire used to measure health-related quality of life across five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension is assessed on a five-level scale, ranging from no problems to extreme problems, allowing for a detailed evaluation of a person's health status. The questionnaire also includes a Visual Analog Scale (VAS) where respondents rate their overall health on a scale from 0 to 100. The EQ-5D-5L is commonly used in clinical and research settings to assess health outcomes, inform healthcare decisions, and evaluate the effectiveness of interventions.

The Oxford Scale, also known as the Medical Research Council (MRC) scale, is a tool used to assess muscle strength. It ranges from 0 to 5, with 0 indicating no muscle contraction and 5 representing normal strength with full resistance. This scale is widely used in clinical settings, particularly in neurology and rehabilitation, to evaluate and monitor muscle strength.

The PERFECT Scheme is a method for assessing pelvic floor muscle function. It stands for Power, Endurance, Repetitions, Fast contractions, Every contraction, Coordination, and Timing. This comprehensive approach is used to evaluate and treat pelvic floor disorders, such as incontinence, allowing for tailored rehabilitation and progress tracking.

The physiotherapist investigates the presence of possible motion synkinesis in an attempt to activate the pelvic floor muscles - short adductors of the hips and gluteal muscles. Presence of motion synkinesis.

The physiotherapist examines the condition of the wound and its surroundings by palpation per vaginam. They assess the presence of any swelling and haematoma of the pubic region (presence YES x NO). They assess the sensitivity (the skin sensitivity and the vaginal sensitivity: increased x decreased x no sensitivity).

The physiotherapist checks the condition of the scar and the surrounding soft tissues of the pelvic floor by palpation per vaginam. They assess the sensitivity per vaginam using palpation (record: decreased x increased x no sensitivity), painfulness (presence YES x NO), displacement of the scar in relation to the bottom (presence YES x NO), and elastici-ty of the scars (presence YES x NO).

The physiotherapist examines the presence of the abdominal separation (DRA). The DRA is examined using palpation. The prevalence of DRA is analyzed and recorded as YES/NO.

The physiotherapist examines hypermobility. The hypermobility is measured using the Beighton score.

The Beighton Score is a quick assessment tool used to evaluate joint hypermobility, commonly in the context of conditions like Ehlers-Danlos Syndrome. It involves scoring five specific movements, with a total score ranging from 0 to 9. Points are awarded for hyperextension of the little fingers, thumbs, elbows, knees, and the ability to place palms flat on the floor with straight knees. A score of 4 or more suggests generalized hypermobility, while a lower score is typically considered within the normal range. This simple test helps identify individuals with hypermobility and is often part of a broader diagnostic evaluation.

The physiotherapist hands the expectant woman the Likert scale to measure the satisfaction with the early physiotherapy care.

A Likert scale is a widely used rating scale that measures attitudes, opinions, or perceptions by asking respondents to indicate their level of agreement or disagreement with a series of statements. It typically consists of 5 or 7 points, ranging from one extreme to another, such as "Strongly Disagree" to "Strongly Agree," with a neutral option in the middle (e.g., "Neither Agree nor Disagree"). The Likert scale is commonly used in surveys and questionnaires to quantify subjective data, making it easier to analyze and interpret responses in a standardized manner.