Physiotherapeutic Interventions Applied to the Bladder Pain Syndrome
Interstitial Cystitis, Painful Bladder Syndrome, Bladder Pain Syndrome
About this trial
This is an interventional treatment trial for Interstitial Cystitis focused on measuring Bladder pain syndrome, Physical therapy, Postural balance, Manual therapy, Biofeedback
Eligibility Criteria
Inclusion Criteria:
Participants are eligible for this multicenter RCT if they meet the following:
- Participant has signed and dated the appropriate Informed Consent document.
- Agreed to participate in study procedures.
- Participant reports a response of at least 1 on the pain, pressure or discomfort scale.
Participant reports an unpleasant sensation of pain, pressure or discomfort, perceived to be related to the bladder and/or pelvic region, associated with lower urinary tract symptoms for the majority of the time during the last 6 months.
Exclusion Criteria:
Individuals will not be eligible for enrollment in the multicenter RCT if they meet any of the criteria listed below:
- Oncology patients
- Previous pelvic radiotherapy treatment
- Systemic or neurological diseases that can compromise the pelvic structures or organs
- Patients with cognitive deficiency
Sites / Locations
- Universidade de São Paulo
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
Active Comparator
E-stim Group
Postural Group
Conventional Group
TENS group was treated with biofeedback, manual therapy, andtranscutaneous electrostimulation (TENS), a peripheral neuromodulation to promote analgesia in pain areas, using two transcutaneous self-adhesive electrodes Axelgaard 5 cm x 5 cm with 2 cm of distance between them. The parameters used were frequency = 100 Hz, pulse width = 50-100 µs, and current intensity according to the patient's sensitivity.
Postural group was treated with biofeedback, manual therapy, and postural exercises , which promoted pelvic mobility and functional training associated with respiratory exercises increasing the diaphragmatic excursion.Postural exercises consisted of 10 repetitions of breathing exercises in the lay-down position, 10 repetitions of hip anteversion and retroversion in the sitting position, and 10 repetitions of hip anteversion, retroversion, and lateral movement in the stand-up position.
Conventional group was treated with biofeedback for pelvic floor relaxation and manual therapy to release the tension in the suprapubic, pelvic, and intravaginal areas. The manual therapy consisted of a myofascial trigger point release maneuver using digital pressure and muscle fiber stretching in pain areas. Biofeedback consisted of pelvic floor muscle coordination and relaxation exercises using intravaginal probes. The training program was initiated with 10 fast contractions with 5 seconds of relaxation between them followed by 10 sustained contractions of 5 seconds with 10 seconds of relaxation between them. Finally, one minute of pelvic floor relaxation was performed.