Pelvic floor muscle relaxation exercise audio files improve pain on pelvic floor muscle examination: a retrospective observational study

Background Little is known about the effect of including pelvic floor muscle relaxation exercises (PFMRE) in a physiotherapy management plan for pelvic pain. Aims This retrospective study evaluated the effect of PFMRE audio files on pelvic pain. It was hypothesised that audio files guiding PFMRE would result in less self-reported pain on digital examination of the pelvic floor muscles. Methods Patient files from a private pelvic health physiotherapy practice were assessed for reports of pain during pelvic floor muscle examination, pre- and post-PFMRE, between August 2020 and August 2022. All patients had chronic pelvic pain, were examined by the same practitioner, and used the same audio files (produced by the treating practitioner). A numerical rating scale (NRS) was used to rate pain. Examinations were conducted approximately 4 weeks apart. Results Fifty-eight patients were eligible to be part of this study. There was a significant decrease in self-reported pain post-PFMRE treatment in both the superficial (mean pain score 2.21 (s.d. 2.33), P < 0.001) and deep pelvic floor muscles (mean pain score 1.12 (s.d. 1.99), P < 0.001). Effect sizes of 2.15 and 2.46 were found for the superficial and deep pelvic floor muscle respectively. Conclusion Pelvic floor muscle relaxation exercise audio files appear to be a useful treatment adjunct to reduce self-reported pain during examination of the pelvic floor muscles. This provides initial insight into how relaxation strategies may fit into multi-modal physiotherapy management programs for chronic pelvic pain. Limitations include the fact that patients were adhering to other treatment advice from the treating practitioner and management advice from other health professionals in their team at the same time.