A wonderful article which clearly puts the finger on the sore spot. In many studies we don’t know the type of intervention due to terms like ‘pelvic floor training’ or a standard of 3 series of 12 seconds or any variation whatsoever. Experience tells us that an individual programme should be custom made based on the function at the start of the therapy. ‘Tailor made’ so to say. Nevertheless, this can be found in only few studies. The ‘why’ is often missing and the motivation or substantiation of the choice for 10, 20 or 30 seconds is often unclear.
But there are more comments for future researchers. A lot of studies, actually do state who conducted the therapy: “an experienced pelvic floor physiotherapist”, “an experienced nurse”, “an experienced physiotherapist” or “an adequately trained doctor.” The definition of “experienced” or “adequately trained”, however, remains unclear. The International Continence Society has already tried to classify the level of education, by specifying the level of pelvic floor education that must be met. This turns out to be extremely complicated, and can be poorly checked or aligned per country. Yet, the need is huge to indicate as detailed as possible who performs the treatment, what the level of knowledge is, what is done exactly and what the exercise physiological rationale is.
Are pelvic floor therapists the only ones in this? No, for example, there were studies published years ago in Great-Britain and The Netherlands investigating gynaecological surgical interventions. These showed that it depends on the doctor and the hospital which techniques were used. The techniques were mentioned most of the time, but upon inquiry the gynaecologist says: it is tailor made and that must stay that way. But this results in a difficult comparison of interventions. Perhaps, we as pelvic floor physiotherapists should give more attention to what we do exactly, so descriptions should state clearly what is actually done in a tailor made programme. In the end, that is what we do, and it gives the reader more insight. And above all: it gives us better options for scientific research.