Randomized Multicenter Feasibility Trial of Myofascial Physical Therapy for the Treatment of Urological Chronic Pelvic Pain Syndromes

Purpose

We determined the feasibility of conducting a randomized clinical trial designed to compare 2 methods of manual therapy (myofascial physical therapy and global therapeutic massage) in patients with urological chronic pelvic pain syndromes.

Materials and Methods

We recruited 48 subjects with chronic prostatitis/chronic pelvic pain syndrome or interstitial cystitis/painful bladder syndrome at 6 clinical centers. Eligible patients were randomized to myofascial physical therapy or global therapeutic massage and were scheduled to receive up to 10 weekly treatments of 1 hour each. Criteria to assess feasibility included adherence of therapists to prescribed therapeutic protocol as determined by records of treatment, adverse events during study treatment and rate of response to therapy as assessed by the patient global response assessment. Primary outcome analysis compared response rates between treatment arms using Mantel-Haenszel methods.

Results

There were 23 (49%) men and 24 (51%) women randomized during a 6-month period. Of the patients 24 (51%) were randomized to global therapeutic massage, 23 (49%) to myofascial physical therapy and 44 (94%) completed the study. Therapist adherence to the treatment protocols was excellent. The global response assessment response rate of 57% in the myofascial physical therapy group was significantly higher than the rate of 21% in the global therapeutic massage treatment group (p = 0.03).

Conclusions

We judged the feasibility of conducting a full-scale trial of physical therapy methods and the preliminary findings of a beneficial effect of myofascial physical therapy warrants further study.

Key Words: prostatitis, cystitis, interstitial, physical therapy modalities

Abbreviations and Acronyms: AE, adverse event, CP, chronic prostatitis, CPPS, chronic pelvic pain syndrome, CPSI, Chronic Prostatitis Symptom Index, CTM, connective tissue manipulation, FSFI, Female Sexual Function Index, GRA, global response assessment, GTM, global therapeutic massage, IC, interstitial cystitis, ICPI, O'Leary-Sant IC Problem Index, ICSI, O'Leary-Sant IC Symptom Index, MPT, myofascial physical therapy, NIH, National Institutes of Health, PBS, painful bladder syndrome, QOL, quality of life, SF-12, 12-Item Short-Form Health Survey, UCPPS, urological chronic pelvic pain syndromes, UPPCRN, Urological Pelvic Pain Collaborative Research Network