{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:42:46Z","timestamp":1792424566746,"version":"4.5.0"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background and Purpose. Women with postpartum pelvic organ prolapse (POP) and urinary incontinence are often treated by physical therapists specializing in women's health. Movement system impairments often coexist in this patient population. The purpose of this case report is to describe the physical therapist treatment of a woman with postpartum POP complicated by additional pelvic symptoms.<\/jats:p>\n               <jats:p>Case Description. A 31-year-old woman presented with postpartum POP, diastasis recti, urinary incontinence, and constipation. Movement system impairments were consistent with a physical therapist diagnosis of femoral adduction-medial rotation syndrome exacerbated by levator ani muscle weakness and incoordination and impaired intra-abdominal pressure regulation. Interventions, based on a movement system guided approach, included postural correction; pelvic-floor, abdominal, and hip muscle strengthening; functional training to correct identified movement faults; and patient education.<\/jats:p>\n               <jats:p>Outcomes. Movement system impairment outcomes included: correction of femoral adduction-medial rotation and knee hyperextension during standing at rest, ambulation, and exercise; increased hip muscle strength; and effective regulation of intra-abdominal pressure (resolution of breath holding with the Valsalva maneuver) during all transitional movements and therapeutic exercise. The patient also demonstrated reductions in POP, urinary, and colorectal symptom severity that exceeded the minimal clinically important difference. Additionally, she demonstrated a reduction in diastasis rectus distance.<\/jats:p>\n               <jats:p>Discussion. A movement system impairment-guided approach led the physical therapist to consider impairments outside the pelvic floor that could have contributed to the patient's pelvic symptoms. Using this approach, the patient achieved resolution of musculoskeletal and movement impairments and reductions in POP, urinary and colorectal symptoms, and symptom-related distress.<\/jats:p>","DOI":"10.2522\/ptj.20160035","type":"journal-article","created":{"date-parts":[[2016,9,2]],"date-time":"2016-09-02T02:45:50Z","timestamp":1472784350000},"page":"464-477","source":"Crossref","is-referenced-by-count":14,"title":["Movement System Impairment-Guided Approach to the Physical Therapist Treatment of a Patient With Postpartum Pelvic Organ Prolapse and Mixed Urinary Incontinence: Case Report"],"prefix":"10.1093","volume":"97","author":[{"given":"Jenny","family":"Kurz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Borello-France","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,9,1]]},"reference":[{"key":"2023011706414261900_B1","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.ogrm.2012.02.003","article-title":"Conservative management of pelvic organ prolapse","volume":"22","author":"Hagen","year":"2012","journal-title":"Obstet Gynaecol Reprod Med"},{"key":"2023011706414261900_B2","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1007\/s00192-013-2301-x","article-title":"Pelvic floor muscle training as an adjunct to prolapse surgery: a randomised feasibility study","volume":"25","author":"McClurg","year":"2014","journal-title":"Int Urogynecol J"},{"key":"2023011706414261900_B3","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/S0140-6736(13)61977-7","article-title":"Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicenter randomized controlled trial","volume":"383","author":"Hagen","year":"2014","journal-title":"Lancet"},{"key":"2023011706414261900_B4","first-page":"1","article-title":"Approaches to management of vaginal vault prolapse","volume":"33;20","author":"Ward","year":"2013","journal-title":"Obstet Gynecol"},{"key":"2023011706414261900_B5","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ijgo.2012.11.012","article-title":"Comparative effect of 2 packages of pelvic floor muscle training on the clinical course of stage I\u2013III pelvic organ prolapse","volume":"121","author":"Kashyap","year":"2013","journal-title":"Int J Gynecol Obstet"},{"key":"2023011706414261900_B6","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/SPV.0b013e31829c64ea","article-title":"Impact of physical therapy on quality of life and function after vaginal reconstructive surgery","volume":"19","author":"Pauls","year":"2013","journal-title":"Female Pelvic Med Reconstr Surg"},{"key":"2023011706414261900_B7","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/j.1479-828X.2005.00415.x","article-title":"Peri-operative physiotherapy improves outcomes for women undergoing incontinence and or prolapse surgery: results of a randomized controlled trial","volume":"45","author":"Jarvis","year":"2005","journal-title":"Aust NZ J Obstet Gynaecol"},{"key":"2023011706414261900_B8","first-page":"133","article-title":"Pelvic floor muscle training for stress urinary incontinence: a randomized, controlled trial comparing different conservative therapies","volume":"16","author":"Huebner","year":"2011","journal-title":"Physio Res Int"},{"key":"2023011706414261900_B9","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/SPV.0b013e31829cbb9b","article-title":"Outcomes of a comprehensive nonsurgical approach to pelvic floor rehabilitation for urinary symptoms, defecatory dysfunction, and pelvic pain","volume":"19","author":"Starr","year":"2013","journal-title":"Female Pelvic Med Reconstr Surg"},{"key":"2023011706414261900_B10","doi-asserted-by":"crossref","first-page":"170.e1","DOI":"10.1016\/j.ajog.2010.02.037","article-title":"Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? 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