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Integrating Electromyography and Sonographic Imaging for Evidence-Based Physical Therapy for Chronic Pelvic Pain

ReHaB Core ⟩ MSOP Lab ⟩

Our team used sonography to evaluate the physical mechanisms underlying Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). We developed and validated a scanning protocol to evaluate the muscles of the male pelvic floor using a transperineal approach. This protocol can be used to evaluate difference among individuals with and without CP/CPPS, as well as identify variations within patients with CP/CPPS. The approach may also be useful for targeting treatments to areas of hyper-contraction (e.g., trigger points) or as a biofeedback tool to train patients in both relaxation techniques and proper exercises for these muscles.

Abstract

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is present in 6-12% of men and is the most frequent urological diagnosis for men younger than 50 years old. CP/CPPS significantly reduces quality of life, even below that of other prevalent chronic conditions (e.g. congestive heart failure, diabetes). CP/CPPS patients are a highly heterogeneous group, with varied pathophysiology. One identified mechanism for CP/CPPS is involuntary localized neuromuscular activity. Physical therapy has emerged as one primary treatment modality for CP/CPPS, but up to 41% of patients report little to no improvement or a worsening of symptoms after a course of physical therapy treatment. There is currently no method for stratifying CP/CPPS patients to ensure that appropriate treatments are being provided. There is an urgent need to identify patients, before treatment begins, who are likely to respond positively to physical therapy. We aim to identify a set of neuromuscular biomarkers for CP/CPPS patients using sonographic imaging (i.e. 2D & 3D, spectral analysis, and elastography) and EMG recording, and to determine the ability of neuromusuclar biomarkers to enhance current clinical phenotyping.

Funding

Type	Source	Amount
Intramural	USC Keck School of Medicine / Southern California Clinical Translational Science Institute (SC CTSI)	$30,000

USC Chan Division of Occupational Science and Occupational Therapy
1540 Alcazar Street, CHP 133, Los Angeles, CA 90089-9003

ACOTE accreditation | NBCOT certification

The USC entry-level master’s degree program (cost of attendance) is fully accredited by the Accreditation Council for Occupational Therapy Education® (ACOTE). The USC entry-level OTD degree program (cost of attendance) has been granted Candidacy Status by ACOTE. View our program’s ACOTE standards public data. ACOTE c/o Accreditation Department, American Occupational Therapy Association, Inc.®, 6116 Executive Boulevard, Suite 200, North Bethesda, MD 20852-4929, (301) 652-6611 x2914, acoteonline.org

Professional program graduates are eligible to apply for certification by National Board for Certification in Occupational Therapy, Inc.® (NBCOT), nbcot.org. Program results from the NBCOT can be found online at www.nbcot.org/Educators-Folder/SchoolPerformance.