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PFD-SENTINEL: Development of a screening tool for pelvic floor dysfunction in female athletes through an international Delphi consensus
  1. Silvia Giagio1,2,
  2. Stefano Salvioli3,4,
  3. Tiziano Innocenti4,5,
  4. Giulia Gava1,6,
  5. Marco Vecchiato7,
  6. Paolo Pillastrini1,2,
  7. Andrea Turolla1,2
  1. 1Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
  2. 2Division of Occupational Medicine, IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic, Bologna, Italy
  3. 3Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
  4. 4GIMBE Foundation, Bologna, Italy
  5. 5Department of Health Science, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  6. 6Gynecology and Physiopathology of Human Reproduction, IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic, Bologna, Italy
  7. 7Sports and Exercise Medicine Division, Department of Medicine, Azienda Ospedale Università Padova, Padova, Italy
  1. Correspondence to Dr Silvia Giagio, Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, 40126, Italy; silvia.giagio2{at}unibo.it

Abstract

To develop a screening tool for pelvic floor dysfunction (PFD) in female athletes for use by sports medicine clinicians (eg, musculoskeletal/sports physiotherapists, sports and exercise medicine physicians), which guides referral to a PFD specialist (eg, pelvic floor/women’s health physiotherapist, gynaecologist, urogynaecologist, urologist).

Between February and April 2022, an international two-round modified Delphi study was conducted to assess expert opinion on which symptoms, risk factors and clinical and sports-related characteristics (items) should be included in a screening tool. We defined consensus a priori as >67% response agreement to pass each round.

41 and 34 experts participated in rounds 1 and 2, respectively. Overall, seven general statements were endorsed as relevant by most participants highlighting the importance of screening for PFD in female athletes. Through consensus, the panel developed the Pelvic Floor Dysfunction-ScrEeNing Tool IN fEmale athLetes (PFD-SENTINEL) and agreed to a cluster of PFD symptoms (n=5) and items (risk factors, clinical and sports-related characteristics; n=28) that should prompt specialist care. A clinical algorithm was also created: a direct referral is recommended when at least one symptom or 14 items are reported. If these thresholds are not reached, continuous monitoring of the athlete’s health is indicated.

Despite increasing awareness and clinical relevance, barriers to identify PFD in female athletes are still present. The PFD-SENTINEL is a new resource for sports medicine clinicians who regularly assess female athletes and represents the first step towards early PFD identification and management. Further studies to validate the tool are needed.

  • sports medicine
  • women
  • athletes
  • pelvic floor

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Footnotes

  • Twitter @silvia_gig, @Dr_Salvioli_Ste, @Innocenti_Tzn, @MVecchiato, @turolla_andrea

  • Contributors Conceptualisation: SG; methodology: SG, AT, SS and TI; formal analysis: SG and SS; investigation: SG, SS, TI; data curation: SG, SS, AT; writing—original draft preparation: SG; writing—review and editing: SG, TI, AT, MV, GG, PP, SS; supervision: AT, PP; project administration: SG. All authors have read and agreed to the submitted version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement statement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Preregistration Giagio S, Turolla A, Innocenti T. Development of a screening tool for pelvic floor dysfunction in female athletes: protocol of a Delphi consensus. medRxiv 2022.10.1101/2022.01.12.22269000

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.