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Pelvic Physical Therapy for Sexual Dysfunction in Gynecologic Oncology Survivors

Not Applicable
Completed
Conditions
Gynecologic Cancer
Sexual Dysfunction
Interventions
Other: Control Arm
Other: Physical Therapy Arm
Other: European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30)
Other: Female Sexual Function Index (FSFI)
Other: Exit Interview
Registration Number
NCT05242770
Lead Sponsor
Wake Forest University Health Sciences
Brief Summary

The purpose of this research study is to investigate the use of pelvic physical therapy for gynecologic cancer survivors who report sexual dysfunction. Physical therapy experts believe that a full 10-week regimen is necessary for true improvement of symptoms. Investigators aim to see if this tense regimen is feasible for survivors. Investigators also aim to see if patients have an improvement in their sexual function and quality of life.

Detailed Description

Primary Objective(s): To determine the feasibility of an intensive pelvic physical therapy intervention with gynecologic cancer survivors reporting sexual dysfunction. Feasibility will be determined by accrual, retention, and adherence.

Secondary Objective(s):

* To demonstrate preliminary efficacy of the pelvic physical therapy intervention on sexual function in gynecologic cancer survivors. Sexual function will be measured three times: at time of randomization (T0), after completion of the 10-week pelvic physical therapy regimen - 3 months after randomization (T1), and 3 months after T1 (T2).

* To demonstrate preliminary efficacy of the pelvic physical therapy intervention on health-related quality of life in gynecologic cancer survivors. Quality of life will be measured at three times (T0) at time of randomization, (T1) after completion of the 10-week pelvic physical therapy regimen - 3 months after randomization, and (T2) 3 months after T1

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
20
Inclusion Criteria
  • History of cervical, ovarian/fallopian tube/primary peritoneal, uterine, or vulvar/vaginal cancer, regardless of stage or amount of prior therapy. Patients must have completed radiation therapy 12 weeks prior enrollment. Patients must be at least 12 weeks remote from surgery. There is no minimum time after completion of chemotherapy for enrollment. There is no upper limit of time from treatment.
  • History of treatment for gynecological cancer - surgery, radiation, chemotherapy, or combination of therapies.
  • Screen positive for sexual dysfunction based on answers to the Brief Sexual Symptom Checklist for Women. A patient screens positive if they answer "no" to the first question (Are you satisfied with your sexual function?) and if they select any answer other than "a" in the third question (Mark which of the following problems you are having). The other questions do not impact whether a patient screens positive or negative. They do not have an impact on study eligibility.
  • English-speaking. Due to the developmental nature of this study, assessing feasibility with a small number of patients, we do not have all response tools and questionnaires translated into multiple languages. In a future larger study, it will be important to translate all documents into multiple languages in order to include non-English speakers.
  • Age ≥18 years.
Exclusion Criteria
  • Active pelvic infection.
  • Presence of vaginal fistula.
  • Deemed not suitable for pelvic physical therapy based on physician assessment. If there is suspicion for infection, disease recurrence, or other concerning medical findings that necessitate further evaluation and work up at that time.
  • Evidence of active cancer.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control ArmControl ArmEducational pamphlet with resources for sexual dysfunction
Physical Therapy ArmExit InterviewPhysical therapy for sexual dysfunction.
Physical Therapy ArmFemale Sexual Function Index (FSFI)Physical therapy for sexual dysfunction.
Physical Therapy ArmPhysical Therapy ArmPhysical therapy for sexual dysfunction.
Physical Therapy ArmEuropean Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30)Physical therapy for sexual dysfunction.
Primary Outcome Measures
NameTimeMethod
Number of Participants Retained to Study Intervention3 months after completion of physical therapy.

Retention is participants' attendance of pelvic physical therapy visits.

Adherence to Study Intervention3 months after completion of physical therapy.

Adherence is the number of enrolled participants completing the interevention.

Accrual to Study InterventionAt baseline

Accrual is the number of participants that screen positive for sexual dysfunction, are eligible for entry into the study and consent to participate in the study.

Secondary Outcome Measures
NameTimeMethod
Female Sexual Function Index (FSFI) QuestionnaireAt time of randomization, 3 months after randomization and 3 months after completion of physical therapy regimen

The questionnaire is comprised of six domains: desire \[two items\], arousal \[four items\], lubrication \[four items\], orgasm, satisfaction, pain \[three items each\]. Score range is 1 to 5. The FSFI total score is the sum of the 6 domain/subscale scores and has a maximum score of 36. Higher scores indicate better functioning. At each time point, 2-sample t-tests or Wilcoxon rank sum tests will be used to compare sexual function between groups. If feasible, mixed effects models with random intercept will be used to compare sexual function between groups over time. Intervention groups, visits, and intervention groups by visits will be included in the model. Contrasts will be used to compare sexual function between groups at each time point.

European Organization for Research and Treatment of Cancer Quality of Life QuestionnaireAt time of randomization, 3 months after randomization and 3 months after completion of physical therapy regimen

The EORTC QLQ-C30 questionnaire will be completed three times during study intervention and is patient reported to assess sexual function and health-related quality of life. Score range is 0 to 100. A high score for a functional scale represents a high/ healthy level of functioning; a high score for the global health status /quality of life represents a high quality of life; a high score for a symptom scale/item represents a high level of symptomatology / problems. At each time point, 2-sample t-tests or Wilcoxon rank sum tests will be used to compare sexual function between groups. If feasible, mixed effects models with random intercept will be used to compare sexual function between groups over time. Intervention groups, visits, and intervention groups by visits will be included in the model. Contrasts will be used to compare sexual function between groups at each time point.

Trial Locations

Locations (1)

Wake Forest Baptist Comprehensive Cancer Center

🇺🇸

Winston-Salem, North Carolina, United States

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