ACCESS TO CERTIFIED PELVIC HEALTH PHYSICAL THERAPISTS ACROSS THE UNITED STATES

S. Cline¹, K. McLaughlin², M. Austin²

¹Johns Hopkins Medicine, Physical Medicine and Rehabilitation, Lutherville, United States, ²Johns Hopkins Medicine, Lutherville, United States

Background: Pelvic Floor Dysfunction (PFD) describes a range of common problems that affect people of all genders. Studies have estimated the lifetime prevalence of PFD among women to be approximately 25%. Pelvic Health Physical Therapy (PHPT) is an important first-line treatment option for patients with PFD and has been associated with improvements in chronic pelvic pain, pelvic organ prolapse, and urinary incontinence.The high prevalence of PFD has created a high demand for PHPT, especially among folks with more severe symptoms. However, it is unclear if there are sufficient providers in the United States (US) to meet this demand.

Purpose: The aim of this study was to examine the number of PHPT specialists in the US as a whole, and within each state.

Methods: This study sought to identify specialized PHPT providers including those with a Certificate of Achievement in Pelvic Health Physical Therapy (CAPP-Pelvic), a Women’s Health Clinical Specialist (WCS) Board Certification, or a Pelvic Rehabilitation Practitioner Certification (PRPC), as of May 31, 2022. Researchers utilized three online databases to identify PHPT providers, each specific to individuals with one of the included specialty certifications. The total number was calculated and any duplicates (i.e, those with multiple certifications) or other false entries were removed. The data was then analyzed by state and compared to current population information in each state, according to the US Census Bureau.

Results: We identified a total number of 1,135 specialized practitioners in the US. The number of PHPT providers ranged from 1 (Vermont) to 119 (California). When compared to the population in each state, the lowest number of PHPT providers was approximately 1 PHPT provider per million people (Alabama) and the highest was approximately 8 PHPT providers per million people (Oregon).

Conclusions: The data within this study indicates that the number of PHPT providers available varies by state and that the overall number of PHPT providers in the US is low. Given the prevalence of PFD in the US, it is unlikely that the total number of providers in most states is sufficient to meet clinical demands.

Implications: This study estimates there to be between one and nine specialized PHPT providers in each state. Given this data, there are likely not enough PHPT providers in the US to meet the clinical demand of patients with PFD. This study demonstrates the need for increasing the number of PHPT providers in order to meet the clinical demand. This may be accomplished by encouraging physical therapists currently practicing PHPT to complete continuing education courses and become certified practitioners of PHPT. Finally, this research supplies a foundation for further research into more specific disparities that may exist within access to specialized pelvic health physical therapy including, but not limited to, gender, religion, ethnicity, and socioeconomic status.

Funding acknowledgements: This was not a funded study.

Keywords:
Pelvic Health
Pelvic Floor
Women's Health

Topics:
Pelvic, sexual and reproductive health
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: Johns Hopkins University/Medicine

Committee: Johns Hopkins Medicine Institutional Review Board (JHM IRB)

Ethics number: IRB00317546