New National Academies Report Calls for Better Research on Women's Health Issues

According to a recent report from the National Academies of Sciences, Engineering, and Medicine, more research is needed to understand the biological, structural, and social factors that influence the trajectory of chronic conditions in women - including many of the conditions that physical therapists treat.

These knowledge gaps "hinder efforts to improve the health of women through diagnosis, treatment, prevention, and management of these chronic conditions and reduce disparities," the report says.

The report studied female-specific and gynecologic conditions that lead to significant morbidity; chronic conditions that predominantly impact women or affect women differently than men; and the accumulation of multiple chronic conditions.

These conditions included some that are frequently treated by physical therapists, such as pelvic floor disorders, chronic pain, cardiovascular disease, and stroke.

"As hands-on clinicians who treat women across the life span, PTs, along with physical therapy researchers, are well-positioned to lead efforts to better understand how to prevent, diagnose, and treat common chronic conditions in women," says Tara Jo Manal, PT, DPT, FAPTA, APTA's vice president of scientific affairs.

Carrie Pagliano, PT, DPT, a board-certified clinical specialist in orthopaedic physical therapy and women's health physical therapy and member of the APTA Media Corps, says pelvic floor physical therapists have been working in these areas of practice and research for more than 40 years.

"Pelvic floor PTs have been the providers that both physicians and patients have turned to when mainstream medicine dismissed women's pain, their search for answers, and when women were being told the problems were in their heads," Pagliano says. "We're one of the only professions that it is accepted that we have expertise across multiple boundaries in medicine. That makes us invaluable to continue to address and help solve these issues of quality of life for patients."

To close some of these gaps in knowledge, the report made several recommendations to the National Institutes of Health and other funders to support research that:

• Improves data collection on the impact of female-specific chronic conditions.

• Explores the pathophysiology and biologic mechanisms underlying chronic conditions in women.

• Determines how hormonal fluctuations play a role in the development of chronic conditions in women, as well as developing better approaches for addressing menopausal symptoms.

• Examines how social determinants of health affect women with various identities, such as identities relating to race and ethnicity, gender or sexual orientation, and cultural norms.

• Investigates the relationship between lifestyle behaviors and traumatic experiences in the development of chronic conditions in women.

• Develops sex- and gender-specific diagnostic tools, as well as tools that can more accurately distinguish between chronic conditions with similar symptoms, such as fibromyalgia and chronic pain.

• Improves the treatment and care of women with multiple chronic conditions, such as by validating diagnostic tools for multiple chronic conditions, ensuring this population is represented in studies, and developing evidence-based treatment and management guidelines.

The group's recommendations for future research overlap with some of the priorities in APTA's "Research Agenda for Physical Therapy From the American Physical Therapy Association."

APTA's agenda has six key areas of focus: population health research, mechanistic research, clinical research, health services research, workforce research, and education and professional development research.

"I hope this report from the National Academies shines a light on the need for more funding in these understudied areas of research and that funders recognize the value physical therapy researchers can bring to research projects to improve the health and well-being of women living with chronic conditions," Manal says.

Although this initiative may seem novel to some, it's a longtime coming for clinicians, researchers, and educators who have worked in this space for years, Pagliano says.

"Physical therapy should be at the forefront of these initiatives, not only to acknowledge the work that we've already done, but to recognize our readiness to continue to provide support and solutions for the future," she says.