Lecture 4

Question 1

T/F pelvic floor is part of the deep core

Answer 1

T (fundamenal 6 pack)

Question 2

T/F intercourse, bowel and bladder function are all ADLs

Answer 2

True

Question 3

Global Muscles

Answer 3

gludes
adductiors
abdominals
multifidi
paraspinals
deep hip rotators

Question 4

sympathetic vs parasympathetic

Answer 4

S- urine Storage
P - Peeing

Question 5

5 “S” Functions of the pelvic floor

Answer 5

sphincteric (allow continence)
sexual
stability
sump pump
support

Question 6

funcitons of pelvic ring/SIJ

Answer 6

• loads transfer from ground to trunk
• stability
• form and force closrue (jont and mm)
• insertion point of several mm
• protects organs

Question 7

stretching this group of mm in the legs promotes relaxation of PFM

Answer 7

ADDuctors

Question 8

how many daily voids are considered healthy

Answer 8

4-7 daily

Question 9

urinating every ____ hours is considered healthy

Answer 9

2-5 hours

Question 10

nocturia

Answer 10

0-1x/night is normal

anything more is not

Question 11

we want a ____ urine stream

Answer 11

steady
(avoid power peeing)

Question 12

bowl movements normal amount

Answer 12

3x/day - 3x/week

Question 13

avoid bladder irritatants like

Answer 13

caffeine, soda, sugar, alcohol

drink still water 1st thing in the AM

Question 14

interventions to resume healthy bladder

Answer 14

• urge distraction
• no “power peeing”
• avoid “just in case” peeing
• manage constipation
• fluid consumption
• avoid OR dilute the bladder irritants
• timed voids as needed

Question 15

urine leads when you exert pressure onyour bladder by cough, sneeze, laugh, exercise, lifting something heavy

Answer 15

stress incontinence

Question 16

a sudden, intense urge to urinate followed by involuntary loss of urine. may need to urinate often including throughout the night. may be caused by aminor condition like infection or more severe like neuro or diabetes

Answer 16

urge incontinence

Question 17

frequent/constant dribbling of urine d/t bladder that doesn’t empty completely

Answer 17

overflow incontinence

Question 18

physical/mental impairment keeps you from making it to the toilet in time.

i.e. severe arthritis can make you not be able to unbutton pants fast enough

Answer 18

funcitonal incontinence

Question 19

experiencing more than 1 type of incontinence

Answer 19

mixed

Question 20

feces or gas leaking unexpectedly from recutm

Answer 20

fecal/anal incontinence

Question 21

begin with gravity reduced positions for PFM exercises if pt is weak

Answer 21

supine
prone
QP

Question 22

The mobility, stability and global strength of this structure is important so pelvic floor mm can focus on their primary function

Answer 22

spine

Question 23

how to “overflow” a PFM contraction

Answer 23

adductor squeeze (involuntary contraction of PFM)

Question 24

PFM contraction goal

Answer 24

goal is to hold for 5-10 secons with rest as long or twice as long as hold

Question 25

contract-relax

Answer 25

hold 3-5 seconds repeating up to 10 times

Question 26

quick contractions

Answer 26

2 seconds on, 2 seconds off (quick)

Question 27

elevator

Answer 27

to increase concentric and eccentric

Question 28

physiological changes in pregnancy

Answer 28

▪ Inc. blood volume ▪ Inc. heart rate ▪ Inc. respiratory rate ▪ Hematocrit levels decrease (anemia) ▪ Inferior vena cava compression ▪ Difficulty with core temperature management ▪ Swelling ▪ General discomfort ▪ Evolving changing center of mass ▪ Hyperemesis ▪ Decreased bone density ▪ Ligament laxity

Question 29

recommended weight gain for pregnant women

Answer 29

15-35 Ibs 11-20 Ibs if obese

Question 30

blood volume increased ____ pounds during pregnancy fluid volume increased ____ pounds during pregnancy

Answer 30

blood: 3-4 pounds fluid: 2-4 pounds

Question 31

exercise percautions for pregnant women

Answer 31

avoid heat, prolonged supine exercise, contact sports, scuba diving, risk of fall activity (skiing, surfing, off-road cycling)

Question 32

ACOG recommends how many mins of moderate intensity aerobic exercise each week?

Answer 32

150 minutes GOAL: maintain or increase strength as body mass increases

Question 33

Exercise considerations in pregnancy

Answer 33

▪ Generally maintaining previous level of intensity is okay ▪ Avoid heat, prolonged supine exercise, contact sports, scuba diving, activities with risk of falling (skiing, surfing, off-road cycling) ▪ Perineal stretching, pelvic floor lengthening in **3rd trimester** ▪ Position modification- quadruped, L sidelying, supine no more than 5 minutes, next to wall for balance ▪ Functional training to prepare for new baby ▪ Activity modification ▪ Lifting mechanics with current children ▪ Thoracic mobility ▪ Posture and postural strength ▪ Use knowledge from previous weeks for exercise management

Question 34

benefits of exercise

Answer 34

may decrease risk of gestational diabetes, preeclampsia c-section

Question 35

warning signs to stop exercise

Answer 35

▪ **Bleeding** from the vagina ▪ Feeling **dizzy** or faint ▪ Shortness of breath **before starting exercise** ▪ Chest pain ▪ Headache ▪ Muscle weakness ▪ **Calf** pain or swelling ▪ Regular, painful contractions of the uterus ▪ Fluid gushing or leaking from the vagina

Question 36

**Absolute** contraindications to exercise in pregnancy

Answer 36

▪ Hemodynamically significant heart disease ▪ Restrictive lung disease ▪ Incompetent cervix/cerclage ▪ Multiple gestation at risk for premature labor ▪ Persistent 2nd or 3rd trimester bleeding ▪ Placenta previa after 26w ▪ Premature labor during current pregnancy ▪ Rupture of membranes ▪ Pregnancy induced hypertension

Question 37

Relative contraindicaitons to exericse in pregnancy

Answer 37

▪ Severe anemia ▪ Unevaluated maternal cardiac arrhythmia ▪ Chronic bronchitis ▪ Poorly controlled hypertension, pre-eclampsia, seizure, DM1, thyroid disease ▪ Extreme morbid obesity or BMI less than 12 ▪ Current IUGR (intrauterine growth restriction) ▪ Heavy smoker ▪ History of extreme sedentary lifestyle

Question 38

modified UE and LE strengthening

Answer 38

Wall or counter push up ▪ Quadruped leg raising or bird dog (opposite arm and leg) ▪ Modified squatting- depth or sit to stand ▪ Scapular retraction (standing, sitting, supine)

Question 39

modified funcitnoal movement for ease and pain mgmt

Answer 39

* Log rolling * Exhale on effort or blow as you go * Cross train functional movement with exercise

Question 40

distasis recti is normal occurenc with pregnany esp after ____ week of gestation

Answer 40

38

Question 41

DR may resolve around

Answer 41

6-8 week time frame

Question 42

normal width of DR

Answer 42

0-2 Fingerwidth

Question 43

return to run has special protocols for women post natal

Answer 43

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