Physiotherapy and management of Pelvic Floor Disorders Flashcards
What are some examples of pelvic floor dysfxn?
- bladder and bowel dysfxn
- prolapse
- vulvodynia
- chronic pelvic pain
Why does pelvic floor dysfxn often occur with pregnancy?
- body changes
- biomechanics
- collagen (hormones)
- ADLs
What are the common pregnancy- related MSK problems?
- back pain
- pelvic GIRDLE pain
- diastasis of rectus abdominis muscle (DRAM) —gap >2.7cm btwn the 2 rectus abdominis m.
- carpal tunnel syndrome
Preg.-related MSK problems should be addressed …why?
- to manage day-today life
- prepare for LABOUR and delivery
- prevent long-term MSK issues
- cope with new bby, physical demands
How does pelvic floor dysfxn present as?
- fecal and urinary incontinence
- diff. defecating
- PAIN (vaginismus, vulvodynia/ pelvic pain)
- prolapse
What do you specifically ask for in PMH for pelvic dysfxn pt?
- Lung disease
- Surgery
- Diabetes
- Neurological
What is done for assessment of pelvic floor dysfxn?
- hx (obs and gynae/ pmh/social hx)
2. bladder and bowel symptoms/ pain issues/ SCD/ quality of life measures/ set goals
What investigations can be done for pelvic floor dysfxn?
- urinanalysis
- post-void RESIDUAL
- vaginal +/- rectal examination
- real time USG biofeedback (translabial/abdominal)
What is post-void residual
- the amount of urine retained in the bladder after a voluntary void
- done with bladder scan/ urinary catheter/ USG
What is stress incontinence?
complaint of any involuntary loss of urine on effort or physical exertion (e.g sporting activities) or on sneezing or coughing
What should be evaluated with lifestyle to manage pelvic floor dysfxn?
healthy BMI
smoking cessation
- ADLs (appropriate exercise)
How to manage bladder symtpoms?
- reduce Caffeine
- train bladder
- voiding/double voiding techniques
- pelvic floor exercises
- address constipation
How to manage bowel symptoms?
- regulate stool to BSC TYPE 3/4 (with food)
- pelvic floor exercises
Pelvic floor exercises should be performed _______
- several times/day
- Kegel exercises strengthens pelvic floor muscles
Name some forms of OTC biofeedback .
pelvic educator vaginal cones kegel exerciser pelvic floor trainers muscle stimulator
