Physiotherapy in Obstetrics Flashcards
what is involved in assessment for pelvic floor dysfunction
PMH SH DH Obs and gynae history Lifestyle Bladder symptoms Bowel symptoms quality of life measures patient set goals
urinalysis post void residual perineal,vaginal/rectal examination ultrasound pelvic organ prolapse pelvic floor assessment
what is used to asses bowel symptoms
the Bristol stool from scale
what is used to asses bladder function
bladder diary
recording time and volume of each urination
what scale is used to asses the strength of the pelvic floor
Modified Oxford Scale
ICS
what are the grades on the modified Oxford scale
Grade 0 - no contraction grate 1- flicker grade 2- weak contraction grade 3- moderate contraction grade 4 - good contraction grade 5 - strong contraction against maximal resistance
what lifestyle changes improve incontinence
healthy BMI avoid constipation smoking cessation avoid heavy lifting caffeine reduction
conservative treatment for urinary incontinence
caffeine reduction bladder training voiding/double voiding techniques pelvic floor exercises constipation management
conservative treatment for faecal incontinence
regulate stool ‘goldilocks poo’
pelvic floor exercises
difficulty wiping clean - give lepicol or similar
urge - holding on programme
frequency - holding on programme and caffeine reduction
what is pelvic floor training
structured pelvic floor exercise programme ensuring correct technique
performed until muscle fatigue several times a day
practised for 15-20 weeks
how do you investigate pelvic floor problems
EMG
Transabdominal ultrasound
how can you asses pelvic floor problems (OTC)
pelvic educator vaginal cones Kegel exercises pelvic floor trainers muscle stimulators
