Physiotherapy Management of Obstetric and Pelvic Floor Disorders Flashcards
what happens to collagen in pregnancy?
is loosened by hormones which in turn loosens joints
what physiological muscle problem is common in pregnant women and is a source of pain?
diastasis of rectus abdominus muscle (stretch out and fascial tissue pops through)
what nerve problem in the arm is common in pregnant women? why is this?
carpal tunnel
more fluid from pregnancy increases fluid in the wrist
when is the carpal tunnel worse?
on flexion of the wrist
Tx carpal tunnel
splint to hold wrist in extension
what aspects of the muscles are assessed in a physio exam?
strength
weakness
wasting
overactivity
what bony landmarks are palpated in a physio exam of the pelvis?
ASIS
PSIS
iliac crest
symphysis pubis
how may pelvic floor dysfunction present?
fecal/urine incontinence
defecation issues
pain - vulval/pelvic
prolapse
what features of the PMH are relevant for pelvic floor dysfunction?
lung disease surgery diabetes neurological obstetric history
what should be explored in the history of someone with PFD?
bladder symptoms
bowel symptoms
pain issues- what where when
feeling something coming down?
Ix PFD?
urinalysis
post void residual volume
vaginal +/- rectal examination
real time ultrasound biofeedback (checks if pelvic floor is contracting)
how is real time USS biofeedback taken?
abdominally or translabially
Tx bladder symptoms conservatively?
caffeine reduction bladder training/drill voiding techniques PF exercises 6x pd addressing constipation diet - eat pears!!
stool should be what type on the BSC?
type 3/4
1st, 2nd and 3rd line Tx for pelvic floor exercises?
- natural pelvic floor exercises
- OTC biofeedback equipment eg slendertone
- core stability exercises eg lumbopelvic cylinder, pilates
