OPEN TO (NO EXCEPTIONS)

PT, PTA, 2nd Year SPT, 3rd Year SPT

DESCRIPTION

PH1 Lab (in-person) offers the physical therapy professional to apply knowledge obtained from PART I (Lecture) in a face-to-face lab course with hands-on activities, including external and internal vaginal examinations. Attendees will work in groups of 2-3 as clinicians and patients. Attendees must have completed PART I before registering and attending the PART II course. 

This lecture course is Part 2 of the Pelvic Health Physical Therapy Level 1 (PH1) course.

The focus of PART II will be on conducting external and internal vaginal examinations. You will be applying your knowledge learned in PART I (Lecture) from the following topics:

• Anatomy of the pelvic girdle
• Physiology of micturition
• Dysfunctions of the lower urinary tract
• Dysfunctions of the pelvic muscles
• Patient history examination
• Testing and treatment interventions for the patient with under active pelvic floor muscle conditions.
• Urogynecologic surgeries
• Medication
• Prevention of pelvic floor dysfunction

LEARNER OBJECTIVES

Examination / Evaluation

• Identify and examine the anatomy of the pelvic girdle
• Describe the function of the lower urinary tract and female pelvic organs.
• Demonstrate proper infection control techniques involved in pelvic floor muscle examination.
• Perform an external evaluation of the female genitalia, verbally identifying bones, ligaments, muscles, and other structures.
• Perform an internal pelvic examination identifying muscles, ligaments, and bony prominences with identification of pelvic floor muscle origins and insertions.
• Demonstrate proper technique in testing muscle strength of the levator ani muscles.
• Demonstrate proper technique in testing for pelvic organ prolapse.
• Demonstrate proper use of handheld EMG biofeedback to assess pelvic floor musculature.

Diagnosis / Prognosis

• Differentiate between under active pelvic floor muscles and overactive pelvic floor muscles.
• Demonstrate an understanding of bladder tests and measurements (bladder diary, urodynamic testing, pad testing, etc.) used in the process of differential diagnosis.
• Demonstrate the ability to compose a plan of care, including functional goals, prognosis, and length of care for the patient under active pelvic floor conditions.
• Explain red flags related to the treatment of the pelvic floor and understand when to refer to another healthcare provider.
• Understand urogynecologic surgeries and their effect on prognosis and pelvic floor muscle dysfunction.
• Demonstrate understanding of various medications and their effects on the bowel and bladder and identify how that may affect the prognosis for a patient with pelvic floor muscle dysfunction.

Intervention

• Explain the effects of the pelvic floor under activity and the proper technique of pelvic muscle exercises for rehabilitative purposes.
• Explain the relationship between the abdominal and pelvic floor muscles as they relate to activities of daily living.
• Describe the various interventions available to strengthen the muscles of the patient with an under active pelvic floor and clinically reason when and why the various interventions might be used.
• Demonstrate proper use of a handheld pelvic floor muscle electrical stimulation unit and explain its appropriate uses for a patient with pelvic floor muscle dysfunction.
• Describe techniques that can be used to train (retrain) the bladder and when each intervention might be used.

PRE-REQUISITES

Successful completion of the Pelvic Health Physical Therapy Level 1 webinar course.

REQUIREMENTS

Dress Code: Please wear comfortable clothes you can easily remove for lab activities, bring a pen/pencil for the on-site lab workbook (workbook will be printed and available onsite), and bring hair band(s) to keep hair away during lab exams (if you have long hair)

PC/Laptop/Printouts: You are not required to bring your laptop or printed course materials however many participants bring them for note-taking.

Lab Participation & Consent: Most of this course is lab-focused to provide more hands-on learning. Participants are expected to stay through the entire course; please make your travel plans accordingly. The Consent & Release Form must be filled out and turned in to the instructor on Day 1 of the course (this form is provided on-site). If the course participant does not turn in the completed form on Day 1, he/she will not be permitted to take the course. All participants must participate in labs as both “therapist” & “patient.” Participants who cannot participate as lab subjects are required to provide their lab partners. Failure to participate as a lab subject, or to provide the required lab partner if needed, will result in forfeiture of course completion and registration costs. If you are unsure whether you need a medical model or are unfamiliar with the process of obtaining a medical model, please read Medical Models for Internal Pelvic Assessment.pdf. Participants that MUST provide their lab partners include (but are not limited to):

• ALL Male participants
• Pregnant women (except with written physician permission for FULL participation)
• Active vaginal infections
• Active STD or herpes lesions
• Active bladder or rectal infections
• Severe pelvic/vaginal/rectal pain that inhibits examination
• Lack of prior vaginal exam by a physician
• Active OB/GYN cancer

ATTENDANCE REQUIREMENT

Attendees must be present throughout the course. Contact hours will be forfeited, and the attendee will be dismissed if the attendee:

• Misses two (2) or more lecture hours
• Misses any part of the Case Study Presentation and related group activities

To advance to the next course level, the attendee who missed the above will have to retake the course at her/his/their own expense. Should extenuating circumstances arise, it is the responsibility of the participant to notify a course faculty member of the need to leave. Consideration for course completion will be made on a case-by-case basis.