Instructional Level: Intermediate to Advanced.

Prerequisites: Licensed health care provider with prior training and experience with internal pelvic floor examinations. Completion of a prerequisite reading available to registered participants.

Target Audience: Physical Therapists (PT) and PT Assistants, Occupational Therapists. Content is not intended for use outside the scope of the learner's state license or regulation.

Description:

This continuing education course is also called a Boost Camp- it is designed to elevate a pelvic health therapists’ skill in evaluation and treatment of pelvic floor dysfunction (PFD). It includes a special emphasis on symptoms that can occur in the postpartum population. Kathe presents evidenced-based examination and treatment updates and clinical treatment pearls curated from over 30 years of teaching and treating PFD. The topics are delivered with recorded lectures/videos and supported by downloadable handouts and references. The learning is self-paced. Your questions will be answered online by using the comment /question section after each lecture topic. Quizzes will monitor your learning throughout the course.

The curriculum includes advanced fascial anatomy of the pelvic floor support system, internal vaginal and rectal evaluation techniques for anterior, posterior and apical support changes, including assessment for perineocele, enterocele, levator ani (LA) avulsion. Evaluation of external perineal landmarks (gh, pb) used for pelvic organ prolapse quantification (POP-Q) and postpartum rehab treatment planning is reviewed.

You will develop a clearer understanding of endopelvic fascia, improve your knowledge of how to palpate the myofascia of the vaginal canal. Exam guides are provided to use in your clinic. This will help you to perform more concise examinations and design appropriate treatment strategies.

Standing, breathing, abdominal wall and posture evaluations are presented to help assess an individual’s ability to manage intraabdominal pressure (IAP). A variety of breathing strategies including hypopressive technique is introduced, and evidence-based information on how to select pessary candidates is reviewed. Patient education and individualized functional treatment progressions will be emphasized.

Objectives

Upon completion of the web-based learning curriculum the participant will be able to:

1.   Name three vaginal pelvic fascia and/or levator hiatus support structures which could contribute to symptoms of pelvic pain.

2.   Name two fascial structures in each of the three levels of Delancey’s fascial support

3.   List three modifiable conditions that could affect results of vaginal fascial examination.

4.   Name the internal vaginal locations and depth of palpation for examination for common levator ani injury/avulsion sites, the ATLA, ATFP, ATRV pelvic fascia, uterosacral ligament, cervix and its posterior fornix

5.   Describe four steps of a digital levator ani injury/avulsion examination.

6.   Name and describe the seven vaginal and two external points of the POP-Q examination.

7.   Describe prolapse exam with a ½ speculum and external POP-Q measurements (gh, pb) including the appropriate instructions and supplies.

8.   Describe two principles of the Hypopressive technique.

9.   Describe three abdominal wall evaluations for patients with PFD.

10. List four breathing techniques for patients with PFD.

11. Describe postural and IAP management strategies for functional activities with PFD.