Pelvic Floor Lecture
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1
what are the three things a healthy pelvic floor is important for
bladder, bowel
sexual activity
health management
sexual activity
health management
2
in terms of voiding / urinating what is considered normal
5-8 in 24 hours
0-1 overnight
every 2-4 hours when awake
urine stream lasts 8 seconds
0-1 overnight
every 2-4 hours when awake
urine stream lasts 8 seconds
3
in terms of bowel movements what is considered normal
1-3x per day to 3x per week
complete emptying
type 3-4 on the bristol stool scale
complete emptying
type 3-4 on the bristol stool scale
4
in terms of sexual activity what is considered normal
no pain or discomfort
5
rehab of dysfunctions in the pelvis that contribute to bowel, bladder, sexual health, and pain complaints
pelvic rehab
6
what are some different approaches to pelvic rehab
behavioral strategies
manual therapies
modalities: biofeedback and electrical stimulation
therapeutic exercises
education: nutrition (diet and fluid intake), medication management
functional re-training: toileting habits
manual therapies
modalities: biofeedback and electrical stimulation
therapeutic exercises
education: nutrition (diet and fluid intake), medication management
functional re-training: toileting habits
7
what are the pelvic rehab settings
- across the lifespan
womens health
cancer rehab
neurorehab
pediatrics: school based, outpatient pediatric clinic
skilled nursing facility
hospital
- imperative to receive written and oral consent
womens health
cancer rehab
neurorehab
pediatrics: school based, outpatient pediatric clinic
skilled nursing facility
hospital
- imperative to receive written and oral consent
8
what are the functions of the pelvic floor
support
sphincteric
sexual function
stability
sump-pump: pelvic floor and diaphragm work together
sphincteric
sexual function
stability
sump-pump: pelvic floor and diaphragm work together
9
what are the key muscles of the female pelvis
levator ani
coccygeus
coccygeus
10
what are the key muscles of the male pelvis
superficial transverse perineal
bulbospongiosus
ischiocavernosus
bulbospongiosus
ischiocavernosus
11
what happens on the inhale during diaphragmatic breathing
diaphragm moves down
belly out
pelvic floor relaxes
belly out
pelvic floor relaxes
12
what happens on the exhale during diaphragmatic breathing
diaphragm moves up
belly in
pelvic floor contracts
belly in
pelvic floor contracts
13
what is the extended PLISSIT model
permission
limited info
specific suggestions
intensive therapy
review and reflection
limited info
specific suggestions
intensive therapy
review and reflection
14
what are the goals of pelvic rehab
achieve urinary continence
achieve urinary completion
improve quality of life
reduce or prevent urinary tract infections
improve independence
promote sexual activity
achieve urinary completion
improve quality of life
reduce or prevent urinary tract infections
improve independence
promote sexual activity
15
what are the types of incontinence
stress incontinence
urge incontinence
mixed incontinence
muscle weakness, tightness, coordination
noctura
fecal incontinence
urge incontinence
mixed incontinence
muscle weakness, tightness, coordination
noctura
fecal incontinence
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