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2023/2024

Prevention and Treatment of Alterations of the Pelvic Floor

Code: 102971 ECTS Credits: 6
Degree Type Year Semester
2500892 Physiotherapy OT 3 2

Contact

Name:
Elena Montiel Morillo
Email:
elena.montiel@uab.cat

Teaching groups languages

You can check it through this link. To consult the language you will need to enter the CODE of the subject. Please note that this information is provisional until 30 November 2023.

External teachers

Elena Montiel Morillo
Yolanda Castellano Madrid

Prerequisites

It is advisable to have knowledge of anatomy and physiology of the uroglycological device and the muscles of the abdominal wall.

"The student will acquire the commitment to preserve the confidentiality and professional secrecy of the data that can be accessed due to the learning of healthcare services. Also in maintaining an attitude of professional ethics in all its actions."

 


Objectives and Contextualisation

The subject is an optional third year of the Physiotherapy degree and forms part of the specific urogynecological training. It is part of the basis of training in physiotherapeutic methods and procedures.

The general objectives of the subject are:

Define the general and specific objectives for the application of physiotherapeutic treatment in alterations of the urogynecological apparatus.

Know the physiotherapeutic evaluation and know the methods, procedures and physiotherapeutic actions, aimed at clinical therapeutics.

Define the general and specific objectives for the application of physiotherapeutic treatment in alterations of the urogynecological apparatus.

Integrate the ethical and professional values, knowledge, skills and attitudes of physiotherapy, to solve specific clinical cases, in the hospital, extrahospital, and primary and community care, and private.

 


Competences

  • Act with ethical responsibility and respect for fundamental rights and duties, diversity and democratic values.
  • Apply quality-assurance mechanisms in physiotherapy practice, in accordance with the recognised and validated criteria.
  • Design the physiotherapy intervention plan in accordance with the criteria of appropriateness, validity and efficiency.
  • Display knowledge of physiotherapy methods, procedures and interventions aimed at health promotion and maintenance.
  • Display knowledge of the morphology, physiology, pathology and conduct of both healthy and sick people, in the natural and social environment.
  • Display knowledge of the physiotherapy methods, procedures and interventions in clinical therapeutics.
  • Evaluate the functional state of the patient, considering the physical, psychological and social aspects.
  • Identify, analyse and solve ethical problems in complex situations
  • Integrate, through clinical experience, the ethical and professional values, knowledge, skills and attitudes of physiotherapy, in order to resolve specific clinical cases in the hospital and non-hospital environments, and primary and community care.
  • Make a physiotherapy diagnosis applying internationally recognised norms and validation instruments.
  • Make changes to methods and processes in the area of knowledge in order to provide innovative responses to society's needs and demands.
  • Participate in drawing up physiotherapy protocols on the basis of scientific evidence, and promote professional activities that facilitate physiotherapy research.
  • Take account of social, economic and environmental impacts when operating within one's own area of knowledge.
  • Take sex- or gender-based inequalities into consideration when operating within one's own area of knowledge.

Learning Outcomes

  1. Analyse a situation and identify its points for improvement.
  2. Analyse the indicators of sustainability of academic and professional activities in the areas of knowledge, integrating social, economic and environmental dimensions.
  3. Analyse the sex- or gender-based inequalities and the gender biases present in one's own area of knowledge.
  4. Apply the correct physiotherapy evaluation procedures to determine the degree of damage to the pelvic floor.
  5. Apply the methods, procedures and interventions of physiotherapy to pelvic floor therapies.
  6. Communicate using language that is not sexist.
  7. Consider how gender stereotypes and roles impinge on the exercise of the profession.
  8. Critically analyse the principles, values and procedures that govern the exercise of the profession.
  9. Define general and specific objectives when using physiotherapy treatment for pelvic floor disorders.
  10. Describe and analyse the evidence-based physiotherapy protocols for pelvic floor disorders.
  11. Describe the circumstances that can influence priorities
  12. Describe the good clinical practice guides for pelvic floor disorders.
  13. Describe the injuries and diseases in obstetrics and gynaecology, identifying the symptoms that appear during the process, their etiology and the associated medical, surgical and rehabilitation treatments.
  14. Design means for preventing pelvic floor disorders and teach about these.
  15. Enumerate the different types of of material and apparatus for using physiotherapy to treat pelvic floor disorders.
  16. Establish a diagnostic physiotherapy hypothesis based on clinical cases in pelvic floor conditions.
  17. Explain the explicit or implicit code of practice of one's own area of knowledge.
  18. Identify situations in which a change or improvement is needed.
  19. Identify the principal forms of sex- or gender-based inequality present in society.
  20. Identify the social, economic and environmental implications of academic and professional activities within one?s own area of knowledge.
  21. Identify, analyse and solve ethical problems in complex situations
  22. Propose new methods or well-founded alternative solutions.
  23. Propose projects and actions in accordance with the principles of ethical responsibility and respect for fundamental rights, diversity and democratic values.
  24. Use physiotherapy to treat clinical cases involving pelvic floor disorders.
  25. Weigh up the impact of any long- or short-term difficulty, harm or discrimination that could be caused to certain persons or groups by the actions or projects.

Content

Theory BLOCK 1

										
											- Anatomy and physiology of the abdominopelvic cavity (Elena Montiel)

- Biomechanics and physiology of the abdominopelvic cavity  (Elena Montiel)
- Introduction to abdominopelvic reeducation (Yolanda Castellano)

- Current evidence on the functioning of the abdominopelvic cavity (Elena Montiel)


  BLOCK 2

- Neurophysiology of urination (Yolanda Castellano)
- Neurophysiology of defecation (Yolanda Castellano)
- Dysfunctions of the pelvic floor (2 parts) (Yolanda Castellano)
- Definition, classification and type of voiding dysfunctions (Yolanda Castellano)
- Definition, classification and type of anorectal dysfunctions (Yolanda Castellano)
- Definition, classification and type of prolapses (Yolanda Castellano)
- Definition, classification and type of sexual dysfunctions (Yolanda Castellano)
- Definition, classification and type of pelvic pain (Yolanda Castellano)


  BLOCK 3

- Role of the physiotherapist (Elena Montiel)
- Methods of evaluation: anamnesis, physical examination, questionnaires, voiding schedules, pad test (test-pad), etc.(Elena Montiel)
- Description of the different techniques of physiotherapy treatment, sanitary education,  conductual changes-(Elena Montiel)
- Description of the different materials and instrumental techniques in the treatment of pelvic dysfunctions (Elena Montiel)

  BLOCK 4

- Obstetrics: role of the physiotherapist in labor and delivery (Yolanda Castellano)
- Postpartum: role of the physiotherapist in the postpartum (Yolanda Castellano)
- Diagnosis and treatment of the different dysfunctions of the pelvic floor (Yolanda Castellano)
- Etiological factors of perineal dysfunction (analysis and prevention) (Elena Montiel)


 SEMINARS

- Practical workshop of exploration and reeducation abdominopelvic (Yolanda Castellano)
- Practical HC design workshopwith simulated clinical cases (group role play)(Elena Montiel)
- Practical workshop of different pelvic floor treatment materials (Elena Montiel)
- Practical workshop of posterior tibial neuromodulation (Elena Montiel)
- Practical workshop of hypopressive abdominal gymnastics (Elena Montiel)
- Practical lumbo-pelvic stabilization workshop (Elena Montiel)
- Practical workshop of maternal preparation (Yolanda Castellano)
- Practical Workshop of External Manual Therapy Pelvic Floor (Yolanda Castellano)
- Workshop on Dismenorrhea, Premenstrual Syndrome and Specific Techniques (Yolanda Castellano)
 
 

Methodology

Teaching is based on theoretical lectures with the support of images,  classes following the methodology of group role plays and practical classes for the teaching of specific techniques.

If the situation requires it virtual classes and /or videos will be held to learn specific techniques.

Annotation: Within the schedule set by the centre or degree programme, 15 minutes of one class will be reserved for students to evaluate their lecturers and their courses or modules through questionnaires.


Activities

Title Hours ECTS Learning Outcomes
Type: Directed      
THEORY (TE) 29 1.16 24, 5, 9, 10, 4, 11, 12, 13, 14, 15, 16, 21
LABORATORY PRACTICES (PLAB) 16 0.64 5, 4, 11, 12, 13, 14, 15, 16
Type: Autonomous      
READING ARTICLES AND REPORTS OF INTEREST 14 0.56 24, 5, 9, 10, 4, 11, 12, 13, 14, 15, 16, 21
SELF-STUDY 44 1.76 24, 5, 9, 10, 4, 11, 12, 13, 14, 15, 16, 21
WORK PREPARATION 38 1.52 24, 5, 9, 10, 4, 11, 12, 13, 14, 15, 16, 21
PRESENTATION / ORAL DEFENSE OF WRITTEN WORKS 3 0.12 24, 5, 9, 10, 4, 11, 12, 13, 14, 15, 16, 21

Assessment

WRITTEN TEST  it is an objective test with multiple choice items with an overall weight of 50% ( classroom )
										
											
										
											4 options per question, of which 1 is correct.
										
											
										
											Each question answered correctly will be valued with 1 point.
										
											
										
											The questions answered wrongly subtract -0.33 points.
										
											
The questions are about theory and practice. 

										
											Unanswered questions will not subtract points.
										
											
										
											It is a PASS with a 5/10.
										
											
										
											Structured oral test associated with the presentation of an oral work, with a global weight of 50%. ( classroom, previously sent by mail in pptx)
										
											
										
											Continuous evaluation exercises associated with seminars with group activities in class under the supervision of the teacher.
										
											
										
											 
										
											
										
											ORAL PRESENTATION will evaluate:
										
											
										
											1. Consistency in the resolution of clinical cases
										
											
										
											2. The adequacy of the content to the work topics
										
											
										
											3. The critical capacity
										
											
										
											4. The ability to synthesize

5.  Uses ethic code rules, respectul, non sexist and professional language. 
										
											
										
											6. The use of bibliographic sources
										
											
										
											- The sources used are adequate for the subject matter
										
											
										
											- Use updated bibliographic sources
										
											
										
											- The bibliographical references are described in full (following the Vancouver Standards or others)

7. Pptx presentation send it previously to oral presentation.
										
											


										
											To pass the subject it will be necessary CONTINUOUS ASSESSEMENT:
										
											
										
											- Pass the oral test, written test with a minimum grade of 5.
										
											
										
											- Having attended 100% of the practical classes (in case of justified reason, 20% of the practical classes are allowed to be missed) (6 classes)
										
											- In case of not do past item, the pupil must to do a written task that will ask the teacher, without calification, before exam date. 
- Obtain a global grade ofthe subject equal to or greater than 5.
- Journal Club  of one article and to do an oral presentation.


CONTINOUS ASSESSMENT RE-TAKE SYSTEM
Students who have not passed the course may opt for a final test of recovery. The maximum grade to obtain is a 5. 


To pass the subject it will be necessary SINGLE ASSESSMENT:
- Pass the oral test, written test with a minimum grade of 5.
- To pass with 7 written Word work of physical therapy tecniques teached at seminaries
- To pass with 7 written Word work of clinic case.
- To send the work of 4 cientific articles in pelvic floor. 

SINGLE ASSESSMENT  RE-TAKE SYSTEM
Students who have not passed the course may opt for a final test of recovery. The maximum grade to obtain is a 5. 
They must to do a synthesis work about tecniques of physical therapy in pelvic floor about a clinic case to determine by the teacher. 


According to article 116.8, when it is considered that the student has not been able to provide sufficient evidence of evaluation in the record, this subject will be recorded as non-assessable. "Non-evaluable" student will be considered as one who has not been submitted to the program evaluation tests, nor to any of the training activities that are considered mandatory.
 
 

Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
Oral defense of works 40% 2 0.08 8, 2, 3, 1, 24, 5, 6, 9, 10, 4, 11, 12, 13, 14, 15, 16, 17, 20, 19, 18, 21, 22, 23, 7, 25
Written-objective test with multiple-choice items 50% 2 0.08 24, 5, 9, 10, 4, 11, 12, 13, 14, 15, 16
Journal Club 10% 2 0.08 10, 4, 12

Bibliography

Espuña Pons, M., Porta Roda, O. Manual of Functional and Surgical Anatomy of the Pelvic Floor Barcelona: Margen Books, 2010
 
Caufriez, M. Gimnasitque abdominal hiporesives. Brussels: MC Editions, 1997 Bourcier, A. Pelvic floor disorders. London: Elsevier, 2004
 
Espuña, M., Salinas, J. Treaty of urogynecology and urinary incontinence. Barcelona: Medicine STM Editoras, 2004
 
Calais-Germain Anatomy for movement. The March Hare, 2007
 
Thibodeau, G., Patton, K. Anatomy and physiology. Harcourt. 4th edition
 
Martínez Bustelo, S., Ferri Morales, A., Patiño Núñez, S., Viñas Diz S., Martínez Rodríguez A. Clinical interview and functional assessment of the pelvic floor. Physiotherapy 2204; 26 (5): 266-80
 
Ragué, J. M. Pelvic floor disorders. Cir Esp. 2005; 77 (5): 254-7
 
Vila Coll M. A., Gallardo Guerra, M. J. Urinary incontinence, a view from Primary Care. Semergen 2005; 31 (6): 270-83
 
Cervera Deval, J., Serralta Davia I., Macia Pareja, C., Moreno Alzuyet, J., Mayoral Azofra, E. Urinary incontinence: A hidden problem? Rehabilitation (Madr) 2004; 38 (1): 1-6
 
González Rebollo, A., Blázquez Sánchez, E., Romo Monje, M., Rioja Toro, J. Rehabilitation treatment of female urinary incontinence. Rehabilitation (Madr) 2003; 37 (2): 79-85
 
Bo, K., Berghams, B., Morkved, S. and Van Kampen, M. (2014) Evidence-Based Physical Therapy for the Pelvic Floor: Bridging Science and Clinical Practice. 2nd Edition, Elsevier, Amsterdam.

Software

No need for any additional program or device