Saturday, December 22, 2012

Pelvic Physiotherapy Distance Journal Club 2013

Purpose - To provide a forum for discussion of current research and new ideas in the field of pelvic physiotherapy.  Research in this area is occurring at a fast pace.  It is nearly impossible to stay up to date alone.  This format allows structured discussion of research and its application to practice.  This forum is not structured to allow for discussion of individual patient questions unless they relate to the articles discussed.  Discussions include clinical application.

 Timing of meeting
Wednesday of the first full week of each month 8:30 PM EST for one hour. In some cases the meeting is moved to the second Wednesday to avoid holidays. 
Schedule for 2013 is as follows:

January 9 – Cindy Neville
February 6 – Pam Downey
March 13 – Beth Shelly
April 3 – Ann Dunbar
May  8 - Jane O’Brien
June  5 – Beth Shelly
July 10 - Michelle Spicka
August 7  - Laura Scheufele
September 11- Ann Dunbar
October 9 - MJ Strahaul
November 6 - Trisha Jenkyns
December 4 – Michelle Spicka

Monday, December 17, 2012

Pelvic Physiotherapy Distance Journal Club 2012 Summary

Listen as experts in the field present and lead discussions of the latest research in the field of Pelvic Dysfunction.  Free to all PTs.  Outlines available on the blog

Recordings available Top right corner – “log in”, Access code – 436790, Dial-in number – (209) 647-1000, Subscriber PIN – 883352.

The entire year outlines and records will be available on CD for $10.00 – email Schedule for 2013 available soon. 

Saturday, December 15, 2012

International Continence Society Debate on the terms “OAB” and “urgency”

This debate occurred at the ICS Annual meeting in Beijing China October 2012. Seven YouTube videos - most 9 to 12 minutes each.  This is a fascinating discussion of some of the issues with the term “OAB”.  Firstly there is evidence that a drop in urethra pressure precedes urgency and detrusor contraction so is it really the bladder which is overactive or is it the urethra which is underactive.  I very strong case for why PFM exercises help OAB.  The role of the nervous system is also discussed as are the influence of the pharmaceutical industry and the needs of the patients.  As you can image, in the end, there is no final answer but the discussion really highlights what is being researched and discussed in the field of bladder dysfunction.  Check it out.

Wednesday, December 12, 2012

Overactive Bladder in Middle Age Women: The Frustration of Baby Boomers with OAB Symptoms

by Nancy Muller. Affiliation: National Association For Continence (NAFC), Charleston, South Carolina, USA. AoU 2010; 1:(1). September 2010

In 2009, NAFC sponsored a nationwide survey of women aged 40 to 65 with overactive bladder (OAB). The purpose was to learn more about what drives women to seek treatment for OAB symptoms and what factors might precipitate stopping or changing treatment.  Results show women are annoyed and frustrated about their symptoms of OAB rather than embarrassed or stigmatized.  The study sheds light on the need for better access to treatment. Read the full paper at


Saturday, December 8, 2012

Diaphragmatic breathing exercises and pelvic floor retraining in children with dysfunctional voiding.

Zivkovic, et al. Eur J Phys Rehabil Med. 2012 Sep;48(3):413-21.
Michelle Spicka, DPT Pelvic PY Distance Journal Club Dec 5, 2012
Primary Aim: To investigate the role of abdominal and pelvic floor muscle (PFM) retraining in children with dysfunctional voiding (DV).
Subjects: 43 patients (65% girls) aged 5-13.  All patients had a diagnosis of dysfunctional voiding and were treated by pediatricians in primary care with timed voiding, hydration and constipation management for 3 months with no significant success. 
Methods: The patients underwent the following treatment program (therapy sessions were monthly for up to 12 months):

Are Transversus Abdominus/Oblique Internal and Pelvic Floor Muscles Coactivated During Pregnancy and Postpartum?

Pereira L, et al.  Neurourol. Urodynam. 2012 Oct 15. Doi: 10.1002/nau.22315.
Michelle Spicka, DPT Pelvic PT Distance Journal Club Dec 5, 2012

Primary Aim: The aim of this study was to simultaneously evaluate both transversus abdominis/internal oblique (Tra/IO) and pelvic floor muscles (PFM) during isometric exercises in nulliparous, pregnant and postpartum women.

Subjects: 81 women divided into 4 groups:
1.       Nulliparous women without urinary symptoms
2.       Primigravid pregnant women at least 24 weeks gestational age
3.       Primiparous postpartum women after vaginal delivery with right mediolateral episiotomy
4.       Primiparous postpartum women after cesarean delivery with 40-60 days of postpartum

Study Design:  A clinical, controlled, prospective study was conducted.