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Prevention and Treatment of Alterations of the Pelvic Floor

Code: 102971
Credits: 6
2026/2027
Degree programme Type Course
Physiotherapy OP 3

Contact lecturer

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

Teaching staff (external to UAB)

Yolanda Castellano Madrid
Elena Montiel Morillo

Group languages

You can consult this information at the end of the document.

Prerequisites

It is advisable to have knowledge of anatomy and physiology of the uroglycological device and the muscles of the abdominal wall. As well as knowledge of critical reading of scientific articles. 

"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

The subject is an elective course in the third year of the Bachelor’s Degree in Physiotherapy and is part of the specific urogynaecological training. It constitutes part of the foundation of training in physiotherapeutic methods and procedures.

The general objectives of the subject are:

  • To define the general and specific objectives for the application of physiotherapeutic treatment in alterations of the urogynaecological system.
  • To know physiotherapeutic assessment and to know the methods, procedures, and physiotherapeutic actions aimed at clinical therapeutics.
  • To define the general and specific objectives for the application of physiotherapeutic treatment in alterations of the urogynaecological system.
  • To Integrate the ethical and professional values, knowledge, skills, and attitudes specific to physiotherapy.
  • To solve concrete clinical cases, such as in the hospital setting, primary and community care, or private practice.

 

Learning outcomes

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

Contents


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)

- Theoretical-practical class simulating the first visit and physiotherapy diagnostic with real clinical cases (role-playing) (Elena Montiel)

- Journal Club, group discussion of relevant foundational papers as well as new ones from the scientific evidence of the physical therapy pelvic floor discipline. (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 on hypopressive abdominal gymnastics and pressure management (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)

 


 

Learning activities and methodology

Title Hours ECTS Learning outcomes
PRESENTATION / ORAL DEFENSE OF WRITTEN WORKS 3 0.12
LABORATORY PRACTICES (PLAB) 16 0.64
KNOWLEDGE DISSEMINATION ACTIVITY 14 0.56
WORK PREPARATION 38 1.52
SELF-STUDY 44 1.76
THEORY (TE) 29 1.16 
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.

Assessment

Continuous assessment activities

Title Weight Hours ECTS Learning outcomes
Written-objective test with multiple-choice items 50% 2 0.08 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14
Oral defense of works 45% 2 0.08 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25
KNOWLEDGE DISSEMINATION ACTIVITY 5% 2 0.08 1, 2, 4, 9, 10, 11, 12, 13, 14, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25

CONTINOUS ASSESSMENT


Continuous assessment exercises associated with the seminars with group activities in theoretical class under the supervision of the professors will be carried out.


WRITTEN TEST Objective Test with multiple-choice items with a global weight of 50% (in-person)

  • 4 options per question, of which 1 is correct.
  • Each correctly answered question will be valued at 1 point.
  • Incorrectly answered questions will deduct -0.33 points.
  • Unanswered questions will not deduct points.
  • The questions cover both the theoretical and practical syllabus.
  • A score of 5 is required to pass.

ORAL PRESENTATION associated with the presentation of a Group Oral project with a total weight of 45% (in-person, the pptx is sent in advance).


It is passed with a score of 5; if not surpassed, it leads to taking the recovery exam directly in the form of 20 questions.


The work will be evaluated based on:


1. Coherence in resolving clinical cases.



2. Appropriateness of the content to the work topics.


3. Critical thinking.



4. Synthesis capability.


5. Follows ethical code standards and uses respectful, non-sexist, and professional language.



6. The use of bibliographic sources:



- There is an appropriateness of the sources used to the topic discussed.



- Uses updated bibliographic sources.



- The bibliographic references are described completely (Vancouver standards or others)


7. Adjustment to the Exposure Time.


8. Oratory (clarity, fluency...)


9. Present it in advance, exclusively the pptx.


KNOWLEDGE DISSEMINATION ACTIVITY

A video will be published on social media, preferably on Instagram, presenting a topic of community interest based on the findings of a research article related to pelvic floor health provided by the course tutor. The video must have a maximum duration of 1 minute and should acknowledge the UAB and the course tutors.

The maximum score for this activity is 0.5 points. Participation in this activity is optional.


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.


20 question test. Wrong answers deduct 0.25. Unanswered questions do not deduct.



SINGLE ASSESSMENT

To pass the course under the single assessment system, students must:

  • Pass the written examination with a minimum grade of 5.
  • Submit a written assignment on the techniques covered during the seminars and obtain a minimum grade of 7.
  • Submit an individually written clinical case report and obtain a minimum grade of 7. If this requirement is not met, students may choose to present the clinical case as part of a group presentation on the scheduled presentation day, in which case a minimum grade of 7 must also be obtained.


KNOWLEDGE DISSEMINATION ACTIVITY

A video will be published on social media, preferably on Instagram, presenting a topic of community interest based on the findings of a research article related to pelvic floor health provided by the course tutor. The video must have a maximum duration of 1 minute and should acknowledge the UAB and the course tutors.


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.




ACADEMIC MISCONDUCT AND OTHER CONSIDERATIONS


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. Seminar attendance is mandatory. If a student has not attended at least 6 out of the 8 classes, the course will be considered non-assessable (not eligible for evaluation). An absence will be considered justified if it is due to medical reasons and the corresponding medical certificate has been submitted to the tutor. A maximum of 2 justified absences will be accepted.



Bibliography

MAIN BIBLIOGRAPHY


  1. Bø K, Berghmans B, Mørkved S, Van Kampen M. Evidence-Based Physical Therapy for the Pelvic Floor: Bridging Science and Clinical Practice. 3rd ed. London: Elsevier; 2023.
  2. Cardozo L, Rovner E, Wagg A, Abrams P, editors. Incontinence. 7th ed. Bristol (UK): International Continence Society; 2023.
  3. Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10:CD005654.
  4. Kegel AH. Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gynecol. 1948;56:238-49.
  5. Laycock J, Jerwood D. Pelvic floor muscle assessment: the PERFECT scheme. Physiotherapy. 2001;87(12):631-42.
  6. DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol. 1994;170(6):1713-23.
  7. Hodges PW, Sapsford R, Pengel LH. Postural and respiratory functions of the pelvic floor muscles. Neurourol Urodyn. 2007;26(3):362-71.
  8. Bø K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(2):76-84.
  9. Herderschee R, Hay-Smith EJC, Herbison GP, Roovers JPWR, Heineman MJ. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2011;(7):CD009252.
  10. National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management (NG123). London: NICE; 2019.


SUPPLEMENTARY BIBLIOGRAPHY

  1. Avery K, Donovan J, Peters TJ, Shaw C, Gotoh M, Abrams P. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn. 2004;23(4):322-30.
  2. Bø K, Finckenhagen HB. Is there any difference in measurement of pelvic floor muscle strength in supine and standing position? Acta Obstet Gynecol Scand. 2003;82(12):1120-4.
  3. Junginger B, Baessler K, Sapsford R, Hodges PW. Effect of abdominal and pelvic floor tasks on muscle activity, abdominal pressure and bladder neck. Int Urogynecol J. 2010;21(1):69-77.
  4. Sapsford RR, Hodges PW. Contraction of the pelvic floor muscles during abdominal manoeuvres. Arch Phys Med Rehabil. 2001;82(8):1081-8.
  5. Dumoulin C, Adewuyi T, Booth J. Adult conservative management. In: Abrams P, Cardozo L, Wagg A, Wein A, editors. Incontinence. 6th ed. Bristol (UK): ICUD-ICS; 2017.
  6. Braekken IH, Majida M, Engh ME, Bø K. Morphological changes after pelvic floor muscle training measured by 3D ultrasound. Obstet Gynecol. 2010;115(2 Pt 1):317-24.
  7. Pelaez M, Gonzalez-Cerron S, Montejo R, Barakat R. Pelvic floor muscle training included in a pregnancy exercise program is effective in primary prevention of urinary incontinence: a randomized controlled trial. Neurourol Urodyn. 2014;33(1):67-71.
  8. Paiva LL, Ferla L, Darski C, Catarino BM, Ramos JGL. Pelvic floor muscle training in groups versus individual or home treatment of women with urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2017;28(3):351-9.
  9. de Jong J, Burkhard F, Zwahlen M, Junginger B, Dumoulin C. Assessment of involuntary pelvic floor muscle contractions in comparison with existing literature and IUGA/ICS terminology reports. Int Urogynecol J. 2024;35(4):823-30.
  10. Bump RC, Hurt WG, Fantl JA, Wyman JF. Assessment of Kegel exercise performance after brief verbal instruction. Am J Obstet Gynecol. 1991;165(2):322-9.


Software

No need for any additional program or device

Course groups and languages

The information provided is provisional until November 30. After this date, you will be able to consult the language of each group through this link. To access the information, you will need to enter the course CODE

Type of teaching Group Language Semester Shift
(TE) Theory 201 Catalan second semester afternoon
(PLAB) Practical laboratories 201 Catalan second semester afternoon
(PLAB) Practical laboratories 202 Catalan second semester afternoon