Dedicated to the Improvement of Women's and Men's Health Globally

2018 CSM SoWH Educational Session Descriptions

THURSDAY

FEBRUARY 22, 2018

Pediatric Pelvic Floor Therapy: Treating Children With Fecal Incontinence

Presented by Caitlin Semmelrock, PT, DPT

8:00 AM – 10:00 AM

Fecal incontinence (FI) has a significant impact on quality of life, globally affecting up to 7.8% of children; functional constipation is the primary cause. Differential diagnoses include anatomical and neurological defects. Many families do not seek help; increased awareness of available resources could result in quicker referrals and prevention of lengthy impairment bouts, symptom severity, and decreased length of treatment time. Physical therapists specializing in treating pelvic floor muscles (PFM) address rectal dyssynergia, neuroplasticity of PFM motor plans, nutrition, visceral mobility, toileting habits, and breathing coordination. With treatment, patients often attain positive outcomes. The speaker will discuss the results of a study demonstrating PFM therapy’s effectiveness for treating frequency of FI and urinary leakage, abdominal pain, bowel movements, medication use, and PFM functioning. Positive outcomes were predicted with increased participation, attendance, and familial support. Attendees will learn about signs and symptoms of constipation, treatment, and review case studies. Clinicians will come away with increased awareness of PFM impairments, resources, appropriate referrals, and interventions for PFM physical therapy.

 

Urinary Incontinence: An Update on the Evidence

Presented by Kari Bø, PhD

8:00 AM – 10:00 AM

This session will give the participants an overview and the latest update on evidence for topics related to physical therapy for the pelvic floor. The lecture will cover the evidence from randomized controlled trials applying different methods such as breathing exercise, abdominal exercise and pilates on female urinary incontinence. In addition, there is increased focus on diastasis recti abdominis both as a specific diagnosis, but also the connection to the pelvic floor muscles. The lecture will cover the connection between the pelvic floor muscles and the inter-rectus distance, assessment methods, risk factors, the relationship between diastasis and low back and pelvic girdle pain, and the effect of different abdominal and pelvic floor muscle exercises on the condition. The theory on how and when new concepts in physical therapy should change clinical practice will be discussed.

 

Complex Cases in Women’s and Men’s Health

Presented by Valerie Bobb, PT, DPT, WCS, ATC,

Albina Heidebrect, PT, DPT, Ramona Horton, PT, MPT, Christin Peters, PT, DPT, OCS, CLT,

Barb Settles Huge, PT, Sagira Vora, PT

11:00 AM – 1:00 PM

Six cases will be presented based on on advanced topics in Women’s and Men’s Health by advanced practitioners in pelvic floor physical therapy. The topics for this year’s symposium include the following subjects:

  • An ultramarathon runner with vulvodynia
  • Chronic constipation with incontinence and dyspareunia
  • Male with testicular pain and pain with ejaculation
  • Traumatic birth with vaginal and pubic bone complaints
  • Osteitis pubis

 

The Art of Dissemination: Bridging the Knowledge Gap

Presented by Meryl Alappattu, DPT, PhD and

Mark Bishop, PT, PhD

11:00 AM – 1:00 PM

Do you have a great idea to get across but don’t know where to start? Maybe you have great clinical findings that you want to present and don’t know if you should do a poster or platform presentation. Are you tired of the same old in-service presentations, or are you nervous about your talk? The most important aspect of any professional interaction with patients, students, or colleagues is the ability to get your message across and effectively disseminate information, yet physical therapists receive little to no instruction on how to share knowledge in a way that is engaging, dynamic, and promotes learning, retention, and application of information. This gap in training is particularly significant given how often physical therapists disseminate information to patients, students, community members, and peers. Dissemination and implementation of research findings in health care is also a priority for federal funding agencies such as the National Institutes of Health. This session will provide attendees with the information and guidance needed to prepare eye-catching presentations for clinical, professional, academic, and research purposes. The speakers will offer guidelines for preparing outstanding oral and poster presentations that target and engage your audience will be covered.

 

Are You Listening to Your Clients? What Their Voices Reveal About Dysfunction

Presented by  Susan Clinton, PT, DScPT, OCS, WCS, FAAOMPT and Ginger Garner, PT, ATC, PYT

3:00 PM – 5:00 PM

Much has been written about breathing and its importance in the role of rehabilitation medicine. Breathing is the essence of life, and dysfunctional breathing has been linked to chronic musculoskeletal pain and diagnosis related to pelvic Floor dysfunction. Voice production – the story of your client – together with the forgotten vital sign respiratory rate hold critical information affecting physical therapy plans of care and outcomes. The thyroepiglottic, glossopharyngeal, and intrinsic and extrinsic laryngeal areas reveal novel insights into the neuroscience of musculoskeletal and neuromuscular regulation and control of pelvic function and health. These supradiaphragmatic and subdiaphragmatic relationships share a bidirectional pathway that not only dictates pelvic health but overall systemic health.

Few studies have explored the relationship of breath, voice, and phonation to physical therapy examination and intervention. The importance of learning effective strategies for creating a change in vocalization, which includes subphonation and phonation as well as orofacial assessment, is underscored by a powerful evidence base which supports the intimate link between the thoracic or laryngeal diaphragm, respiratory diaphragm, and pelvic diaphragm functioning. Becoming proficient with a skillset to affect these areas can expand intervention strategies for pelvic physical therapists and anyone who strives to change stress response and look for underlying drives of persistent pain and musculoskeletal dysfunction.

 

It’s Not Just About Sticking It In!  A Novel Approach to Dilator Therapy

Presented by Darla Cathcart, DPT and Mandi Murtaugh, PT, DPT, WCS

3:00 PM – 5:00 PM

Penetrative disorders (vaginismus) affect 5-17% of women in the United States, and can have a sizeable impact on intimate relationships, family planning, and medical procedures. Dilator therapy is a widely-used approach in physical therapy to address these symptoms and has historically included a focus on passive treatment geared toward tolerance of insertion. Some women are not motivated to continue self-treatment and feel disempowered due to lack of improvement with passive intervention. This session will provide background information on terminology and historical dilator interventions for women with penetrative disorders (vaginismus). Differentiation of lifelong (primary) and acquired (secondary) penetrative disorders (vaginismus) will be described. Instruction and case studies will be used to demonstrate a novel approach to include dilators (also known as vaginal trainers or accommodators) to provide methods for graded exposure and transition to a woman’s functional goals. Appropriate inclusion of the woman’s partner will be discussed. Finally, discussion will include the importance of the words and terms we use with our patients to reduce fear and anxiety and to empower her to obtain her desired goals.

 

Sports Performance Programming for the Pregnant and Postpartum Female Athlete

Presented by Carol Ferkovic Mack, PT, DPT, SCS and Meghan Rohde, PT, DPT, SCS, CSCS, USAW, Cert. DN

3:00 PM – 5:00 PM

This session is designed for students, new graduate physical therapists, and seasoned therapists who wish to deepen their knowledge of the pregnant and postpartum athlete. Attendees will learn maternal and fetal physiology as well as the indications, contraindications, and precautions for all types of exercise in this female athlete population. The speakers will discuss the signs and symptoms of emergency indications to terminate exercise, special tests related to pelvic girdle pain, diastasis recti, and pelvic floor dysfunction. Therapists will learn how the changes in the center of mass affect technique and performance in athletes who are active in weightlifting, powerlifting, CrossFit, and endurance sports. After reviewing the principles of exercise prescription and programming applied to this population, the clinician will be able to develop an exercise program for the athlete who wishes to continue weightlifting, powerlifting, CrossFit, and endurance sports without medical complications.

 

 

FRIDAY

FEBRUARY 23, 2018

 

Everyone’s Pain is Different

Presented by Adriaan Louw, PT, PhD and Kory Zimney, PT, DPT

8:00 AM – 10:00 AM

Every person’s pain experience is different. We know pain is produced by the brain when it faces a threat. What’s interesting is that when people are faced by a seemingly similar threat, some experience pain and others not. It is well established that various other factors determine whether or not someone experiences pain. This session will delve into various peculiarities that are clinically and fundamentally important to know when it comes to treating people in pain. The speakers will discuss pain in a variety of contexts, including gender, culture, kids, parents, genetics, nature versus nurture, work, pain ratings, social context, personality traits, money, and more. What is truly remarkable is how significantly these factors influence the pain experience and how little physical therapists realize it, let alone address or attenuate for in treatment. As physical therapy gains its rightful place in the frontlines of treating chronic pain, this session is a must for all clinicians in all facets of physical therapy.

 

Traveling Through the Worldwide Fistula Fund

Presented by Karla Wente, PT, DPT, WCS, CLT

8:00 AM – 10:00 AM

In this session, Dr. Karla Wente will describe her journey to the Danja Fistula Center in Niger, Africa, through the Worldwide Fistula Fund. She will present information about fistula and morbidity in the vulnerable female population in Niger and similar African countries, as well as the pre- and postoperative opportunities for women’s health physical therapy. Additionally, she will present the importance of global health education as a means to promote the value of physical therapy and women’s health worldwide. This session will be presented with stories illustrating the power of physical therapy missions at home and abroad.

 

Don’t Forget the Males: Evidence Based Physical Therapy for Male Pelvic Floor Dysfunctions

Presented by Ruth Maher, PT, PhD, DPT, WCS, BCB-PMD, Julie Peterson, PT, DPT, WCS, and Albert Threlkeld, PT, PhD

11:00 AM – 1:00 PM

Many physical therapists working in the women’s health arena are also seeing male patients with an array of pelvic floor dysfunctions such as urinary incontinence, erectile dysfunction, and chronic pelvic pain. The effects of pelvic floor dysfunction for men can be as debilitating as it is for women, resulting in emotional and physical distress in addition to substantial costs to the health care system. Estimates of the prevalence of stress urinary incontinence (SUI) after radical prostatectomy has been reported to be 2.5% to 90%, at a cost burden of $19 to $32 billion in the United States. Erectile dysfunction prevalence range from 9% to 40% of men by age 40 and generally increase by 10% in each decade of life thereafter, with chronic prostatitis/chronic pelvic pain syndrome affecting from 2% to 10% of men worldwide.

For the clinician interested in treating these patients, anatomical knowledge is crucial to ensure competent assessment, examination, and choice of appropriate intervention. This presentation will provide an in-depth review of male anatomy and its association with male pelvic floor dysfunction. The speakers will discuss evidence-based assessment and interventions along with validated objective clinical outcome measures for use in this population.

 

The Anatomy of a Clinical Practice Guideline

Presented by Meryl Alappattu, DPT, PhD, Susan Clinton, PT, DScPT, OCS, WCS, FAAOMPT, Eileen Johnson, PT, DPT, WCS, Jenny LaCross, PT, DPT, WCS, ATC, CLT-LANA, J. Adrienne McAuley, PT, DPT, Med, OCS , Adrienne Simonds, PT, PhD

11:00 AM – 1:00 PM

APTA and the specialty sections have joined together to support the development of clinical practice guidelines to reflect robust evidence for physical therapist clinical practice. The Section on Women’s Health has been actively working to achieve this goal for the past 5-6 years. There are several guidelines under development that have received funds and sponsorship from the section and APTA. This session will introduce attendees to the what, why, and how of the developing clinical practice guidelines for the Section on Women’s Health.

 

Women’s Health and Pelvic Floor Physical Therapy in the Military and VA:  A Way Forward

Presented by Stephanie Fournier, PT, DPT, PhD(c), WCS, CLT-LANA and Leigh Lechanski, PT, DPT, OCS

11:00 AM – 1:00 PM

This session will describe the current state of women’s health and pelvic floor physical therapy in the military and the Department of Veteran’s Affairs (VA) health care settings. The presenters will explore the challenges in both settings for specialty patient care. They will discuss proposed improvements in this area of specialty practice in both settings to optimize outcomes and the health care experience. Attendees will learn about the importance of women’s health and pelvic floor specialists as they relate to readiness and patient experience in the military and VA health care settings.

 

Pelvis, Power, and the Passenger:  An Interdisciplinary Approach to Birth Outcomes

Presented by Amber Anderson, PT, DPT, WCS

3:00 PM – 5:00 PM

Birth is a pivotal life experience for women who choose it. There has been a recent trend in the US toward intervention-free births and a push for true informed consent during the intrapartum process. This session will inform you how to optimize the birth experience for your patient by improving mechanics, enhancing motor control, facilitating mobility, providing objective data for birth plans, fostering a team approach with other providers, and preventing injury. Learn how to guide your patients through preparation for, participation in, and recovery from the labor and birth process.

 

Women’s Health Residency Panel

Presented by Valerie Bobb, PT, DPT, WCS, ATC

3:00 PM – 5:00 PM

In this session, directors from a few of the Women’s Health residencies will discuss what a residency in the field of women’s health includes, how the programs are set up and regulated, what qualities make a great resident, which programs are available, and their current status. In addition to residency directors, current and recently graduated students will be on the panel to give their insight into a “day in the life” of a resident. The panel discussion will be followed with an interactive question-and-answer period in order for students to ask anything else they would like to know about each residency. This forum will be geared towards students who want to learn more about or pursue a women’s health residency.

 

SATURDAY

FEBRUARY 24, 2018

 

Tackling Sacroiliac Dysfunction and Pelvic Girdle Pain

Presented by Deborah Riczo, PT, DPT, Med

8:00 AM – 10:00 AM

People across the lifespan can have complaints of pelvic girdle pain, including pain around the sacroiliac joints. This can include young athletes, women of child-bearing age, and even those in their elderly years. Intermittent urinary leakage to total incontinence can also be present. Physical therapists in all arenas of care, from acute care to rehabilitation to outpatient, and specialty areas ranging from pediatric to geriatric are confronted with pelvic girdle pain complaints from their patients. Diagnostic approaches are known to lag behind research; this lag is apparent in ruling out/in sacroiliac dysfunction. In this presentation, the speakers will review the evidence on assessing and treating sacroiliac dysfunction.

 

Tell That to the Arresting Officer!  The Entrepreneurial PT Guide to Compliance

Presented by Nancy Beckley, MS, MBA, CHC and Sandy Hilton, PT, DPT, MS

8:00 AM – 10:00 AM

Are you starting a private practice? Thinking about it? The internet is full of advice, but will “advice” guide you down the right pathway with respect to all the laws, regulations, and policies? It is often tempting to take advice that fits your premises or supports your position. Advisors and others offering advice on listserves, at conferences, and in education may be well-intentioned, but perhaps not entirely accurate. In addition to federal health care laws, there are state laws (including your physical therapy practice act) relating to insurance, patient privacy, and practice. Do you know the rules that are applicable to your practice: Tricare rule on PTAs? Civil rights requirements if you accept Medicaid or Tricare? HIPAA HITECH requirements for covered entities and business associates? Fraud provisions w/ commercial payers, and out-of-network risks? Do you know who is monitoring online activity and how it may affect you in an audit or investigation? In this session, a rehab compliance expert and a private practice entrepreneur with a successful cash-based practice that is enrolled in Medicare will help you navigate these questions.

 

Staying Present:  Mindfulness Meditation and Yoga in Pelvic Physical Therapy

Presented by Susan Giglio, BSPT and Laurie Nelson VanCott, MSPT

8:00 AM – 10:00 AM

This experiential program will explain the science and the research behind mindfulness meditation and yoga. There is compelling evidence that supports using these techniques with our patients as well as evidence that supports improved job satisfaction and decreased burnout for the practitioner. This session will be primarily lecture with a short mindfulness and movement experience to allow the attendees to immediately reap the benefits of this ancient practice.

 

Multidisciplinary Treatment of Individuals With Pain Disorders

Presented by Paula Breuer, PT, LPT,  Megan Driscoll, MOT, OTR/L,  Michael Turnwald, SPT, CSCS

11:00 AM – 1:00 PM

In this session, evidence meets practice in multidisciplinary instruction of managing individuals with pain disorders using a team approach. Occupational therapy, psychology, and physical therapy will provide the evidence and methodology behind their integrated goals and interventions for treating individuals with chronic pain using neuroscience education, self-management techniques, graded activity, behavioral modification, and coping strategies to improve patient function and self-efficacy. Attendees will learn the importance of treating the patient both physically and mentally, as well as the roles that real and perceived barriers play in a patient’s successful outcomes.

 

Breastfeeding Success: The Role for Physical Therapists

Presented by Peg Maas, PT, DPT, WCS, CLT

11:00 AM – 1:00 PM

Physical therapists who understand the autonomic nervous system, lymphatic system, and fundamentals of tissue function can bring helpful professional skills and perspective to the realm of breastfeeding issues when they understand the anatomy and physiology of lactation and differential diagnoses in that arena. Trained physical therapists providing support, education, manual therapy, modalities, and home program ideas are excellent team members in the care of women with lactation pain and can help reduce the likelihood of women discontinuing breastfeeding. In this session, attendees will learn the anatomy and physiology of lactation, the role of the autonomic nervous system and lymphatic system in breastfeeding function, and how to use manual lymphatic massage, education, and other physical therapy skills and interventions to assist these women. The speakers will discuss differential diagnosis and case studies, as well as strategies for starting a program to care for this population.

 

Spinal Cord Injury and Women Fertility: The Role of the Interdisciplinary Team

Presented by Tabitha Rivers, DPT

11:00 AM – 1:00 PM

Spinal cord injury (SCI) is a life-altering experience that affects approximately 276,000 people in the United States. Eighty percent of this population is male and much of the current research is directed towards understanding etiologies as they pertain to the male anatomy and physioanatomy. Although women comprise only 20% of the current population of spinal cord injured persons, there are many issues these newly injured women must face to integrate successfully back into society. One of area in which there is a deficit in educational information for women is how spinal cord injury affects women’s sexuality, fertility, and pregnancy.

The members of the SCI interdisciplinary team should be comprised of a physical medicine and rehabilitation physician, psychologist, dietician, physical therapist, occupational therapist, nurse, pharmacist, and obstetrician/gynecologist, as appropriate. The goal of the interdisciplinary team is to provide the necessary educational tools for spinal cord injured women to make knowledge-based decisions related to sexuality, fertility, pregnancy, and the postpartum period based on the patient’s current functional status. The SCI interdisciplinary team should work closely with the patient to offer their expertise to help spinal cord injured women with becoming sexually independent again and help them explore the options of motherhood in the future.

Women’s Health in a DPT Curriculum: Integration Without Adding to Academic Bloat

Presented by Skye Donovan, PT, PhD, OCS and Carrie Pagliano, DPT, OCS, WCS, MTC

3:00 PM – 5:00 PM

Professional education programs are faced with the constant challenge of meeting the demands of advancing evidence, innovative practice, and entry-level practice standards. Curricula may be suffering from “academic bloat,” with a heavy emphasis on content from an already long list of content areas, but clinicians and students may be demanding exposure to emerging areas of practice. Current CAPTE guidelines specifically list genital, reproductive, lymphatic, and systems interactions, pointing to inclusion of women’s health as part of a comprehensive curriculum. The APTA Section on Women’s Health published guidelines for inclusion of women’s health education content into the entry-level DPT curriculum. A corresponding survey demonstrated a significant variance in how this information is addressed across the curriculum. Although the preferred method was integration through multiple courses ranging from anatomy to musculoskeletal, others use elective courses and expert topics speakers.

Barriers to integration of women’s health content include access to qualified faculty, insufficient time, and lack of clinical education sites. Additional obstacles address whether women’s health education at an entry level constitutes requirement of internal assessment and treatment. Discussion of sex and sexual function is challenging and may be a barrier for students and clinicians alike. Providing students with communication strategies to respectfully address concerns regarding sex as an activity of daily living is an asset for many patient populations. This session will describe strategies for integrating women’s health content as a curricular thread.

Structural Violence, Traumatic Life Events, and Health in Vulnerable Populations

Presented by Bassima Schbley, PhD, LMSW, Lori Walton, PhD, DPT, MS, MPH(s), Najah Zaeed, DrPH, MSW

3:00 PM – 5:00 PM

Health professionals, including physical therapists and physical therapist assistants, are committed to reducing chronic health conditions and promoting health and wellness for the patients and communities they serve. Vulnerable communities experience traumatic life events from structural systems that promote inequity and perpetuate extreme hardship conditions such as war, poverty, intimate partner violence, societal violence and aggression, and other chronic stressors that negatively affect chronic mental and physical health issues. The effect of traumatic life events and structural violence on the neurologic system begins very early in the prenatal period, with genetic and epigenetic alteration in development during the critical fetal developmental phases. This presentation will begin to explore the prevalence, type, and cumulative effect of traumatic life events as they relate to structural violence on vulnerable population health outcomes, health-related quality of life, and neurologic, genetic, epigenetic, and immune system implications for chronic disease. The speakers will discuss a comprehensive, interprofessional, collaborative, community-based model and its sustainability and long-term patient and program success, with direct implications for successful health care provider leadership and management.

 

 

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