By Wendy M. Featherstone, PT, DPT, President, SoWH

At the recent Combined Sections Meeting in Chicago the task force on governance review presented proposed changes to the APTA Board of Directors and the Component Leadership. The details of the proposal will be considered by the APTA Board of Directors at their meeting in April, with further updates available in May. The proposal will be discussed at the House of Delegates in June.

The proposal includes some significant changes for the Component Chapters and Sections, and I strongly urge that you stay abreast of the proposal and discussion through your Delegates.

To summarize, the proposal includes the following as it relates to the structure of the Sections:

• The 9 clinically-based Sections will be transitioned to “Academies”. Members would pay to join each Academy, with multi-academy discounts. These include
  
  
  • Geriatrics
  • Pediatrics
  • Orthopedics and Sports Medicine
  • Oncology
  • Women’s Health
  • Cardiovascular and Pulmonary
  • Neurologic
  • Integumentary
  • Multisystem Acuity



• Non-clinical Sections will be transitioned to “Councils” and will have Institutional membership. Institutions pay to join and each has a voting member. Individual members can join and pay dues without a vote. These include
  
  
  • Academic
  • Business and Practice Management
  • PTA Educator
  • Research



• “Communities of Practice” would be developed to meet member needs. All members would have free access. These include:
  
  
  • Aquatics
  • Clinical Diagnostics, Therapeutics and Technology
  • Education
  • Federal
  • Health Policy
  • Health Promotion and Wellness
  • Home Health

Time and space does not allow for more detailed description of the proposals, and there are changes to the Chapter, APTA Board of Directors, and House of Delegates included in the proposal as well. To provide more information to the membership, a webinar was developed and can be found here on the APTA website.

It is important to stress that no decisions have been made at this time. There will be discussion at the 2012 House of Delegates and throughout 2012 and early 2013, with the earliest decisions being voted upon at the House of Delegates in 2013.

This is your opportunity to inform yourself and express your opinions to your voting delegates. As your delegate to the House, I am happy to collect your input and bring it forward to the ongoing discussion. I can be reached via email at wfeather@rochester.rr.com

 

 

By Amy Pannullo PT, DPT, WCS, CLT, ATC, Nominating Committee

The Section on Women’s Health is excited to announce our recent election results:

• President:  Wendy Featherstone
• Treasurer: Sara Reardon
• Director of Research: Secili DeStefano
• Director of Education: Darla Cathcart
• Nominating Committee: Karen Weeks

These elected individuals will serve a 3 year term commenced at CSM 2012 and conclude at CSM 2015.  Congratulations to our elected candidates and thank you to those who took time to run!

It is never too early to start thinking about next year’s elections!  Nominations were opened at CSM 2012 in Chicago for the following positions:

• Vice President
• Director of Practice
• Director of Communications
• Nominating Committee

Terms are three years, running CSM 2013-CSM 2016.  You can find position descriptions here on the SoWH website

It is the goal of the Nominating Committee that no position goes uncontested for the 2012 election.  The Section on Women’s Health is fortunate to have such highly skilled and motivated Clinicians.  If you or someone you may know would be a good fit for a position, we encourage you to enter the election.

For more information, to nominate or become a nominee, please contact:

Carrie Pagliano, PT, DPT, OCS, WCS, MTC
Nominating Committee Chair
carriejamesdpt@hotmail.com

Help us increase our voter participation… Make sure your voice is heard this year!

 

By Natalie J. Sebba, PT, DPT, WCS, CLT –WHSC, Public Relations and Marketing

Introducing two of our new WCS clinicians……

Cheryl Wisinski, PT, DPT, WCS

As many know Dr. Wisinski is an established clinician in our field of women’s health having worked in the specialty for many years.  In fact Dr. Wisinski was one of the early SACE item writers for the WCS examination.  This commitment contributed to the establishment of our specialization. 
When asked how the WCS might affect her career it became clear that in fact Cheryl pursued specialization to fulfill a personal goal of achievement.  Cheryl feels, “that the t-DPT and the WCS process has been a wonderful journey that has made me a better therapist.  I am able to confidently treat more complex patients.  It feels good to feel more knowledgeable.”  Cheryl is a wonderful example of what professionalism means. 
Dr. Wisinski prepared for the examination by studying with a partner and she strongly recommends it.  Her partner was across the country and each week they had a phone study session.  Cheryl says, “It was fun to teach yourself all you need to know.  The WCS preparation is the ultimate continuing education.  I promise it will make you a better women’s health therapist.”

 

Sara Reardon, PT, DPT, WCS

Dr. Reardon is an amazing specialist who demonstrates true dedication to our field.  Sara began her career in women’s health, following PT school graduation, at a private practice in Austin, TX.  Sara was fortunate to work with “an amazing mentor who truly set the bar for how a women’s health PT should treat patients and continuously focus on personal and professional growth.”

This background gave Sara the foundation she needed to excel in women’s health.  She joined Texas Women’s University and the Baylor Women’s Health Residency program where she serves as a residency mentor and continues to treat solely pelvic floor dysfunction.  Sara expresses a passion for treating her patients stating, “I consider it an honor that they trust me with their care. It’s an extremely rewarding job that I have.”

Sara was motivated to pursue the WCS because she feels it distinguishes her as a specialist with advanced clinical knowledge and skills in women’s health that exceed that of the general physical therapist.  Sara states, “It is my hope that board certification keeps our profession motivated to continue moving forward and becoming experts in our field.”

Ladies, we are honored to congratulate you on your WCS certification.

 

By Christina L. Holladay, PT, DPT, MA, WCS, CLT-LANA, CSCS

While establishing a residency may seem to be a daunting task, there are two learning models that can facilitate good learning experiences for your potential residents.  As mentioned in the previous newsletter by Julie Guthrie, distance learning / regional mentoring is one model, while another is computer-based training.

At Duke University Medical Center in Durham, NC, we offer accredited residencies in cardiovascular and pulmonary, pediatrics, sports, and women’s health, as well as accredited fellowships in orthopedic manual therapy and sports medicine.  In order for the participants in these programs to gain breadth and depth of knowledge while at Duke, and to learn from the other specialty areas, a central website was set up online, on the Duke Blackboard system.  Our women’s health residents, for example, are able to gain more knowledge about the female athlete triad from our sports residents, or collaborate with the cardiovascular and pulmonary residents in treating cystic fibrosis patients who experience urinary incontinence.

Information available on Blackboard is grouped under main topic “folders”: Acute Care, Cardiopulmonary, Manual Therapy, Oncology, Pediatrics, Sports, and Women’s Health.  Within the Women’s Health folder, subject areas include an overview of the residency curriculum, and PowerPoint learning modules and evidence-based articles about pelvic floor rehabilitation, obstetrics, lymphedema, oncology, orthopedics, osteoporosis, and domestic violence / abuse.  The PowerPoint learning modules were developed by our Women’s Health team, as were quizzes that are to be completed upon completion of each learning module.  Residents are able to check the curriculum for relevant learning modules and complete them independently.  After reviewing PowerPoints, articles, and other reference sources, residents discuss the material with their mentors and how it can be applied to patient evaluations and treatments.

While developing learning modules, gathering articles, and organizing the information is time consuming, it is a worthwhile investment in the future of your residency program.  Advantages of this computer-based training model include: 24-hour availability of a structured, focused curriculum to guide the residents’ learning, decreased cost in time and money for providing learning experiences (after learning modules have been developed), and the ability to learn from other residencies and fellowships.

If you would like to learn more about computer-based learning models and how they could facilitate your residency, please contact the Women’s Health Residency Committee.

 

By Sandy Hilton, MS PT, Director of Programming

 

Thanks to everyone who made CSM2012 fun and educational! The entire conference was the largest yet, with 12,654 Physical Therapists, Physical Therapy Assistants, and students.  The SoWH programming began with 2 pre-conference sessions and went strong through Saturday evening. Programming included over 30 speakers, 3 closed out sessions and generated some excellent discussion.

Handouts from the sessions are available through 17 July, 2012 and can be accessed with your registration code here.

What's Next?

Introducing: The Advanced Clinical Seminar Series!  We are starting a new tradition for a fall seminar addressing clinical needs and current research.  We are setting the bar high with Paul Hodges and Lorimer Moseley as our first speakers.

Join us in Portland, Oregon from 12-14 October for Paul Hodges and Lorimer Moseley together for 2.5 days of clinical application in pelvic pain.  This conference will explore the idea that we are dealing with a complex system that has almost infinite demands upon it.  If you have heard either speak before you can attest to the great delivery, style and fun in store despite the complex subject matter.

• The speakers will discuss how we meet the demands of postural control, movement, continence and respiration under normal and pathological constraints, how this function is compromised in pathological states and what might be done about it to return optimal function. 
• They will also address how we maintain a unified body - the idea of cortical representations, perception, locating one's body in space, integrating perceptual and homeostatic control, pain, fatigue, fear etc,  what goes wrong in pain disorders and what might be done to return to optimal function.

The advantage of Portland is an international airport and light rail transportation directly from the airport to the downtown area.  You will not need a rental car!  The Benson Hotel is located in a beautiful part of downtown Portland with many restaurants, shops and parks nearby.  We have kept the cost low for members and are bringing you a one-of-a-kind high-powered opportunity for access to the most current of research in motor and sensory dysfunction, application to complex pain patients and time for discussion of case studies and questions.   We are advertising this outside of the section and outside of the country, so do take advantage of this unique opportunity and reserve your spot and Hotel room now!

Go to the SOWH webpage and register online.

Looking Forward to CSM2013 in San Diego!
You may have noticed the large numbers for CSM 2012, and may have heard that the conference has outgrown the Nashville location.  This is true.  The location and the dates have changed.  CSM 2013 will be in San Diego, California from 20 – 24 January 2013.  The pre-conference dates are Sunday and Monday with the main conference Tuesday through Thursday.  

Eric Franklin (dancer, instructor, author of Pelvic Pain) will be presenting our 2-day pre-conference in 2013 in a timely follow-on to the Advanced Clinical Seminar by Paul Hodges and Lorimer Moseley.  Learn the theories and evidence behind sensory/motor training from the researchers, and then come learn some practical ideas and exercises for sensory motor movements to use in the clinic.

We need your talent!  Submissions are open until 2 April, 2012. I hope that the discussions and enthusiasm generated by the great speakers in Chicago will transfer to those of you with ideas, passion and talent to submit your plans for a 2 or 4 hour session in January 2013 for the next Combined Sections Meeting.  There is great talent in the section, new and seasoned, from all over the country.  I look forward to seeing you share your skills.

I am also interested in hearing what sort of programming you are hoping to see? What do you want to brush up on? Send me an email and you can be part of designing the type of experience you are seeking.

 

By Darla Cathcart, PT, DPT, WCS, CLT, Director of Education

 

The SoWH has two series of certificate courses, or CAPP courses.  These are:

• Certificate of Achievement in Pelvic Physical Therapy (CAPP-Pelvic)
• Certificate of Achievement in Pregnancy and Postpartum (CAPP-OB)

These courses have been developed through volunteer author contributions and collaboration.  During the SoWH business meeting at CSM, a motion was made and approved to establish a task force that would review and provide feedback and recommendations for curricular CAPP Course refinement.  This offers an exciting opportunity to further enhance these evidence-based courses.  Darla Cathcart, the Director of Education, is currently in the process of creating a formal job description and inviting members to participate in this task force.  The plan is to have the task force assembled and beginning work by May 2012.

The task force member make-up will include the following, each of whom being a member of the Section on Women’s Health:

• 1 student
• 1 licensed therapist who is within one year of completion of her first CAPP-Pelvic course
• 1 licensed therapist who is within one year of completion of her first CAPP-OB course
• 1 licensed therapist who is within 2-5 years of completion of a CAPP course
• 1 CAPP-Pelvic certificate therapist
• 1 CAPP-OB certificate therapist
• 2 university professors skilled in curriculum development
• 1 CAPP Pelvic instructor
• 1 CAPP OB Instructor

Thank you to the members of SoWH for attending and supporting these courses, and to the volunteers who give of their resources to create these courses.

Updates will be given in future newsletters as this new task force is established and begins its work!

 

By Natalie J. Sebba, PT, DPT, WCS, CLT, Public Relations and Marketing, WHSC

 

We are excited to introduce your new Women’s Health Specialty Council members!

Chair: Tracy Spitznagle, PT, DPT, WCS
Item Writing Coordinator: Ruth Maher, PT, DPT, WCS
Public Relations Marketing: Natalie J. Sebba, PT, DPT, WCS, CLT

CSM was a busy and productive conference for the new specialty council.  We attended several sessions with the ABPTS and have a number of important updates for our members:

• The APTA is proud to announce the certification of 1,179 new specialists in 2011!  This includes a total of 111 WCS’s 29 of which are new this year!! 
• The women’s health section continues to be the fastest growing section of the APTA!

• The ABPTS has a new website!   www.abpts.org

Please visit the new site and become familiar with the many new easy to use features. 

• One of the most exciting tools of the new website is the “Find a Specialist.”  This feature highlights ALL credentialed specialists even if they are not currently a member of the APTA.  We encourage you to update your profile and add a photo!

• ABPTS is going electronic!
• Beginning this year all specialization applications and re-certification applications will be electronic.  This will make the application process easier both for the clinicians and the staff at ABPTS.

 

• 2012 WCS application deadline is July 2, 2012
• Current residents can apply under the residency qualification guidelines if they will receive proof of completion by January 31, 2013.

The entire team of women’s health specialization members convened for an excellent item writing workshop before the start of CSM.  A HUGE kudos goes out to the SACE item writers, the CCE’s and to Ruth Maher for working so well together.   Throughout the day the team accomplished:

• 74 items revised and improved
• 15 new items generated
• LOTS of laughs and fun was had!

Your team of WCS SACE item writers and CCE’s are proud to be working to improve and expand our specialization exam.

 

By Secili DeStefano PT, DPT, OCS, Director of Research

 

“Be a Pioneer” to increase research in women’s health.  Our goal is to help grow the body evidence for women’s health physical therapy.

Our fundraising goal is  $10, 000 for the SOWH Endowment for Research Excellence in Women’s Health Physical Therapy this year. Thank you to those who gave generous contributions in 2011!

The SOWH Board has 100% participation in fundraiser donations. Can you do the same? The endowment will provide research funds into perpetuity. The SOWH is investing $100,000 over a period of 5 years. After that time, the interest earned from the principal investment of $100,000 will fund the future competitive research grant awards program. By increasing the amount of money to the principal investment, we can earn more interest to fund future grants.

• Consider making an annual gift. 
• Tell your colleagues, friends, family and patients about this great opportunity to grow SOWH Endowment for Research Excellence in Women’s Health Physical Therapy.
• Consider a donation of any amount that you can afford.
• Memorialize a loved one and donate in their honor.
• Click here to make a tribute donation
  • Be sure to indicate the donation is for the SOWH Endowment

• Donate at a suggested fundraising levels below:
• Founder $5,000+
• Visionary $1,000 - $4,999
• Pioneer $500 - $999
• Friend $250 - $499
• Patron $25 - $249

 

• Donate using one of these 3 easy methods:
• ONLINE at  www.foundation4pt.kintera.org/SOWH
• CALL TOLL-FREE: (800) 875–1378 & ask to speak with Susan Maida -
       * especially if this is a tribute donation.
• MAIL your donation to:

              Foundation for Physical Therapy
             1111 N. Fairfax Street
             Alexandria, VA 22314
             Attn: SOWH Foundation for Research Excellence

 

2012 SOWH Research Grant Award – DEADLINE: MAY 1, 2012.

The submission deadline for the SOWH Research Grant Award Program is May 1, 2012. The funding provides up to $5000 for projects to be completed within one year. For more information, please visit our website.

Please contact the Director of Research (Secili DeStefano, PT, DPT, OCS) for more information at research@womenshealthapta.org.

 

Thank you to the outgoing Director of Research, SOWH Research Committee and Task Force Volunteer Members.

Thanks to Ann Marie Flores, PT, PhD, CLT, the outgoing Director of Research, who during her two successful terms strived for and achieved excellence for the SOWH and our profession in moving us forward in the area of research. Under her guidance the SOWH secured a new publisher for our journal and we are well on the path to Medline indexing. We also entered into a relationship with the Foundation to create the first endowment for women’s health physical therapy research. The small grant program was revised to allow for presentation of results at CSM and the submission guidelines were revised and updated to be similar to other common funding mechanisms. Under her guidance, the SOWH became the first section in APTA history to offer a funded travel award, later named the “Elaine Meadows Research Scholar Award) in honor of the late SOWH member Elaine Meadows. Dr. Flores also played a major role in helping to secure outstanding legal advice on all SOWH contracts, agreements and policies.

Thank you to the  SOWH Research Committee volunteer members - Pamela Downey, Sub-Committee Chair for Poster and Platform Reviews, KC Valentine, Patricia Downey,  Laura Krum, and Ramona Horton. As always, they did an excellent job preparing and executing platform and poster presentation review and preparation.

 We look ahead with enthusiasm as The Task Force on Research (members include Ann Marie Flores, Sara Sauder, Lisa Tate) develops ways to deliver news about high impact research concerning women’s health physical therapy to the membership.  Thanks to everyone who is serving!  Stay tuned for more on the committee and task force in the next newsletter. 

 

Congratulations Cynthia Chiarello, PT, PhD on your 2012 Research Poster and Platform Award.  Cynthia Chiarello, PT, PhD gave outstanding and informative platform presentation entitled “Measurement of Inter-Recti Distance: Are Calipers and RUSI Comparable?”  Hope you got the chance to see her!

 We had many fantastic researchers this year.  In fact, many attendees remarked on the exceptional quality and clinical relevance of the research presented.  We look forward to vanguard presentations next year!

Let us celebrate your success!  Please e-mail a summary of your research news, tips or informative websites to the Director of Research (Secili DeStefano PT, DPT, OCS) at research@womenshealthapta.org.  Please be sure that your news does not exceed 350 words per newsworthy item.

 

Research Tips.  Did you know you that there is a lot of free information available for research studies?  Are you interested in searching for grants or are you looking for potential collaborators?  Do you want to be a part of a consortium? There are many places to go for good information and women’s health research.  For instance:

• NIH’s Office of Research on Women’s Health website: http://orwh.od.nih.gov/ 
• Medline Plus (NLM) website for women’s health: http://www.nlm.nih.gov/medlineplus/womenshealth.html 
• CDC’s website: http://www.cdc.gov/women/ 
• DHHS website: http://www.womenshealth.gov/about-us/ 
• NIAID: http://www.niaid.nih.gov/topics/womenshealth/pages/default.aspx 
• NCI- On Homepage: Women’s Cancers : http://www.cancer.gov/cancertopics/types/womenscancers
• AHRQ website: http://www.ahrq.gov/.  Each of the buttons down the left-hand side have items of interest.  If you click on the “Priority Populations” button, there are many interesting topics.
• Grants funded by NIH and AHRQ and some other agencies.  Look to see what is being done as well as for potential collaborators: 
  http://projectreporter.nih.gov/reporter.cfm
• Chronic Pain Consortium.  http://painconsortium.nih.gov/index.html
  (Note at the bottom, you can join a chronic pain listserve http://painconsortium.nih.gov/.

Don’t forget that the SOWH offers email blasts for research.  Do you have a research project you would like to let others know about?  The SOWH sends email blasts providing important information about research to our members. The guidelines are as follows:

1) Specify the subject line of the email blast.
2) Include the content of email blast along with any images to be embedded (short, sweet and eye-catching gets attention).
3) Specify the group or subgroup of members to send the blast (e.g. all members, WCS only, etc.).
4) Include the release date for the email blast.
5) Email your request to:

 

Director of Communications
Communications@womenshealthapta.org

and/or

Director of Research
Research@womenshealthapta.org

 

 

By Susan Abis, PT, Federal Government Affairs Chair

 

It has been a turbulent few months for APTA, given all that is going on in Congress with respect to Medicare.  On February 17th, members of the House of Representatives and Senate were able to resolve several issues relating to Medicare- passing legislation to avert the 27.4% projected cuts under the physician fee schedule and extending the therapy caps exceptions process through 2012. Beginning on October 1 of this year, those patients who surpass $3700 in combined physical/ speech therapy will be subject to manual medical review.  Additionally, the cap and exceptions process will be applied to hospital outpatient departments no later than October 1, 2012.

 The law also directs the Medicare Payment Advisory Committee (MEDPAC) to submit a report by June 15, 2013 with recommendations to reform the outpatient therapy payment system.  It is hoped that any alternative payment system will address the therapist’s clinical judgment as well as severity of patient condition.  In addition, the General Accountability office (GAO) will be mandated to issue a report by May 13, 2013 regarding implementation of the manual medical review process of patients surpassing the cap.  In addition, the new legislation mandates the consistent use of the KX modifier at the cap ($1880 for 2012).  By October 1, 2012, all claims must also include the NPI number of the physician ordering the care. 

In the coming weeks, this legislation will be sent to President Obama for signature.  APTA is continuing to work with CMS and reaching out to begin dialogue about implementation of this legislation.  It is ever more important at this time that we continue to dialogue with our member of the house and senate to assure that our patient needs are known and , of course- THANK them for support in passing this legislation.  Consider becoming part of the Grassroots effort by logging on to APTA and looking for advocacy.  It takes but minutes to have your voice heard in Washington

 

 

By Jennifer Klestinski, PT, MPT, OCS, WCS, CSCS, BCB-PMD (Director of Communications)

 

Welcome NEW (marketing-related) volunteers!  On behalf of all members, the Board of Directors & Leadership committees would like to thank the following WH PTs who have chosen to give of their time & talents via service in appointed volunteer positions:

• Colleen Gest - Media Coordinator
• Lisa Odabachian - SUNA Liaison
• Amber Anderson & Susan Schulz – Social Media assistants

If you enjoy marketing WH PT, are website savvy, or are looking to get involved in any way from big to small, contact the Director of Communications, Jennifer Klestinski, at communications@womenshealthapta.org to learn more about the open CSM Booth Coordinator or Web Therapy Tips Coordinator position.

Website Updates:
With web committee and member input, the new PT Locator feature at http://www.womenshealthapta.org/find-a-physical-therapist/index.cfm has been revised to help members better market their practice!  It now features the popular and user-friendly zip code radius search option to better capture all women’s health PTs in both metro and rural locations nation-wide.  Check it out and let us know what you think.

A new Online Store launched in February!  This easy to use and eye catching store features home study modules, gifts of Lucinda Pins for colleagues or coworkers, and marketing materials.  Check it out today at https://www.womenshealthapta.org/store/). 

Did you know?  The Section on Women’s Health website is your 24hr a day, 365 day a year public relations specialist.  It is the face of WH PT.  In order to keep it current and as accurate as possible, we ask Section members to assist the web committee by letting us know if you find outdated information, a non-working link, typo, or if you just have a suggestion.  Send us text in an email or attach a Word document with recommendations to Section Webmaster, Cheryl Wisinski at captcheryl@gmail.com. 

A CSM Highlight:
A donation of $245 was given to the New Orleans Women’s Shelter (http://www.nolawomenshelter.org/our-story.)  For nearly a decade, the Section’s Board of Directors has donated a portion of the profits from the sale of Lucinda Pins at the CSM booth to a women’s & children’s shelter in the CSM host city of the prior year.  Consider purchasing the pins for family, coworkers, and friends at CSM 2013 and let’s challenge ourselves to a new charitable “PR” (aka personal record) in Nashville! 

Marketing & PR Tools: Need a good patient or public education video?  Check out this PBS video with Section president Wendy Featherstone on a panel discussion regarding pelvic organ prolapse (POP):  (video).

Consider joining one of any number of pelvic health-related groups on LinkedIn (example) or Twitter to key into the patient perspective or to weigh in on the researcher and/or provider perspectives.  You can follow the Section on Women’s Health on Twitter at: @Womens_PT.

ICS Liaison Update
International Continence Society in Glasgow, UK
Beate Carrière, PT, CIFK, CAPP

The 41st annual meeting of the international continence society (ICS) took place in Glasgow, United Kingdom (UK).  As usual, the physical therapists (PT’s) of the association met separately on August 28th a day before the conference officially started on August 29th-Sept 2nd, 2011.

Because of the closure of all airports on the East coast due to the hurricane Irene I arrived in Glasgow 12 hours later than planned and I could not participate in the Sunday meetings of the physical therapists. On Sunday morning the British association of chartered physiotherapist in Women’s health (ACPWH) invited all PT’s attending the conference to their annual conference which was scheduled in conjunction with the ICS. Britt Stuge spoke about anatomy, examination and treatment of pelvic girdle pain -including the development and implementations of European Guidelines.

Diane Stark, who also participated in the multicentre randomized controlled trial (RCT) of pelvic floor muscle training intervention for women with pelvic floor organ prolapse (POP) gave a talk about prolapse: the role of physiotherapy and its management and prevention. The abstract of the above RCT on POP written by Hagen S, Stark D, Glazener C et al. was awarded the best clinical abstract of the ICS conference. Later, at the ICS roundtable Marijke Slieker also spoke about prolapse, a theme which has been researched by PT’s in several countries which was reflected in various posters. While some researchers (e.g. Hagen et al., Frawley et al.) investigate pelvic floor muscle training and its effect on patients with prolapse, other focus on exercises which decrease the size of the hiatus to reduce or prevent prolapse (Bø et al.) Andrew et al. presented a poster concluding that excessive distensibility (ballooning) of the levator hiatus is more likely the cause rather than the effect of female pelvic organ prolapse.

The ICS 10th physiotherapy round table program started at 1pm after a lunch invitation of the British women’s health group.  Marijke van Kampen (chair of the physiotherapy committee) and Chantal Dumoulin (trustee of ICS board) introduced the attendents. Marijke Slieker reviewed the 10 year history of Round Tables, Helena Frawley represented the ICS education committee, Ruth Hawkes and Kate Lough were from the ACPWH and chair of the conference committee 2011.

Kari Bø moderated a session about Scientific projects and studies which included percutaneous tibial nerve stimulation for over active bladder. Irmina Nahon lecture was about using real time ultrasound (US) to assess post prostatectomy male pelvic floors. Esther Bols, PhD a student from the Netherlands did a RCT about rectal balloon training as add-on therapy to pelvic floor muscle training in adults with fecal incontinence and prediction of outcome. Alexandra Vermandel, PT lectured about potty training. After the lectures brief workshops were offered the therapists ranging through the full spectrum of physical therapy treatments of the pelvic floor.The day ended with buffet for the participants.

The following two days, August 29 and 30 were full of workshops which usually lasted 1.5 to 3 hours and covered a variety of interests for all attendants of the conference. In all there were approx. 40 workshops to choose from and it was often difficult to decide. Nine of the workshops were chaired by physical therapist (PT) and many others with PT speakers. It is always fascinating to go to workshops about the brain and the pelvic floor and new anatomy findings, because new technology helps us to understand how these muscular system works.

 3-D transperineal US imaging, MRI and MRI diffusion tensor imaging (DTI) allows physicians to infer the direction of fibers and micro-structural organization in vivo.  Sinha, Bhargava  and Mittal received a prize for best basic science abstract investigating the external anal sphincter (EAS) with such methods. Mittal discussed their findings in a workshop: Pelvic floor anatomy and function: several muscles and several functions. They propose that the EAS is not a circular muscle but is interwoven with the transverse perinei muscle in a “purse-string” morphology crossing over to the opposite side. They also suggest that the anterior end of the EAS muscle fibers are inserted to the midline structure of the perineal body. These new finding have implications for surgery and probably also exercises. In the pubo-rectalis may be blending in with the EAS as well and it might be beneficial to strengthen them together.

The antenatal and post partum pelvic floor muscle training in prevention of urinary incontinence (UI) was a 3 hour workshop including half an hour exercises with Kari Bø, a leader in physical therapy research on pelvic floor incontinence. During the workshop there was also given an overview of evidence in the preventive and treatment of pre-and postnatal UI, presented by Siv Mørkved. Research supports physical therapy treatment both during pregnancy and afterwards in order to prevent SI. Exercises in the study were instructed by skilled physiotherapists and lasted 45-60 minutes and took place weekly with 5-15 women. Specific strength training was done for the Pelvic floor muscles (PFM) and relaxation of other muscles in various positions, including standing with the legs apart. Near maximal contractions for 6-8 seconds hold was recommended followed by 3-4 fast contractions and resting periods for 6 second. Between these PFM sessions general exercises were instructed to music. The women were instructed to perform daily 2-3 sets of intensive PFM contractions and to keep a diary about the daily exercises.

Adherence to exercises was discussed in this workshop and in a separate workshop in greater detail. It became obvious how difficult it is for a therapist not to tell the patient what to do rather than developing skills which helps the patient to realize what he/she has to do to adhere to exercises and stay motivated. Open ended questioning, affirmation, reflective listening and summarizing are part of motivational interviewing. It is important to find out what the patient already knows. It is also important for the therapist to ask the patient if he/she can use the information given by the therapist.  Ultimately the goal is that the patient decides that exercising is beneficial. The workshop about facilitating behavioral change and treatment adherence: theory and skills to support the success of conservative interventions for incontinence should be taught in physical therapy schools, because it is extremely important for all health professionals to improve their motivational skills. Many more workshops were offered which were of great interests to physiotherapist. On two days one-hour-long pelvic floor exercise classes were instructed by Kari Bø and Siv Mørkved for pre- and post natal women, by Chantal Dumoulin and Fetske Hogen Esch for treatment of UI in aging women.

Physical therapists were involved in expert sessions, public forum and in lectures and poster presentations, in total there were 500 PT’s in attendance of this meeting. They met at the welcome reception in the exhibit hall over lunch or at the Gala dinner, where Jo Laycock the British Physiotherapist who influenced so many of Women’s Health Physiotherapists long before she retired, received her second Lifetime achievement award. This is a great honor to all physical therapists of the world. There was time to interact with our peers from many different countries, exchange knowledge and meet other health professionals. Every year the meeting is a wonderful occasion to update the information we need to improve our skills. We also meet the persons whose papers we read in the journals and that promotes an open mind and a network of persons one can ask if question arise during our work.

This time, Beth Shelly from the APTA women’s health group was attending the meeting, which takes place yearly. The next meeting will be in from October 15-19 2012 in Beijing, China. Save the date!