MFVM0711s Examination methods in physiotherapy in gynaecology and obstetrics - seminar

Faculty of Medicine
autumn 2025
Extent and Intensity
0/4/0. 2 credit(s). Type of Completion: k (colloquium).
Teacher(s)
Mgr. Marika Bajerová (seminar tutor)
doc. PhDr. Filip Dosbaba, Ph.D., MBA (seminar tutor)
Guaranteed by
doc. PhDr. Filip Dosbaba, Ph.D., MBA
Rehabilitation Clinic – Joint workplaces with the University Hospital Brno - workplaces of the Bohunice and Mater. Hospital – Faculty of Medicine
Supplier department: Rehabilitation Clinic – Joint workplaces with the University Hospital Brno - workplaces of the Bohunice and Mater. Hospital – Faculty of Medicine
Timetable
Thu 16. 10. 8:00–11:30 232, Thu 23. 10. 8:00–11:30 232, Thu 30. 10. 8:00–11:30 232, Thu 6. 11. 8:00–11:30 F37/431, 8:00–11:30 F37/429
Prerequisites
Intended for students
Course Enrolment Limitations
The course is only offered to the students of the study fields the course is directly associated with.
fields of study / plans the course is directly associated with
Course objectives
The student will gain an overview of the available physiotherapy options for selected conditions in gynecology and obstetrics based on evidence-based medicine/practice.
They will learn basic examination and therapy of painful musculoskeletal disorders during pregnancy and postpartum, in chronic pelvic pain syndrome, urinary and fecal incontinence, and pelvic organ prolapse.
They will learn how to educate patients with postoperative scars after gynecological surgeries and scars resulting from cesarean sections and birth injuries, as well as how to prevent the formation of postoperative adhesions.
Learning outcomes
After completing the course, the student will be able to:
Provide expert and targeted care to patients in gynecology and obstetrics inpatient wards.
Perform basic musculoskeletal examinations and conduct basic therapy for outpatient patients with selected gynecological conditions, during pregnancy, and postpartum.
Syllabus
  • Examination of the musculoskeletal system during pregnancy. Movements of the pelvic bones of the birthing woman during vaginal delivery (counter-nutation/nutation of the sacral bone). Diastasis of the abdominal muscles during pregnancy. Neurological (disc herniation), orthopedic (symphysiolysis, coccyx fracture, hip dysplasia, total hip replacement), rheumatologic (ankylosing spondylitis), and traumatic musculoskeletal disorders in pregnancy. Kinesiotherapy during pregnancy.
  • Examination of the musculoskeletal system postpartum. Diastasis of the abdominal muscles. Symphysiolysis. Coccygodynia. Acute and chronic pain of the scar after cesarean section and scars after birth injuries following vaginal delivery (episiotomy, spontaneous perineal rupture, OASIS). Kinesiotherapy after delivery.
  • Urinary and fecal incontinence. Dyssynergy of the pelvic floor muscles. Myostimulation and biofeedback. Physiotherapy after urogynecological surgeries (TOT, TVT, sacrocolpopexy, sacrospinous ligament fixation). Kinesiotherapy for urinary incontinence.
  • Chronic pelvic pain syndrome (dysmenorrhea, endometriosis, pudendal neuralgia) and physiotherapy options. Physiotherapy after gynecological surgeries (abdominal hysterectomy, TLH, LAVH). Treatment of abdominal surgical scars. Kinesiotherapy in the postoperative period.
Literature
    required literature
  • Hesselman S, Högberg U, Råssjö at al. Abdominal adhesions in gynaecologic surgery after caesarean section: A longitudinal population-based register study. BJOG 2018, 124, 597-603. • Nikolajsen L, Sorensen H C, Jensen T S, Kehlet H. Chronic pain followin
  • Gilbert I, Gaudreault N, Gaboury I. Exploring the effects of standardized soft tissue mobilization on the viscoelastic properties, pressure pain thresholds, and tactile pressure thresholds of the caesarean section scar. Journal of integrative and comple
  • Signorello LB, Harlow BL, Chekos AK, Repke JT. (2001) Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women. American journal of obstetrics and gynecology.184(5):881-890
  • Bocchini R, Chiarioni G, Corazziari E, et al. Pelvic floor rehabilitation for defecation disorders. Tech Coloproctology. 2019;23(2):101-115. doi:10.1007/s10151-018-1921-z
  • Lavand’homme P. Chronic pain after childbirth. Curr Opin Anaesthesiol. 2013 Jun;26(3):273-7.doi: 10.1097/ACO.0b013e328360c57b
  • Rustamova S, Predanic M, Sumersile M et al. Changes in symphysis pubis width during labor. J. Perinat. Med. 37 (2009) 370–373
  • Ejegård H, Ryding EL, Sjögren B. (2008) Sexuality after delivery with episiotomy: a long-term follow-up. Gynecologic and obstetric investigation.66(1):1-7
  • Klein MC, Gauthier RJ, Robbins JM, Kaczorowski J, Jorgensen SH, Franco ED, Johnson B, Waghorn K, Gelfand MM, Guralnick MS. (1994) Relationship of episiotomy to perineal trauma and morbidity, sexual dysfunction, and pelvic floor relaxation. American journ
  • Tichý M. Dysfunkce kloubu. Podstata konceptu funkční manuální medicíny. 1. vyd. V Praze: Miroslav Tichý, 2005. 119 s. ISBN 80-239-5523-3
  • Buhling KJ, Schmidt S, Robinson JN, Klapp C, Siebert G, Dudenhausen JW. (2006) Rate of dyspareunia after delivery in primiparae according to mode of delivery. European Journal of Obstetrics & Gynecology and Reproductive Biology.124(1):42-46.
  • Rychlíková E. Manuální medicína: průvodce diagnostikou a léčbou vertebrogenních poruch. 3., rozš. vyd. Praha: Maxdorf, ©2004. 530 s. ISBN 80-7345-010 0
  • Fauconnier A, Goltzene A, Issartel F, Janse-Marec J, Blondel B, Fritel X. (2012) Late post-partum dyspareunia: does delivery play a role? Progrès en urologie.22(4):225-232
  • Rusavy Z, Jansova M, Kalis V. Anal incontinence severity assessment tools used worldwide. Int J Gynaecol Obstet. 2014 Aug;126(2):146-50. doi: 10.1016/j.ijgo.2014.02.025. Epub 2014 May 2. PMID: 24845554.
  • Bali S, Bagga R, Sarkar P. Pelvic Floor Exercises Alone or in Combination with Perineal Electrical Stimulation for Uterine Prolapse: A Pilot Randomized Trial. JK Sci J Med Educ Res. 2023;25(2):87-92. https://journal.jkscience.org/index.php/JK-Science/art
  • Lewit K. Manipulační léčba v myoskeletální medicíně. 5., přeprac. vyd. Praha: Sdělovací technika, ©2003. 411 s. ISBN 80-86645-04-5
  • Hite M, Curran T. Biofeedback for Pelvic Floor Disorders. Clin Colon Rectal Surg. 2021;34(1):56-61. doi:10.1055/s-0040-1714287
  • Seong MK, Jung SI, Kim TW, Joh HK. Comparative analysis of summary scoring systems in measuring fecal incontinence. J Korean Surg Soc. 2011 Nov;81(5):326-31. doi: 10.4174/jkss.2011.81.5.326. Epub 2011 Nov 1. PMID: 22148125; PMCID: PMC3229001
  • Kapandji A.I. The physiology of the joints: The spinal column, pelvic girdle and head (seventh edition). Handspring Publishing. 2018
  • Barrett G, Pendry E, Peacock J, Victor C, Thakar R, Manyonda I. (2000) Women's sexual health after childbirth. BJOG: An International Journal of Obstetrics & Gynaecology.107(2):186-195
  • Öztürk Ö, Özin Y, Bacaksız F, et al. The Efficacy of Biofeedback Treatment in Patients with Fecal Incontinence. Turk J Gastroenterol. 2021;32(7):567-574. doi:10.5152/tjg.2021.20430
  • Kolář P et al. Rehabilitace v klinické praxi. Praha: Galén, ©2009. xxxi, 713 s. ISBN 978-80-7262-657-1
  • Comesaña A, Vicente SM del P, Ferreira TD et al. Effect of myofascial induction therapy on post-c-section scars, more than one and a half years old. Pilot study. J Bodyw Mov Ther. 2017;21(1): 197–204. doi:10.1016/j.jbmt.2016.07.003
  • Huang Y, Huang Z, Ou Y, Yin L, Sun Y, Zong H. Meta-analysis of the therapeutic effect of electrical stimulation combined with pelvic floor muscle exercise on female pelvic floor dysfunction. Eur J Med Res. 2024;29(1). doi:10.1186/s40001-024-01979-1
  • Todhunter-Brown A, Hazelton C, Campbell P, Elders A, Hagen S, McClurg D. Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2022;9(9):CD012337. doi:10.1002/146518
  • Burkhard (Chair) FC, Brosch JLHR, Cruz F, et al. EAU Guidelines on Urinary Incontinence in Adults.; 2020.
  • Wu X, Zheng X, Yi X, Lai P, Lan Y. Electromyographic Biofeedback for Stress Urinary Incontinence or Pelvic Floor Dysfunction in Women: A Systematic Review and Meta-Analysis. Adv Ther. 2021;38(8):4163-4177. doi:10.1007/s12325-021-01831-6
  • Norton C, Gibbs A, Kamm MA. Randomized, controlled trial of anal electrical stimulation for fecal incontinence. Dis Colon Rectum. 2006 Feb;49(2):190-6. doi: 10.1007/s10350-005-0251-1. PMID: 16362803
  • Park MI. Can electrical stimulation therapy be helpful for patients with chronic constipation refractory to biofeedback therapy? J Neurogastroenterol Motil. 2013 Jul;19(3):279-80. doi: 10.5056/jnm.2013.19.3.279. Epub 2013 Jul 8. PMID: 23875093; PMCID: PM
  • McClurg D, Pollock A, Campbell P, et al. Conservative interventions for urinary incontinence in women: an Overview of Cochrane systematic reviews. Cochrane Incontinence Group, ed. Cochrane Database Syst Rev. Published online September 1, 2016. doi:10.100
    not specified
  • Weerasinghe K, Rishard M, Brabaharan S, Walpita Y. Physiotherapy training education prior to elective caesarean section and its impact on post-natal quality of life: a secondary analysis of a randomized controlled trial. BMC Res Notes. 2023;16(1):1-8. do
  • Obstetrics & Gynecology and Reproductive Biology.124(1):42-46. • Radestad I, Olsson A, Nissen E, Rubertsson C. (2008) Tears in the vagina, perineum, sphincter ani, and rectum and first sexual intercourse after childbirth: a nationwide follow-up. Birth.3
  • Shin TM, Bordeaux JS. The role of massage in scar management: A literature review. Dermatol Surg. 2012;38(3):414–423. doi:10.1111/j.1524- 4725.2011.02201.x
  • Macarthur AJ, Macarthur C. (2004) Incidence, severity, and determinants of perineal pain after vaginal delivery: a prospective cohort study. American journal of obstetrics and gynecology.191(4):1199-1204
  • Hosker G, Cody JD, Norton CC. Electrical stimulation for faecal incontinence in adults. Cochrane Database Syst Rev. 2007;2007(3):CD001310. doi:10.1002/14651858.CD001310.pub2
  • Pelvic Floor Muscle Training for Stress Urinary Incontinence, Fecal Incontinence, and Pelvic Organ Prolapse: A Health Technology Assessment. Ont Health Technol Assess Ser. 2024;24(6):1-172. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393479/
Teaching methods
Completion: practical and oral exam in a group setting
Assessment methods
Completion: practical and oral exam in a group setting
Language of instruction
Czech
Further Comments
Study Materials
The course is taught annually.
Listed among pre-requisites of other courses
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