PelviCore Technique Exercise DVD. Kari Bo. Produced by TENA. Free copy available at http://www.corewellnessprogram.us. 20 minutes.
PelviCore Technique is a pelvic floor exercise DVD developed by Kari Bo, professor of exercise science and physiotherapy, at the Norwegian School of Sports Sciences. She has spent 20 years studying pelvic floor dysfunction. The PelviCore Technique incorporates exercises based on her research of the pelvic floor muscles to improve pelvic floor muscle control and reduce incontinence.
The DVD begins with an introduction that outlines how to use the exercise DVD and helps users identify the pelvic floor muscles. Unfortunately, this section does not use anatomy pictures or models. Ms Bo uses a unique technique to help the users identify and learn the pelvic floor muscle contraction. She has the users sit on the corner of a table to gain the sensory input of sitting on the pelvic floor muscles and cues them to lift the pelvic floor from the surface that they are sitting on. I believe this technique is effective in helping women perform an isolated pelvic floor muscle contraction.
The DVD consists of 2 programs; the full 20-minute PelviCore Technique and a shorter Instant Control Program. The full 20-minute exercise program is a general conditioning program of all the muscles (locals and global) that define the core (deep abdominals, pelvic floor, spinal extensors, gluteals, and diaphragm). The Instant Control Program is a functional strengthening program of the pelvic floor muscles and includes exercising pelvic floor muscles while lifting and coughing. The exercises focus on the global muscles.
Pelvic floor muscle contractions are performed in 3 different positions; prone with one hip externally rotated and knee flexed, the "frog" position, and in standing. Women are also encouraged to perform the exercises in sitting if they have difficulty with assuming any of the positions in the DVD. Ms Bo uses five maximal pelvic floor contractions in both sustained and quick flick methods to ensure that both the fast and slow twitch fibers are exercised. It appears that the author is more concerned with focusing on strong, isolated contractions of the pelvic floor versus increasing the number of repetitions. The author and 2 other women are shown performing the exercises. The music is difficult to hear.
I would recommend this video as a preventative exercise program for women who have a history of childbirth or abdominal and pelvic procedures. It may be beneficial if used as a group exercise class within the community at local health fairs, park districts, or hospital wellness classes. The exercises in the program are detailed and easy to follow and can be performed by all women.
I have performed these exercises 3 to 5 times a week for 2 weeks. At the end of the 2 weeks, I felt as if my overall posture had improved and my tummy had become firmer. I think this DVD can be used by physical therapists to instruct to their clients prior to discharge as a follow-up home program. Kari Bo states the exercise program has cured stress incontinence in 60% to 70% of the women who have used the DVD. These exercises, if continued as a maintenance program, will maintain the strength and health of the pelvic floor muscles.
Akta Shah, MSPT, MTC, Addison, Illinois
Hysterectomy, Vaginal Repair, and Surgery for Stress Incontinence, 6th ed. S. Hasslett, M. Jennings, H. Walsgrove, W. and Weathertt. Beaconsfield, UK: Beaconsfield Publishers Ltd. http://www.beaconsfield-publishers.co.uk. E-mail: [email protected]. for card payment details. Soft cover, 48 pages, single copy airmail postpaid $12.50.
This book targets women who may face pelvic surgeries in the United Kingdom. It begins with a brief introduction to a woman's reproductive anatomy. Illustrations in this section are clearly labeled and contain enough information for the lay person to understand her anatomy.
The next several pages discuss the different types of surgical procedures including hysterectomy, anterior and posterior vaginal vault repair, and stress urinary incontinence. Possible alternatives to hysterectomy are mentioned later; this might better serve the reader if this information precedes discussion of surgery. No alternatives are offered for urgency, frequency, or anal incontinence.
More than half of the book is dedicated to general care after surgery, both immediately postoperatively and care at home. Illustrations about practical matters (getting out of bed, how to sit on the toilet to minimize straining, coughing, and exercising) are well done. There is discussion about practical matters such as hygiene, fatigue, constipation, lifting, driving, housework, hormonal replacement therapy, and sexual activity. This information is a major strength for this little text. The authors very wisely mention possible emotional reactions several times in the text. This is an area that is often neglected and if feelings of depression and/or vulnerability happen, it is reassuring that other women may have had similar reactions. However, beyond support of family and friends, no other intervention (support groups or professional counseling) is recommended.
Mention is made of the fact that "smear" test (Papanicolaou test) are no longer needed for women who have had a total hysterectomy with bilateral salpingo-oophorectomy. However, the authors fail to emphasize the need for an annual pelvic examination. Even though the ovaries were removed, there remains a small risk of ovarian cancer for these women.
This book could be very beneficial for its intended readers. It should be noted that hospital procedures and length of stays for certain surgeries may be very different in the United States. The therapist who recommends this book to her patients should read all of the instructions and exercises carefully and modify as needed. The "Useful Sources of Information" are all from the United Kingdom. Since Web addresses are included, this may be of some use when augmented with the therapist's own suggestions on resources in the United States. The last page "Additional Reading" sites many texts that are no longer in print, so the therapist should also have a list of books currently available in this country. Despite some limitations, I would recommend this book because it may fill a gap in practical, user-friendly information for your patients.
Elaine Pomerantz, South Orange, New Jersey
Gait Analysis: Normal and Pathological Function, 2nd ed. Jacquelin Perry and Judith M. Burnfield. Thorofare, NJ: SLACK Inc; 2010. Hard cover, 576 pages, $92.95.
Author Jacquelin Perry, MD, is professor of biokinesiology and physical therapy. She also directs a pathokinesiology laboratory and postpolio service. Her coauthor, Judith Burnfield, PT, PhD, is director of rehabilitation in physical therapy and movement science.
The book is divided into six sections: fundamentals of gait, normal gait, pathological gait, clinical considerations, advanced locomotor functions, and quantified gait analysis. The text also includes a list of abbreviations and acronyms, a glossary, and normative joint motion values index.
Section 1 defines the gait cycle and basic terminology related to cycle divisions, stride, and step. Chapter 2 breaks down the phases of gait. These first 2 chapters are appropriately concise. This section ends with a detailed look at the body units and their function during the different phases.
In section 2, a chapter is devoted to focusing on a body part/complex, starting with the ankle/foot and working up to the arm. Each of these chapters explains the functional interpretation of that body part during gait, increasing clinical usability of the information in gait evaluation. Chapter 9 brings all the body parts together to review total limb function and synergistic relationships in each phase.
The Pathological Gait Section reviews the influence of individual impairments on the gait cycle. Impairments discussed include deformity, muscle weakness, sensory loss, impaired motor control, and pain. Chapters 11 to 14 examine the specific deviations that occur related to body parts/complexes and discusses possible causes. For instance, the effect of iliotibial band contracture on creating anterior pelvic tilt in standing is explained. Use of supine lying test for clinical diagnosis is encouraged as an alternative to the Ober test because of compensations that may create false-negative results with the Ober test. Another example is brief discussion of pelvic obliquity and hip joint asymmetry created by scoliosis.
Specific pathologies and the deviations associated with each one is then discussed; for example, rheumatoid arthritis and above-knee amputation with prosthesis. Subsequent chapters review pediatric gait analysis, stair negotiation, and running. The text concludes with an outline of different types of quantified gait analysis and related information such as energy expenditure.
This book is intended for a health care professional and is very appropriate for physical therapists or physical therapy assistants. I would recommend it as a reference tool that is clearly written and well referenced. The layout of the book into sections enhances the ease of reading and locating the information. The depth of detail would greatly assist the clinician who desires an extensive knowledge in gait examination and interpretation. This text does not specifically address the effects of gait on conditions, such as pregnancy or pelvic pain, commonly seen by the women's health therapist, nor does it specifically address the potential impact of some of the deeper hip musculature such as the obturator internus or piriformis. The book does state that the role of abdominals in normal pelvic tilt is not yet reported in literature. It is likely that these subpopulations or specific muscles have also not been studied.
Darla Cathcart, PT, MPT, WCS, CLT, Shreveport, Louisiana
Men After 50: Now What? A Handbook for Selfcare and Treatment. A. Janet and T. Hulme. Missoula, MT: Phoenix Publishing Co; 2010. Soft bound, 136 pages, $14.95.
Janet Hulme has 36 years of experience as a physical therapist specializing in women's health, chronic pain, and incontinence. This is one of the only books available that addresses male urinary and bowel dysfunction. Chapter 1 covers normal function and dysfunction of the male urinary and gastrointestinal systems. This chapter offers detailed descriptions of the anatomy accompanied by beautiful, simple, anatomical depictions of each system. The author also includes discussion of normal and abnormal urinary functions. The urinary dysfunctions that are covered include overactive bladder, urine flow pressure, incomplete emptying, and incontinence. The gastrointestinal issues covered include underactive bowel, flatulence, overactive bowel, and fecal incontinence. The end of the first chapter includes an introduction of the pelvic muscle system, as well as the roll-out and roll-in muscles. The author explains the relationship of these muscles with the function of the pelvic floor.
The next 5 chapters take the reader through various conditions they may encounter, including benign prostate enlargement, prostate cancer, chronic pelvic pain, erectile dysfunction, and bowel dysfunctions. Screening, assessment, and common treatments are covered for each diagnosis. The treatment mentioned for each diagnosis does include the "Beyond Kegels Protocol." Chapter 7 contains symptom questionnaires the author created to help men recognize the issues and discuss them with their physician.
Chapter 8 explains the Beyond Kegels Protocol, which includes Physiological Quieting, Roll for Control Exercises, and Wonder W'edge Inversion, as well as lifestyle changes. Lifestyle changes that are suggested include improving sleep, nutrition, and walking. Physiological quieting is described as a way to "balance the bowel and bladder and the nervous system that controls them." A CD is included. The Roll for Control Exercises, including pictures, are described in great detail. The wedge is used both to help back pain and pelvic pain and to help realign the bladder, bowel, and pelvic muscles. The rest of the book then describes the specific steps of the protocol for each individual diagnosis.
Overall, this book can certainly be used to educate patients about various conditions, as well as what is normal versus what is not normal as men age. The use of the Beyond Kegels Protocol does break down treatment into 4 steps, which seem manageable. However, the fact that each step suggests the use of equipment (order form in the back of the book) means self-treating a dysfunction would end up costing more than $86.85 for the book plus the equipment suggested. This book is a resource for patients and therapists who are looking for assistance in explaining male pelvic issues to patients.
Sarah Haag, Chicago, Illinois
Comprehensive Wound Management, 2nd ed. Glen Irion, Thorofare, NJ: SLACK Inc; 2010. Hard bound, 384 pages, $74.95.
Glen Irion is a physical therapist and certified wound specialist who teaches the physical therapy program at the University of South Alabama, Mobile, Alabama.
This book is a comprehensive text for health care professionals, especially physical therapists. There is a multitude of color photographs as well as line drawings throughout the text to help convey information. Useful information for physical therapy practice is provided in highlighted sections in each chapter. Each chapter has references from recent articles and texts. An appendix on wound care resources for professionals is included.
The basic science section contains information on anatomy and physiology of the skin. Biomechanics of skin and scar tissue are explained as well as the changes that occur with aging. Normal wound healing, the effects of oxygen on a wound, fetal wound healing, and various operative repairs are included. Abnormal wound healing is then presented in great detail. A summary of the importance of proper nutrient levels needed to provide best environment for healing is provided. The patient section includes a chapter on history taking and patient interview questions. It is very thorough and helps the reader discern which bits of information are important. The physical examination, including a full systems review, is also covered. There are descriptions of multiple tests that give information about all systems and how to use equipment needed to perform these tests.
The wound section devotes a chapter on common etiologies of wounds including a good deal of information on neuropathy, arterial disease, chronic venous insufficiency, lymphatic disease, peripheral artery disease, acute (traumatic,) and burns. The piece on pressure wounds includes a discussion of staging wounds and recognizing risk factors, as well as support surfaces for managing pressure wounds. The lymphedema information is basic and accurate. Wound assessment covers areas to document including size, appearance of the wound bed and the surrounding skin, and wound-related pain. Diagnosis is covered and leads the reader through the many aspects that need to be considered in the assessment, with research to support the recommendations. Infection control, including many pictures of proper and improper techniques, is covered. Pain control is addressed, outlining medical management as well as modality use. Wound bed preparation compares many techniques and details current research recommendations. Dressings are also discussed, with rationales for when each application is appropriate. A smaller chapter on scar management is also included. Adjunct interventions such as modalities, hyperbaric oxygen, negative pressure, and leeches are covered, with rationale and research supporting each. Thermal injuries and their unique care are included in a separate chapter. A chapter on special cases covers cancer, autoimmune diseases, vaso-occlusive disorders, bariatrics, pediatrics, and geriatrics.
A large chapter on documentation includes sample forms, sample notes with "Guide Language," legal issues, and more. Components of the plan of care for wounds are covered in depth. Coordination of care between clinicians and disciplines is also discussed. Another chapter includes regulations, reimbursement, and psychosocial issues related to wound care.
This is an inclusive book on wound care that is a valuable teaching tool for therapists working with wounds. The information is well supported by research, and there are many tools to facilitate excellent wound care in the clinic. [shadowed white circle]
Bobbie Stergar, PT, CLT, Peoria, Illinois