9th Physiotherapy Round Table Toronto 2010

The 9th Physiotherapy Round Table, held in Toronto, was attended by no fewer than 147 participants. The high quality of the interesting presentations and workshops helped to make this meeting a tremendous success.

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Speakers from the Physiotherapy Round Table

Marijke van Kampen, chair of the ICS Physiotherapy Committee, opened the meeting by warmly welcoming everyone and announcing that the next Physiotherapy Round Table will be held in Glasgow in 2011. Evelyne Gentilcore, chair of the Women’s Health Division of the Canadian Physiotherapy Division, also welcomed the physiotherapists to Toronto and promised us a host of interesting activities, both inside and outside the convention centre. We would like to thank them for their gift of very handy water bottles.

We heard from Chantal Dumoulin, member of the ICS Board of Trustees, that the main goals of the ICS Board include the development of the science of urinary continence. Advances include increased accessibility to research, training and scientific information. Of special interest is the funding of grants, fellowships and travel awards. Helena Frawley, member of the Education Committee, provided us with an overview of this committee’s activities: reviewing abstracts of annual meeting workshops and courses, reviewing application forms, handout of guidelines, defining the role of Physiotherapy on the Education Committee and Workshops and Courses Sub-committee, so as to ensure that the physiotherapy presence remains strong. Representing the Scientific Committee, Kari Bo announced that the highest number of abstracts (1374) had been reviewed this year and explained the scoring system. Kari has now retired from this position and we would like to thank her for the excellent job she did.

A number of interesting presentations on studies and projects then followed. The handouts of these presentations can be found on the ICS website. Inge Geraerts and Marijke van Kampen discussed their research project proposal concerning urinary incontinence and erectile dysfunction after open and robot radical prostatectomy. The aim of the study will be to evaluate the effect of preoperative pelvic floor muscle (PFM) exercises for urinary incontinence after open and robotic radical prostatectomy. Differences between several structures of the PFM will be verified in continent and incontinent patients with transperineal ultrasound. In addition, the pattern of change in physical activity level twelve months after surgery will be evaluated. Patients who have not recovered erectile function after twelve months will then be randomised into a group of intensive PFM exercises and electro-stimulation or no exercises.

Nadia Keswahni and Linda McLean looked at the reliability and validity of surface electromyography (sEMG) of the PFM and compared a new electrode to an available intravaginal probe (Femiscan). Excellent consistency of results within the same testing session was demonstrated. The Femiscan recorded significantly higher amplitudes from the PFM during hip adduction and external rotation at submaximal efforts compared to the new probe. It was concluded that the new probe is superior to the Femiscan for recording sEMG of the PFM, as it seems to record less crosstalk from the hip muscles while maintaining a high degree of reliability.

Stephanie Madill would like to determine the correlation between sEMG, vaginal dynamometry and pelvic MRI in older women with stress urinary incontinence. The aim of the project is to describe the effects of the PFM rehabilitation programme on PFM activation, force and morphology in correlation with continence, and to explore changes in brain activation in correlation with continence following a PFM rehabilitation program in older women with stress urinary incontinence (SUI). This research will provide insight into which measures produce the most information about the SUI continence mechanism, used as guide in the development of assessment tools and protocols. The project is expected to increase knowledge of the mechanism by which the PFM rehabilitation programme reduces urinary leakage. 

Stephanie Thibault-Gagnon researched PFM morphology in women with and without provoked vestibulodynia (PVD). The aim of this study was to determine if there are differences in PFM morphology measured with 3-D and 4-D ultrasound imaging.  The primary results provide further insight into pathophysiology of PVD and suggest that women with PVD have smaller levator hiatuses and shorter pubovisceral muscles than woman without PVD. During contraction of the PFM or valsalva, the morphology changes seem to be equivalent in both groups. 

In her enlightening state-of-the-art session, Kari Bo emphasised the difficulties of providing evidence for the effectiveness of interventions, not only for physiotherapy, but also for other disciplines. We recommend that you read her presentation on the ICS website.

The workshops on female sexual dysfunction, male incontinence, pregnancy, biomechanics of the pelvic floor, urinary incontinence in the elderly, prolapse and clinical considerations of sEMG led to animated discussions with a follow-up during the informal part of the meeting.   We would like to thank all the organisers and speakers at this successful meeting.

Jacqueline de Jong

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