Course type: Practical
Pelvic, Obstetric and Gynaecological Physiotherapy
Pelvic Health Physiotherapy:
lower bowel dysfunction – an entry level course
8-10 October 2021
Milton Keynes University Hospital, H8 Standing Way,
Eaglestone, Milton Keynes, Buckinghamshire, MK6 5LD
£345 POGP member/affiliate
This POGP certified workshop has been developed for Registered Physiotherapists who have not completed an accredited continence course but wish to develop their knowledge and skills in the assessment and management of women with lower bowel dysfunction. It may be of value to those already working in the speciality who wish to update their knowledge and practical skills. It is not suitable for physiotherapy students but may be useful for a newly qualified physiotherapist preparing for a rotation in Pelvic Health.
POGP recommends that participants complete of a number of specified learning tasks prior to the workshop.
The workshop content includes: professional issues; relevant anatomy and physiology; subjective and objective assessment of the patient with lower bowel dysfunction and relevant treatment. Practical sessions include ano-rectal examination as well as the application of treatment techniques including rectal sensation testing, rectal balloon expulsion training and electrical stimulation.
During the workshop each participant will normally carry out at least one ano-rectal examination. The practical sessions include peer physical examination and are compliant with the requirements of CSP information paper PD092 (see further information below). Female participants may choose to act as a model during the practical sessions. Valid consent procedures are used throughout. A participant choosing to act as a model may opt out of having practical techniques performed on them at any stage.
Please note: vaginal examination is not included as any part of this workshop.
Whilst not a pre-requisite POGP advises that completion of the ‘Pelvic Health Physiotherapy: female urinary dysfunction – an entry level course’ (or equivalent) is beneficial before attending this workshop.
1. To introduce essential and current evidence-based information on the physiotherapy assessment and management of lower bowel dysfunction.
2. To provide tutor led practical experience of both ano-rectal examination and the application of techniques used in the treatment of lower bowel dysfunction.
On completion of the programme the participants should be:
- Able to adequately assess a patient with lower bowel dysfunction
- Able to formulate an effective management plan of a patient with lower bowel dysfunction
- Able to apply appropriate treatment modalities
- Aware of and conform to professional standards in relation to the assessment and management of men and women with lower bowel dysfunction
It is recommended that you familiarise yourself with the following documents prior to the workshop:
- Any protocols/policies from your own workplace that are relevant to your professional practice in the assessment and management of people presenting with lower bowel dysfunction.
- Chartered Society of Physiotherapy (2012) Pelvic floor examination - CSP expectations PD092, Chartered Society of Physiotherapy, UK
- Chartered Society of Physiotherapy (2013) Chaperoning and related issues PD104, Chartered Society of Physiotherapy, UK
If you practice outside of the UK you are not likely to be able to access these information papers. It would be appropriate for you to review the legislation and professional guidance applicable in your country. Consider how it applies to practice with this client group. If you are practising in the UK but are not a CSP member you are also not likely to access these document. If this is the case, please contact the course administrator.
For those participants who have not previously attended the ‘Pelvic Health Physiotherapy: female urinary dysfunction – an entry level course’ programme it is recommended that you review the anatomy of the pelvic floor – the endopelvic fascia, levator ani, perineal membrane, external superficial muscles, external anal sphincter and associated pelvic muscles (eg obturator internus & piriformis).
You may find it helpful to view diagrams to demonstrate the layers, especially regarding the muscles that you are able to palpate. If you have an Athens password you may be able to access www.anatomy.tv Alternatively you may you may find the following YouTube link helpful: http://www.youtube.com/watch?v=P3BBAMWm2Eo (accessed 12/3/20)
It is also recommended that you update yourself on the current legislation/guidance relating to consent. If you practice in the UK this will include the CSP guidance on consent: PD078, which is available as a downloadable PDF file at: http://www.csp.org.uk/publications/consent-physiotherapy-practice (accessed 12/3/20), as well as relevant sections of the HCPC ‘Standards of conduct, performance and ethics’. You may also include relevant consent policies in operation in your workplace. Consider how the issues raised in the legislation/guidance apply to people presenting for physiotherapy assessment and management of lower bowel dysfunction.
The following books may be helpful for any further pre-workshop learning that you have identified:
Bo K, Berghmans B, Morkved S, Van Kampen M (2015) Evidence-Based Physical Therapy for the Pelvic Floor Bridging Science and Clinical Practice. Churchill Livingstone. ISBN 9780702044434
Laycock J., Haslam J. (eds) (2008) Therapeutic Management of Incontinence and Pelvic Pain (2nd Ed). Springer, London.
POGP workshop programme (3 day taught workshop)
9-00 Welcome and introduction
9-20 Professional issues: infection control, consent, chaperones and confidentiality
10-50 Anatomy and physiology of the lower bowel and pelvic floor complex
12-00 Patho-physiology of ano-rectal dysfunction
14-00 Verbal/subjective assessment
15-30 Objective assessment
9-00 Observation of ano-rectal examination
Concurrent case study discussions
Practical session: ano-rectal examination
Break will be taken at a suitable time within this session
12-30 Facilitated reflective practice (including case study discussions)
14-00 Anal sphincter/pelvic floor muscle training
14-45 Theory of treatment/management of constipation
Break will be taken at a suitable time within this session
9-00 Theory of neuromuscular electrical stimulation for lower bowel dysfunction
10-15 Theory of treatment/management of anal incontinence
11-45 Case study discussions
13-30 Demonstration of practical techniques used in the treatment of lower bowel dysfunction
Rectal sensation testing, balloon expulsion techniques, teaching optimal position/action for defaecation
Break will be taken at a suitable time within this session
15-30 Facilitated reflective practice
16-15 Final comments
Information for the practical session on anorectal assessment.
The practical sessions include peer physical examination (PPE) and are compliant with the requirements of CSP information paper PD092.
All participants have the right to opt in or out of the practical sessions. All participants may choose to act as a model during the practical sessions, however they also have the right to decline to be examined by any specific course participants due to embarrassment or other factors. If a participant does not want to examine a course participant they usually have the option of completing the examination on one of the tutors. Another alternative is for course participants to arrange to have their own ‘live’ model present but they must meet any extra costs incurred.
In the case of a participant declining to complete at least one ano-rectal examination on a ‘live’ model it will not be possible to complete the skills checklist and the participant will not be able to complete the programme.
Valid consent procedures are used throughout. A participant choosing to act as a model may opt out of having practical techniques performed on them at any stage.
Delegate Terms and Conditions
Cancellation by a participant
Where a place on a course has been confirmed a 90% refund will be given for cancellation up to 4 weeks before the workshop, a 50% refund will be given for cancellation up to 2 weeks before the course. No refund will be given for a cancellation within 2 weeks of the course. If eligible for a refund this must be claimed within three months of the course taking place.
This includes failure to attend a course due to illness. In the event of becoming unwell or physically incapacitated prior to attendance on a course the participant should contact the POGP workshop administrator or POGP workshop coordinator if they are hoping to still attend. POGP reserves the right to make the final decision whether a participant can attend the course. Failure of the participant to disclose any changes to health could result in a participant being turned away on arrival at the course venue or during the course itself. The policy will also be valid for a cancellation of a place for an overseas participant. In addition, any extra costs incurred for bank charges and administration will be subtracted from the final refund.
Participants who fail to attend the course on the date booked without giving notice or who give notice after the course has started are not eligible for a refund or a transfer to another course regardless of the reason for non-attendance
Cancellation by POGP
In the very unlikely unforeseeable event that we have to cancel a course we will offer you the choice of a full refund of the course fee or a free transfer to the same POGP course that is hosted at a different location/date within the same calendar year.
We will try to give you at least 2 weeks’ notice but sometimes (for example when a course is cancelled due to bad weather) this is not possible. We reserve the right to cancel a course where we believe the weather conditions are so bad that it would be unreasonable to expect participants and/or tutors to travel to the venue. If we make the decision that it is reasonable to run the course and it goes ahead as planned, failure to attend the course may result in the loss of the course fee. It is the participant’s responsibility to research alternative methods of transportation before a course to assure you can attend. We reserve the right to alter any specified course tutor (to cover for sickness or late unavailability) to enable an advertised course to run.
We recommend that you book fully refundable travel and accommodation for your course. POGP accepts no liability for non-refundable costs in the event that a course is cancelled. You might like to consider travel insurance to cover any significant non-refundable costs incurred.
Cancellation due to COVID-19
Refunds due to COVID-19 can only be given in the following circumstances:
If POGP cancels the course prior to commencement POGP participants will be offered the opportunity to transfer to a future POGP course. If an alternative date is not acceptable the course fee will be refunded with no administration fee charged. However, POGP is not responsible for any travel or other expenses which may have been incurred.
The same rules will apply to participants who are unable to attend the POGP course due to travel restrictions imposed by the UK government or, for overseas participants travel restrictions imposed by their national government. Documentary evidence may be required for overseas participants.
If a participant is unable to attend due to COVID-19 related issues a full refund of the course fee will be given. This includes if you are self-quarantining, living with someone who is self-islolating or have symptoms of COVID-19.
If this is the case please email email@example.com to notify POGP.
In the event of a participant having to quarantine following a visit abroad in accordance with UK government guidelines, then the COVID-19 cancellation section of this document is not applicable.
POGP reserves the right to alter the cancellation policy to reflect the changing directives from the UK government.