Celebrating Success: New Master of Physiotherapy (Pelvic Health) Program
Thorlene Egerton & Elise Fraser
Our School of Physiotherapy recently launched a new Master of Physiotherapy (Pelvic Health) program to address the growing demand for specialised training in this field. The 3-year part-time course provides advanced education and clinical skills focused on the assessment, treatment, and management of pelvic floor disorders, incontinence, and other pelvic health conditions. It is designed to equip physiotherapists with the necessary knowledge and skills to deliver high-quality, evidence-based care to patients experiencing pelvic health issues.
The course is run mostly online apart from two x 2-week intensives on campus. Since its inception, the program has attracted a cohort of dedicated students from around the country, who have embraced the opportunity to delve deeper into this crucial area of healthcare. So far 20 students have been awarded their Masters. Through a comprehensive curriculum and hands-on practical skills training, they have acquired specialised knowledge and honed their abilities to address pelvic floor disorders, incontinence, and other related conditions effectively.
In this article, we will hear from two recently graduated students who share their personal reflections on the transformative journey they embarked upon through this program. Their insights shed light on the profound impact it has had on their professional growth and ability to provide comprehensive care to patients. For further information, contact Elise Fraser (fraser.e@unimelb.edu.au).
1. Karen Benson
“The Masters of Physiotherapy (Pelvic Health) was both a personal and career achievement. Commencing the program during the Covid-19 lockdown gave me focus and inspiration at a time when many things were uncertain. Through the subjects, I developed professional friendships and found a renewed passion in the specialised field that I was drawn to many years previously. It also highlighted my interest in academia, both teaching and research. While the workload was high, the course structure allowed me to manage part-time work and family life. Of specific appeal to me was the ability to select electives relevant to my physiotherapy clinical role, and also achieve APA Titling through the Advanced Clinical Practice subject.”
Karen completed a systematic review for her capstone project:
Features of effective pelvic floor muscle training programs: A systematic review and meta-analysis
Pelvic floor muscle training (PFMT) has been demonstrated to be effective in treating urinary incontinence (UI) in women. However, the features of published PFMT protocols vary widely. The aim of this review was to examine the PFMT protocols that have shown clinical or statistical effectiveness in the treatment UI in women compared to no treatment, placebo, sham, or other inactive control treatments.
Five databases were searched for relevant studies. Risk of bias was assessed with the Cochrane Risk of Bias 2 tool. Data were synthesised using meta-analysis and narrative approaches, and the GRADE framework was used to determine the evidence quality. Data was extracted through use of the Consensus on Exercise Reporting Template (CERT) – PFMT.
All interventions were safe and effective at improving UI symptoms, yet only some were effective at improving QoL and PFM function. It appears the most effective protocols involve exercise characteristics aimed at increasing strength, hypertrophy, and coordination using muscle physiology training principles of duration and load, performed three times per day over twelve weeks. These programs also include elements of progression, motivation, adherence, and education.
2. Caitlin Broger
“Completing the capstone project in the final stages of the Masters course has allowed me to cohesively apply a broad range of skills developed over the past three years to an area of pelvic health that is still in the early stages of rollout in my workplace. Investigating vaginal pessary use has broadened both my understanding and my awareness of senior hospital management decision-making, and how to advocate for evidence-based conservative management options. A new pessary service will provide a sustainable and effective treatment option for a broad population of women suffering from prolapse. It will also support medical practitioners not currently able to offer this cost-effective device for women, whilst enhancing my clinical satisfaction in the workplace.”
Caitlin completed a clinic-based quality improvement project for her capstone subject:
Supporting Pessary Care
Pessaries are part of the best-practice care of women with symptomatic pelvic organ prolapse which affects 10-20% of Australian women. These vaginal support devices should be offered in a variety of sizes and shapes to be optimised to a woman’s vaginal prolapse anatomy and lifestyle choices including sexual activity. However, local gynaecologists and women’s health physiotherapists in our Northern Sydney local health network believe many prolapse care providers lack sufficient pessary stock and training to optimise pessary provision. Local practitioners reported strong desire to complete further education and expand pessary offerings, with peer-reviewed literature supporting further training to reduce risks for both patients and healthcare providers.
Subsequent quality improvement project development involved creation of a context-specific webinar-based training program: Supporting Pessary Care, targeted to prolapse care providers. Education was evidence-based, with active learning strategies employed to build knowledge on optimal pessary care and develop local referral pathways.
A systematic evaluation of the pilot program supported achievement of the primary outcome of improving providers perceived and actual pessary knowledge. Qualitative data supported the education format and webinar content inclusion. The project will lead to increased support for women suffering from POP through increased practitioner awareness of evidence-based care.