Is there a case for direct PT intervention in the acute postpartum phase? After c-section?
Answer
On the bedside, I would say absolutely that women can benefit from intervention on the bedside. This is an acute abdominal surgery. Providing them with an abdominal binder, teaching them about how to assess the health of their incision, how to monitor the incision, and how to start beginning contracting the abdominal muscles. Yes, the had a C-section, but they can still contract the abdominal muscles? Can they perform isometric contractions? Letting them know that after six weeks there should be no more pain and that the scar should move normally. Teaching them huffing, the bridge and twist is possible. All those things can be performed on the bedside. Unfortunately in the acute hospital environment, you don't get any extra reimbursement for more physical therapy, so there needs to be a philosophical support for intervention for pregnant and postpartum women from a leadership level.
Cynthia Neville, PT, DPT, WCS, BCB-PMD
Dr. Cynthia (Cindy) Neville, PT, DPT, WCS is Assistant Professor of Physical Therapy, Mayo Clinic Alix College of Medicine, in Jacksonville, Florida. She is a Women’s Health Certified Specialist (WCS), board certified by the American Board of Physical Therapy Specialties. She serves on the faculty of the Mayo Clinic Florida Orthopedic Physical Therapy Residency Program, and advises multiple medical specialty programs at Mayo Clinic Florida. Her outpatient clinical practice at Mayo Clinic Florida serves women and men with pelvic floor disorders. Dr. Neville has authored and co-authored several research articles and book chapters on the topics of pelvic health rehabilitation, pelvic pain, and urinary incontinence. She has presented her research and provided rehabilitation and medical education nationally and internationally. She has developed successful Pelvic and Women’s Health Rehabilitation Programs at premier healthcare organizations including the Rehabilitation Institute of Chicago (now the Shirley Ryan Ability Lab) and Mayo Clinic Florida. At Brooks Rehabilitation in Jacksonville, Dr. Neville developed the first institutional pelvic health rehabilitation program across all levels of care, and the first credentialed physical therapy women’s health residency program in the state of Florida. She has trained more than a thousand physical therapists, occupational therapists, physical therapist assistants, and physicians in pelvic floor examination and pelvic health rehabilitation.
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