DPT DPT Women's Health & Pelvic Floor Rehabilitation 1 — Questions and Answers
Question 1: Which muscle group forms the primary support structure of the pelvic floor and is targeted in pelvic floor rehabilitation?
- Levator ani muscle group (Correct answer)
- Iliopsoas
- Gluteus maximus
- Transversus abdominis alone
Correct answer: Levator ani muscle group
The levator ani (pubococcygeus, iliococcygeus, puborectalis) forms the primary muscular hammock of the pelvic floor supporting pelvic organs.
Question 2: Stress urinary incontinence is best defined as:
- Involuntary urine leakage with increased intra-abdominal pressure activities like coughing or sneezing (Correct answer)
- A strong urge to void that cannot be suppressed
- Continuous urine leakage due to an overfull bladder
- Leakage caused by neurological dysfunction
Correct answer: Involuntary urine leakage with increased intra-abdominal pressure activities like coughing or sneezing
Stress UI occurs when intra-abdominal pressure exceeds urethral closure pressure, typically during physical stress such as coughing, sneezing, or exercise.
Question 3: A patient is 6 weeks postpartum with a grade II cystocele. Which intervention is most appropriate as a first-line PT treatment?
- Pelvic floor muscle training targeting levator ani strength and coordination (Correct answer)
- High-intensity plyometric exercise
- Abdominal crunches to increase core stability
- Immediate return to running program
Correct answer: Pelvic floor muscle training targeting levator ani strength and coordination
First-line treatment for cystocele involves pelvic floor muscle training to improve support and reduce prolapse symptoms before progressing activity.
Question 4: During pregnancy, the hormone relaxin primarily affects physical therapy management by:
- Increasing ligamentous laxity, requiring modification of joint loading activities (Correct answer)
- Strengthening pelvic ligaments for delivery
- Reducing muscle tone to prevent cramps
- Increasing bone mineral density
Correct answer: Increasing ligamentous laxity, requiring modification of joint loading activities
Relaxin loosens ligaments and joints throughout the body during pregnancy, increasing injury risk and requiring careful activity modification.
Question 5: Which assessment tool is commonly used by pelvic floor PTs to grade pelvic floor muscle strength on internal examination?
- Modified Oxford Scale (0–5) (Correct answer)
- Manual Muscle Testing (0–5 MMT)
- Dynamometry
- Surface EMG only
Correct answer: Modified Oxford Scale (0–5)
The Modified Oxford Scale grades pelvic floor muscle contraction from 0 (no contraction) to 5 (strong lift against resistance) via internal vaginal palpation.
Question 6: Diastasis recti abdominis (DRA) is most accurately diagnosed by assessing:
- Inter-recti distance (IRD) at the linea alba using ultrasound or palpation (Correct answer)
- Abdominal muscle strength via sit-up test
- Lumbar lordosis angle
- Hip flexor tightness
Correct answer: Inter-recti distance (IRD) at the linea alba using ultrasound or palpation
DRA is defined by a widened inter-recti distance at the linea alba, typically measured by ultrasound imaging or calibrated finger-width palpation.
DPT DPT Women's Health & Pelvic Floor Rehabilitation 1
Which muscle group forms the primary support structure of the pelvic floor and is targeted in pelvic floor rehabilitation?