Training of Physical Therapists in Pelvic Floor Techniques: Is Care Available in the Rural Midwest?

Introduction: The number of patients affected by pelvic floor disfunction is predicted to continue to grow in the future. Pelvic floor physical therapy (PFPT) is a benign, first-line treatment for a variety of pelvic disorders. There is currently a failure rate estimated at 19.8 percent for this conservative therapy. The present study aims to investigate if the high failure rate of conservative treatment is due to a lack of training and availability of therapists in the rural health care setting.

Methods: An anonymous survey was distributed to 53 physical therapists who practice within a targeted rural healthcare setting. Questions were designed to determine training received in graduate and post-graduate courses in PFPT while gauging level of involvement of PFPT within their practice. Proportions were calculated and then analyzed independently for standard deviation, standard error, and 80 percent confidence intervals.

Results: This project had a 45 percent response rate. 58 percent of these therapists received less than 2 hours of didactics in PFPT, and only 29 percent of the participants had a lab included in their graduate school curriculum. 95 percent of the participants attended additional post-graduate training in PFPT. The average number of courses attended was 3.33. Participants who stated that their training included hands-on training in female and/or male external and internal physical exam was 91.6 percent.

Conclusion: This study identified only 53 providers in this rural healthcare region who are not receiving adequate training in PFPT during graduate school. Therapists have to seek post-graduate courses in order to be prepared to provide these services to patients.