DPT DPT Women's Health & Pelvic Floor Rehabilitation 2 — Questions and Answers
Question 1: Overactive bladder (OAB) with urge incontinence is best managed with which behavioral PT intervention?
- Bladder retraining with progressive voiding intervals and urge suppression techniques (Correct answer)
- Restricting all fluid intake
- Immediate pelvic floor strengthening only
- High-load resistance training
Correct answer: Bladder retraining with progressive voiding intervals and urge suppression techniques
Bladder retraining gradually increases voiding intervals while teaching urge suppression strategies, effectively reducing urgency and frequency in OAB.
Question 2: Which postpartum condition is characterized by pelvic girdle pain at the pubic symphysis with a palpable gap and pain on single-leg stance?
- Pubic symphysis diastasis (Correct answer)
- Sacroiliac joint dysfunction
- Hip labral tear
- Femoral stress fracture
Correct answer: Pubic symphysis diastasis
Pubic symphysis diastasis involves separation of the symphysis pubis, causing midline pubic pain and instability worsened by single-leg activities.
Question 3: A PT is treating a patient with vulvodynia and vaginismus. The most appropriate initial intervention is:
- Graded vaginal desensitization with dilators combined with pelvic floor down-training (Correct answer)
- Aggressive pelvic floor strengthening
- High-intensity ultrasound
- Immediate functional exercise
Correct answer: Graded vaginal desensitization with dilators combined with pelvic floor down-training
Vaginismus involves involuntary pelvic floor hypertonicity; treatment begins with desensitization, relaxation, and graded dilation rather than strengthening.
Question 4: Sacroiliac joint (SIJ) dysfunction is common in pregnancy. Which provocative test cluster has the highest sensitivity for SIJ pain?
- Posterior pelvic pain provocation test (P4/PPPP) combined with active straight leg raise (ASLR) (Correct answer)
- FABER test alone
- Thomas test
- Trendelenburg test
Correct answer: Posterior pelvic pain provocation test (P4/PPPP) combined with active straight leg raise (ASLR)
The combination of P4 and ASLR tests demonstrates the highest sensitivity and specificity for pregnancy-related posterior pelvic/SIJ pain.
Question 5: Which evidence-based intervention is most effective for stress urinary incontinence according to major clinical guidelines (APTA, ACOG)?
- Supervised pelvic floor muscle training (PFMT) for at least 3 months (Correct answer)
- Electrical stimulation alone
- Manual perineal massage only
- Biofeedback without exercise
Correct answer: Supervised pelvic floor muscle training (PFMT) for at least 3 months
Supervised PFMT for a minimum of 3 months is the first-line recommendation by APTA and ACOG for stress urinary incontinence with strong evidence.
Question 6: Lymphedema management after breast cancer treatment falls under women's health PT and primarily uses which treatment approach?
- Complete decongestive therapy (CDT): manual lymphatic drainage, compression, exercise, and skin care (Correct answer)
- High-intensity resistance training of the affected limb
- Heat application and elevation only
- TENS and ultrasound
Correct answer: Complete decongestive therapy (CDT): manual lymphatic drainage, compression, exercise, and skin care
CDT is the gold-standard multicomponent approach for lymphedema, combining manual drainage, compression bandaging, therapeutic exercise, and skin care.
DPT DPT Women's Health & Pelvic Floor Rehabilitation 2
Overactive bladder (OAB) with urge incontinence is best managed with which behavioral PT intervention?