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Biofeedback for Pelvic Muscle Dysfunction Satellite Lab Course

This article is contributed by faculty members Tiffany Lee and Jane Kaufman. Their course, Biofeedback for Pelvic Floor Muscle Dysfunction, is scheduled for December 4-5, 2021 provides a safe space for clinicians to learn and practice this valuable tool.

Rarely do practitioners see a topic so argued in pelvic rehabilitation as the use of surface EMG biofeedback. There are practitioners who boldly state they are for or against it on their social media accounts and clinic pages. Therapists are not questioning the use of biofeedback with neurologic or orthopedic applications, so why is it such a polarizing topic in pelvic health? The Pelvic Rehab Report sits down with faculty members Tiffany Lee and Jane Kaufman to discuss the tool they love. This month they published a Special Issue article in the Biofeedback Journal for the Association for Applied Psychophysiology and Biofeedback. These two instructors have over 50 years of combined experience using biofeedback.(*)

Biofeedback provides visual and auditory feedback of muscle activity and is a non-invasive technique that allows patients to adjust muscle function, strength, and behaviors to improve pelvic floor function. The small electrical signal (EMG) provides information about an unconscious process and is presented visually on a computer screen, giving the patient immediate knowledge of muscle function, enabling the patient to learn how to alter the physiological process through verbal and visual cues.  Jane Kaufman explains that "many patients gain knowledge and awareness of the pelvic floor muscle through tactile feedback, but the visual representation is what helps patients to hone in on body awareness and connect all the dots." Muscle evaluation through digital exam offers strength but does not appropriately address electrical activity such as resting tone, ability to recruit or release tone in the muscle.  The use of biofeedback addresses the specificity of muscle contraction and release offering an additional view of muscle function. 

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Laura Rowan OT L
Lindsey Vestal MS OT

This week The Pelvic Rehab Report sat down with some of our favorite Occupational Therapists to discuss the role of OTs in the field of pelvic rehabilitation. The following blog is provided by Tiffany Ellsworth Lee MA, OTR, BCB-PMD, PRPC, Lindsey Vestal, MS, OT, and Laura Rowan OT/L.

Most people associate pelvic health with PTs- so many are surprised to see OTs in this specialty. Herman and Wallace faculty and instructor Tiffany Ellsworth Lee MA, OTR, BCB-PMD, PRPC, LPF-CT has been an OT for 28 years and has spent the last 20 years specializing in pelvic health. She recalls, “My first Herman and Wallace course was PF1 11 years ago. I was the only OT in a class of 50. I was so appreciative of H&W’s foresight to include OTs in the course offerings. A PT sat down next to me and said, “Why are you here? I didn’t know OTs could treat pelvic health!” Yes, we can! It is within our scope of practice and the majority of therapist specialized learning comes post-graduation.

Lindsey Vestal, OTR/L has been an OT for 11 years and her private practice focuses on pre and postnatal people. She is a moderator of the Facebook group “OTs for Pelvic Health” with over 3,100 members. She is bringing awareness to the PH specialty by educating OTs on the best way to treat and collaborate with PTs and other providers in the field. She says, “ Just as OTs and PTs work side-by-side in other fields of rehab, there's a huge need for us to work collaborating in pelvic health. In grad school, OTs study motivational interviewing, nonverbal communication, we have mental health classes and a strong background in sensory approaches, energy conservation, self-regulation strategies, the involvement of the nervous system, time management, working with trauma, habits, routines, ADLs, the musculoskeletal system, functional movement, and activity grading. Pelvic floor function is a crucial part of a much broader functional task of toileting and intimacy, both of which have broader connections within a person’s emotional, cognitive, and social abilities. It's also important to consider the social implications for people with pelvic floor issues such as withdrawal from social and recreational activities, social isolation, disempowerment, lack of self-esteem, anxiety, depression, and the impact on close relationships such as with our spouse, our friends, and our children. This OT-specific background has given me a great foundation to serve my PF population.”

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Tiffany Ellsworth Lee MA, OTR, BCB-PMD joined the Herman & Wallace faculty to teach a course on biofeedback along with Jane Kaufman, PT, M.Ed, BCB-PMD. The month of April is Occupational Therapy month, and we are celebrating by highlighting the role that Occupational Therapists play in pelvic floor rehabilitation. Tiffany founded a biofeedback program at Central Texas Medical Center in San Marcos in 2004, and currently runs her a pelvic rehab private practice .

Working in this area of biofeedback is extremely rewarding and fulfilling to help change peoples’ lives. I have a private practice now exclusively dedicated to treating patients with pelvic floor dysfunction. I became involved in working with patients with incontinence and pelvic floor disorders because of many opportunities along my career path. I have been an Occupational Therapist since 1994. Both of my parents are also OTs, so I think I was born to do this!

Erica Vitek, MOT, OTR, BCB-PMD, PRPC wrote a blog recently about the role of OTs in pelvic health. She writes:

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Upcoming Continuing Education Courses

Pelvic Floor Level 1 - Self-Hosted

Jan 22, 2022 - Jan 23, 2022
Location: Self-Hosted Course

Pelvic Floor Level 1 - New York City, NY Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: KNOSIS Center for Physiotherapy & Wellness

Pelvic Floor Level 1 - Birmingham, AL Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: TherapySouth

Pelvic Floor Level 1 - Kirkland, WA Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: Evergreen Health

Pelvic Floor Level 1 - Virginia Beach, VA Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: Ivy Rehab (Virginia Beach, VA)

Male Pelvic Floor - Shelby, NC Satellite Location

Jan 22, 2022 - Jan 23, 2022
Location: Ivy Rehab Physical Therapy (Shelby, NC)

Pelvic Floor Level 1 - Des Plaines, IL Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: Team Rehabilitation (Des Plaines)

Pelvic Floor Level 1 - Cranford, NJ Satellite Location

Jan 22, 2022 - Jan 23, 2022
Location: Ivy Rehab Physical Therapy (Cranford, NJ)

Pelvic Floor Level 1 - Kerrville, TX Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: Peterson Regional Medical Center

Male Pelvic Floor - Las Vegas, NV Satellite Location

Jan 22, 2022 - Jan 23, 2022
Location: Action Therapeutics LLC

Pelvic Floor Level 1 - Torrance, CA Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: Women's Advantage Inc

Male Pelvic Floor - Self-Hosted

Jan 22, 2022 - Jan 23, 2022
Location: Self-Hosted Course

Pelvic Floor Level 1 - Syracuse, NY Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: Onondaga Physical Therapy

Restorative Yoga for Physical Therapists - Remote Course

Jan 22, 2022 - Jan 23, 2022
Location: Replacement Remote Course

Pelvic Floor Level 1 - Salt Lake City, UT Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: Utah Physical Therapy

Pelvic Floor Level 1 - Decatur, GA Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: Kemper Pelvic Physiotherapy

Pelvic Floor Level 1 - Chico, CA Satellite Location (SOLD OUT)

Jan 22, 2022 - Jan 23, 2022
Location: Enloe Rehabilitation Center

Pelvic Floor Level 2B - Annapolis, MD Satellite Course (SOLD OUT)

Jan 29, 2022 - Jan 30, 2022
Location: Lynch Physical Therapy

Oncology of the Pelvic Floor Level 1 - Remote Course

Jan 29, 2022 - Jan 30, 2022
Location: Replacement Remote Course

Postpartum Rehabilitation - Remote Course

Jan 29, 2022 - Jan 30, 2022
Location: Replacement Remote Course

Pelvic Floor Level 2B - Tampa, FL Satellite Course (SOLD OUT)

Jan 29, 2022 - Jan 30, 2022
Location: Bloom Pelvic Therapy

Pelvic Floor Level 2B - Lansdale, PA Satellite Course

Jan 29, 2022 - Jan 30, 2022
Location: Ivy Rehab (Lansdale, PA)

Pelvic Floor Level 2B - Shelby, NC Satellite Course

Jan 29, 2022 - Jan 30, 2022
Location: Ivy Rehab Physical Therapy (Shelby, NC)

Pelvic Floor Level 2B - El Paso, TX Satellite Course

Jan 29, 2022 - Jan 30, 2022
Location: Border Physical Therapy

Pelvic Floor Level 2B - Tullahoma, TN Satellite Course

Jan 29, 2022 - Jan 30, 2022
Location: TOP Rehab

Pelvic Floor Level 2B - South Jordan, UT Satellite Course

Jan 29, 2022 - Jan 30, 2022
Location: South Jordan Health Center

Pelvic Floor Level 2B - Self-Hosted

Jan 29, 2022 - Jan 30, 2022
Location: Self-Hosted Course

Coccydynia and Painful Sitting - Remote Course

Feb 4, 2022
Location: Short Form Remote Course

Athletes & Pelvic Rehabilitation - Remote Course

Feb 5, 2022 - Feb 6, 2022
Location: Replacement Remote Course