[TEST] This two-and-a-half day class is the next step for therapists those who focus on the pediatric pelvic floor patient population. It is designed to expand your knowledge of development of normal bowel patterns in children, introduce the new Rome IV criteria (Zeevenhoovenet al. 2017), and review the anatomy and physiology of the GI system with emphasis pediatric Functional Gastrointestinal Disorders (FGID).

According to van den Berg et al, up to 30 percent of children suffer from constipation and account for approximately 3% to 5% of all visits to pediatricians. Early intervention can avoid stool-withholding patterns with worsening constipation leading to prolonged bowel issues into adulthood (Chase, Lewina, 2017) with psychosocial consequences.

This course will delve into the most common types of functional constipation and tests and measures used to assess it. Special emphasis on constipation with coexistence of fecal incontinence (Nurko, Scott. 2011) and the psychological effects of these disorders will also be presented.

Additionally, participants who have not yet been trained will learn external and internal anorectal PFM evaluation of the pediatric perineum. Indications for rectal balloon training and determining the appropriate patient will be instructed with lab. Functional defecatory positions for breathing and PFM relaxation, manual therapy techniques of the abdominal wall and viscera will be taught. Video demonstrations of pediatric patients are also presented. Treatment techniques and progressions, including management of supplements and dietary influences will be discussed.

This course is appropriate for physical therapists, occupational therapists, pediatric nurse practitioners and medical doctors.

Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.

Prerequisites:

This course is available to pelvic health physical therapists interested in expanding their practice as well as pediatric therapists. It requires Pediatric Pelvic Floor Dysfunction and Incontinence live class. Participants should also have a basic knowledge of biofeedback and pelvic floor muscle anatomy.

What to Bring:

For the lab please bring TheraBand medium resistance 4-5 feet long and 10 cuff pound weight or equivalent.
Be sure to wear loose fitting pants for external PFM palpation. Jeans and tight fitting yoga pants are not acceptable.

References: Zeevenhooven, J, Koppen I, Benninga, M. The new Rome IV criteria for functional gastrointestinal disorders in infants and toddlers. Pediatric gastroenterology, Hepatology and Nutrition. January 2017.
Nurko S, Scott S. Coexistence of constipation and incontinence of children and adults. Best practice & research Clinical gastroenterology. 2011;25(1):29-41. doi:10.1016/j.bpg.2010.12.002.
van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol 2006; 101:2401.
Loening-Baucke V. Prevalence, symptoms and outcome of constipation in infants and toddlers. J Pediatr 2005; 146:359.
Chase J, Lewina S. childhood incontinence and pelvic floor muscle function; can be learned from adult research? JPUrol (2017) 13, 94-101