1. Improving the Pelvic Floor: What is possible in the older person and how do you do it?

2. Physiotherapy is an evidenced based profession

3. Evidence for Pelvic Floor Muscle Training (PFMT) in the Elderly Not a lot of it!!! Difficulty with chronological age Length of studies average 8 weeks Small sample sizes

4. 5 th International Consultation on Incontinence: “there is no reason to suspect that interventions proven to be effective in the management of community dwelling older people should not be effective in the frail elderly and that such interventions should not be withheld for reasons of age alone.”

5. So….. what can be done with the pelvic floor muscles of the older person??? ….exactly the same as what can be done for the younger person!!

6. Anatomy

8. Roles of the Pelvic Floor Muscles Bladder function: continence : urgency Bowel function: fullness : continence : solid / liquid / gas

9. Roles of the Pelvic Floor Muscles con’t: Support the pelvic organs Sexual role (Guide baby during vaginal delivery)

10. Correct Pelvic Floor Contraction

11. Correct Pelvic Floor Contraction con’t… Muscles that stop the flow of urine Muscles that lift the penis

12. Correct Pelvic Floor Contraction con’t: Squeeze and lift

14. Pelvic Floor Contraction con’t… 2 ways of contracting the pelvic floor muscles: Fast contractionsSlow contractions BOTH ARE IMPORTANT !!

15. Pelvic Floor Strengthening Program How long hold? How many at that hold in a row ? (while breathing) How many no hold? 3s 2 8 3 TIMES A DAY !!! 3s x 2 x 8

16. Let’s empower our clients/patients/residents NOT to be like the bats!! Teach them to exercise the pelvic floor muscles