Occupational Therapy intervention of male pelvic floor should not follow a "cookbook " method, since all individuals are unique and may present with various symptoms. The therapist should make the occupational therapy intervention client-centered and tailored to meet the client's specific goals and needs.
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Intervention Approaches
There are various intervention approaches used in occupational therapy, including prevention, maintenance, modification, establishment or restoration, creation or promotion, and advocacy. These approaches are not intended to be used in isolation; they are combined to meet client needs.
Below are some interventions that can be utilized with various Pelvic floor dysfunction & symptoms associated with pelvic dysfunction:
Education to Client/ Caregiver
Education to Client/ Caregiver
Educate clients on condition/ symptom pathology
Educate on Plan of Care (POC)
Educate on the daily treatment plan and rehabilitation expectations
Educate on Empowerment and session control
Education on Environmental modification following home/ work assessment
"Squatty Potty" - to promote anorectal angle
donut cushion for post Prostatectomy
Education on proper body mechanics
bowel and bladder movement
Sitting
Physical Agent Modalities (PAMs)/ Preparatory activities
Physical Agent Modalities (PAMs)/ Preparatory activities
Moist Heat Packs (mhP)
Used to increase circulation and promote healing. Increased blood flow increases soft-tissue elasticity and promotes extensibility before stretch, thereby allowing more permanent soft-tissue elongation, improving joint movement, and reducing joint stiffness. Heat may also be used to relieve muscle spasms and decrease pain (Pendleton & Schultz-Krohn, 2018).
It can be used with open wounds, but exercise caution.
Contraindications: Acute inflammatory conditions of joints or skin, sensory losses, impaired vascular structures, and malignancies. (Pendleton & Schultz-Krohn, 2018)
Cyrotherapy
Cold therapy is often used to treat edema, pain, and inflammation. Cold induces vasoconstriction, thereby reducing blood flow to injured tissues. Cold reduces muscle spasms by reducing firing from afferent muscle spindles (Pendleton & Schultz-Krohn, 2018).
Cryotherapy is contraindicated in patients with cold intolerance, sensory disturbances, and/or vascular repair.
Covered by a towel to prevent tissue injury/ damage (Pendleton & Schultz-Krohn, 2018).
CardioVascular Activity
Manual Therapy
Manual Therapy
Adhesion reduction
Myofascial release
Soft Tissue Mobilization (STM)
Scar tissue
Massage
Mobilization
Visceral Mobilization
Colon Massage: helpful in promoting awareness of body regions and body "signals" as well as restoring the motility function of the colon (Mason, 2023; Fekri et al., 2021)
Musculoskeletal Mobilization
Joint Mobilization
Nerve release
Behavioral Re-Education
Behavioral Re-Education
Bowel + Bladder Training
Diaries+ routines
Toileting positioning
Breathing strategies
Box breathing
Lifestyle modifications
Avoid Just in Case
Urge Drills
Functional Movement
Intra-abdominal pressure management
Continent transfers
Home/ Community mobility
ADL/IADLs: Dressing, lifting, exercise, item retrieval
Self-care
Nutrition+ sleep
Pain/ stress management
Energy conservation
Toileting Hygiene aids
Mental Health/Relaxation Techniques
Mental Health/Relaxation Techniques
Cognitive Behavioral Therapy for ADLs/IADLs
Nervous system regulation
Box/diaphragmatic breathing
Guided Imagery
Body Scanning
Tai Chi
Orient (dropping the Anchor) (5,4,3,2,1)
Perception
Positive Self-talk/ Image
Practice
Meditation + Mindfulness
Relaxation Techniques
Yoga Routines
Yoga Asanas are useful for promoting awareness of breath and relaxation rather than tensing the body globally, and for directing attention to the pelvic region (2023)
reduction of pelvic pain, depression, and anxiety (Cramer et al., 2018; Nag and Kodali, 2013; Saxena et al., 2017)
Restorative yoga postures (asanas) may be used to calm, center, and reduce pelvic pain (2023)
Stress Response training
Psychoeducation
Resource education
Lifestyle: Light Exposure, Nutrition, Sleep, Movement
Nuero-Reducation
Nuero-Reducation
Downtraining
Uptraining
Biofeedback: use of instrumentation to provide visual or auditory signals that indicate some change in a biological process, such as skin temperature, as it occurs. Signals increase the client's awareness of these changes so that the changes may come under voluntary control. Biofeedback assumes that a maladaptive physiological response causes pain (Padrettis)
Interoception training
Motor Sensory Awareness Training
Neural Guides
Sexual Health
Sexual Health
Adaptive Equipment
Lubrication
Penetration bumper
Neuro re-education
Preparatory Techniques
Positioning training
Body Awareness and arousal process
Educating on Safe Sex Practices
Occupational Therapy Sexual Assessment Framework (SAF)
Home Exercise Program/ Exercise Programs
Home Exercise Program/ Exercise Programs
HEP2GO is a site that allows therapists to build and customize their home exercise program based on client needs and progression.
Posture education
Stretching/ lengthening
Strengthening
Core and slute strengthening will support pelvic (Dodson,
Coordination
Graded exposure
Interoceptive + Sensory
Energy Conservation
Trauma-Informed Care
Trauma-Informed Care
Case Study
Case Study
John (They/Them) is a 40-year-old who enjoys swimming, cycling, and gardening, engaging in the activities3-4 times a week. John is a Human Resources manager who works from home and sits for extended periods. John presents to the occupational therapy services due to experiencing leaking and wetting undergarments/clothes following urination (Post-Void Dribble). They state the symptoms have taken a toll on their engagement in social & leisure activities as they are scared of going to a social event and wetting themselves and not being at home to change clothes. John currently does not wear pads. John's goal is to return to leisure engagement in activities at the level prior to symptom onset.
-Utilize concepts gained throughout the previous pages to identify assessments you would utilize with John.
- What intervention would you implement with John and why?
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