Abstract:

Introduction:
During last years, we observe a transformation of the paradigm in the field of women’s health: physical prevention and treatment during pregnancy and after delivery, in gynecological conditions and diseases.

Objective:
Our goal was to introduce an electronic module on the topic “Physical modalities in the field of Obstetrics and Gynecology” and to test the interest of potential workers in the field: students in physiotherapy and in midwifery – during their university education, and in the post-educational preparation of medical doctors – residents during the specialization in “Physical and Rehabilitation medicine (PRM)”.

Methodology:
We decided to prepare an electronic educational module on this topic, to introduce it in the education and to test the interest of potential professionals in this area.
We prepared electronic educational materials, including the potential of physical modalities for prevention and treatment of conditions in Obstetrics and Gynecology, as: physical activity, analytic exercises, relaxing massage and soft-tissue techniques, lymphatic drainage and LPG endermology, transcutaneous electroneurostimulation (TENS), ultrasound, deep oscillation; climatotherapy at the seaside and the mountain; hydro-, balneo and thalassotherapy; peloidotherapy, etc. Concerning the future mothers, we emphasized on the kinesiological analysis of the musculo-skeletal and articular changes during pregnancy, during and after delivery; about the movements of the sacro-iliac joints; about different respiration techniques. For the period of pregnancy, we emphasized on muscle imbalance, reduced passive joint stability, pregnancy-related lumbo-pelvic pain, pelvic floor muscles dysfunction, urinary incontinence. We formulated principles of antenatal education of pregnant women – for correct posture and movements, recommendations for basic physical activity and specific analytic exercises for training of muscles stabilizing the pelvis and the truncus, for prevention of back pain and oedemas in lower extremities.
For the period after delivery and for patients after gynecological operations, we presented basic pelvic floor muscle exercises (Kegels), and analytic exercises for training of abdominal muscles. We emphasized on the necessity of training the muscles of the pelvic floor in cases of urinary incontinence – during the post-natal period and after gynecological surgical interventions. We included the physical prevention in patients with premenstrual syndrome and dysmenorrhea, climax and post-climacteric conditions, chronic non-specific inflammations of the genitals, obstructions of the Eustachian tubes and sterility, and others. For these patients, we included information about particular electrotherapeutic methods, specific balneo-therapeutic and peloido-therapeutic techniques, etc.

Materials:
We prepared a detailed questionnaire, testing the level of interest of students in Physiotherapy (course 4) and in Nursing (course 4), and the interest of medical doctors – residents in PRM. At the end of the educational module, we evaluated the level of competence in the field of our students and trainees.

Results:
The obtained results demonstrated the efficacy of the educational module and the significant level of interest of the responders.

Conclusion:
Based on the analysis of this increasing interest in the field, we decided to develop a full educational module on the topic “Physical modalities in the field of Obstetrics and Gynecology”.

Keywords:

Physical prevention, physical therapy, rehabilitation, pregnancy, gynecology, lumbo-pelvic pain, urinary incontinence, Kegels.