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Pelvic Physiotherapy in the Netherlands, not only for women
– Reported, June 08, 2013
Furthermore guidelines are being developed for faecal incontinence, treatment of total anal rupture, treatment
of lichen and planus sclerosis and two multidisciplinary guidelines on the treatment of incontinence in elderly patients and women. Guidelines are becoming more and more living documents, updated quickly whenever new evidence has become available.
Electronic Patient Record (Personal Health Record)
To register and follow the treatment and results of a patient an Electronic Patient Record especially suited for pelvic physiotherapy has been developed. This contains not only items concerning the patients personal administration, but also the patient interview and history, physical examination, validated questionnaires, therapy, interventions and treatment goals, treatment program and outcomes.
Maintaining quality
The pelvic physiotherapists are registered in the so-called Central Register for Quality of the Royal Dutch Association for Physical Therapy. In 2011 there are more than 430 registered pelvic physiotherapists practising their profession in the Netherlands. Almost all are af? liated as members to the Dutch Association of Pelvic Physiotherapy (NVFB). The registered Pelvic Physiotherapists are obliged to maintain there quality by means of life long learning through anticipating in educational courses, congresses, symposia, meetings, etc. The quality of all post degree education is audited and accredited by an independent board of the KNGF. Education Pelvic physiotherapy is a specialism within the ?eld of physiotherapy in the Netherlands. The education is a 3 year master degree programme and one can only be enrolled after successful completion of their bachelor physiotherapy diploma. Pelvic physiotherapy in the Netherlands is internationally renowned for its high standard. The program has a strong focus on evidence based and clinical based diagnostics and treatment, skills training, ?eld experience and (applied) research. Furthermore, aspects like professional attitude, patient/therapist dynamics and emotional integrity are strong focal points within the program.Pelvic physiotherapy for both men and women, young and old. Pelvic physiotherapy is often solely associated with the treatment of female incontinence. However the scope of pelvic physiotherapy in the Netherlands is much broader. Clients are both male and female, from children to the elderly. Apart from urinary incontinence pelvic physiotherapists also see clients with faecal incontinence, urge incontinence, dif?culty in expelling urine and/or faeces, urogenital prolapse, abdominal pain, pain in the pelvic ?oor and in the genitalia or prostate (chronic pelvic pain syndrome, CPPS).
Also sexual disorders, such as vaginism, vulvodynia, dyspareunia pelvic physiotherapist will ? rstly carry out a screening to detect any contra-indications for pelvic physiotherapy treatment. A report is sent to the general physician.
How does the Dutch Health Care system works?
Every Dutch citizen has to have a standard health insurance by law. People can supplement their standard insurance although the standard covers a fairly broad range health services. Physiotherapy however is covered in supplemental insurance packages. Since January 2011, pelvic physiotherapist for urinary incontinence is covered in the standard insurance for a total of 9 treatments.
Pre- and postnatal care
The Dutch Association of Pelvic Physiotherapy (NVFB) has also developed an evidence-based preventive product for pregnant women. This product is registered under the name NVFBZwangerFit® and offers (pelvic)physiotherapists a program geared towards pre- and postnatal women. This program contains stateof-the-art knowledge regarding pelvic pain, exercise physiology and pelvic ?oor dysfunctions in relation to pregnancy. Through the expert guidance of a quali?ed NVFB-ZwangerFit® instructor the participants of the program are guided in the prevention of pelvic(?oor) dysfunction. This in order to feel good, be active and fully participate before and directly after their maternity leave.
Scienti?c development
Pelvic physiotherapy is performed on the principles of evidence based and/or consensus/clinical based practice. There is a growing and erectile dysfunction having a relation to the pelvic ?oor are diagnosed and treated. Furthermore pregnancy related pelvic pain and lower back pain are treated by a pelvic physiotherapist. Finally, pelvic physiotherapists commonly treat pre- and post operative patients in relation to surgical procedures in the lower abdomen and pelvic region.
Different roles of the pelvic physiotherapist
Pelvic physiotherapists play a role in all levels of the health care in the Netherlands. Many work in the private sector, having their own practice. A smaller number work in a hospital or rehabilitation centre. All university hospitals have pelvic physiotherapists working, mostly involved in research.A number of pelvic physiotherapists participate in specialized pelvic ?oor centres in hospitals and are strongly linked to multidisciplinary pelvic ?oor teams.
Referral needed?
Patients can be referred for diagnosis and therapy by general practitioners and other clinicians working in the pelvic ?oor ? eld. Patients whom are referred by a physician are required to have appropriate referral notice.
Consultation
To determine if there is an indication for pelvic physiotherapy treatment physicians can utilize a pelvic physiotherapy consult. After the diagnostic process the physician receives a written report with the test outcomes. The decision to subsequently start pelvic physical therapy treatment lays with the designated physician.
Direct Access Physical Therapy (DTF)
In the Netherlands patients no longer require a referral to make use of pelvic physiotherapy. Through the consumer website www.defysiotherapeut.com patients can view all registered pelvic physiotherapists. When a patient visits a pelvic physiotherapist through direct access the pelvic physiotherapist will ?rstly carry out a screening to detect any contra-indications for pelvic physiotherapy treatment. A report is sent to the general physician.
CREDITS.
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