{"id":6485,"date":"2023-06-11T16:13:09","date_gmt":"2023-06-11T16:13:09","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/an-overview-of-physiotherapy-assessment-and-treatment-of-the-pelvic-floor-fr\/"},"modified":"2023-06-11T16:13:09","modified_gmt":"2023-06-11T16:13:09","slug":"an-overview-of-physiotherapy-assessment-and-treatment-of-the-pelvic-floor-fr","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/fr\/an-overview-of-physiotherapy-assessment-and-treatment-of-the-pelvic-floor-fr\/","title":{"rendered":"Un aper\u00e7u de l&rsquo;\u00e9valuation et du traitement du plancher pelvien en physioth\u00e9rapie"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\"> <b>\u00c9diteur original <\/b>&#8211; <a href=\"\/User:Jess_Bell\" title=\"User:Jess Bell\">Jess Bell<\/a> \u00e0 partir d&rsquo;un cours d&rsquo;<a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/members.physio-pedia.com\/course_tutor\/ibukun-afolabi\/\">Ibukun Afolabi<\/a><br \/>\n<b>Principaux contributeurs<\/b>  &#8211;  <a href=\"\/User:Jess_Bell\" class=\"mw-userlink\" title=\"User:Jess Bell\"><bdi>Jess Bell<\/bdi><\/a>,  <a href=\"\/User:Kim_Jackson\" class=\"mw-userlink\" title=\"User:Kim Jackson\"><bdi>Kim Jackson<\/bdi><\/a>,  <a href=\"\/User:Tarina_van_der_Stockt\" class=\"mw-userlink\" title=\"User:Tarina van der Stockt\"><bdi>Tarina van der Stockt<\/bdi><\/a>,  <a href=\"\/User:Carin_Hunter\" class=\"mw-userlink\" title=\"User:Carin Hunter\"><bdi>Carin Hunter<\/bdi><\/a> et <a href=\"\/User:Nupur_Smit_Shah\" class=\"mw-userlink\" title=\"User:Nupur Smit Shah\"><bdi>Nupur Smit Shah<\/bdi><\/a><\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input type=\"checkbox\" role=\"button\" id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display:none\"><\/p>\n<div class=\"toctitle\" lang=\"en\" dir=\"ltr\">\n<h2 id=\"mw-toc-heading\">Contenu<\/h2>\n<p><span class=\"toctogglespan\"><label class=\"toctogglelabel\" for=\"toctogglecheckbox\"><\/label><\/span><\/p>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Introduction\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Introduction<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Clinic_Environment\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">L&rsquo;environnement clinique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-3\"><a href=\"#The_Initial_Assessment\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">L&rsquo;\u00e9valuation initiale<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-4\"><a href=\"#Subjective_Evaluation\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">L&rsquo;\u00e9valuation subjective<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-5\"><a href=\"#Objective_Evaluation_of_the_External_Body\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">L&rsquo;\u00e9valuation objective du corps en externe <\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-6\"><a href=\"#Objective_Evaluation_of_the_Pelvic_Floor\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">L&rsquo;\u00e9valuation objective du plancher pelvien <\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-7\"><a href=\"#Treatment\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">Le traitement<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-8\"><a href=\"#Specific_Bladder_and_Bowel_Retraining_Techniques\"><span class=\"tocnumber\">8<\/span> <span class=\"toctext\">Techniques sp\u00e9cifiques de r\u00e9\u00e9ducation v\u00e9sicale et intestinale <\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-9\"><a href=\"#Urinary_Incontinence\"><span class=\"tocnumber\">8.1<\/span> <span class=\"toctext\">Incontinence urinaire<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#Overactive_Bladder\"><span class=\"tocnumber\">8.2<\/span> <span class=\"toctext\">Vessie hyperactive<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-11\"><a href=\"#Constipation\"><span class=\"tocnumber\">8.3<\/span> <span class=\"toctext\">Constipation<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-12\"><a href=\"#Resources_-_Pelvic_Physiotherapy_Special_Interest_Groups\"><span class=\"tocnumber\">9<\/span> <span class=\"toctext\">Ressources &#8211; Groupes d&rsquo;int\u00e9r\u00eat sp\u00e9cialis\u00e9s en physioth\u00e9rapie p\u00e9rin\u00e9ale<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-13\"><a href=\"#References\"><span class=\"tocnumber\">10<\/span> <span class=\"toctext\">R\u00e9f\u00e9rences<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span class=\"mw-headline\" id=\"Introduction\">Introduction<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=1\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Introduction\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=1\" title=\"Edit section: Introduction\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Cette page a pour but de fournir une introduction \u00e0 l&rsquo;\u00e9valuation et au traitement physioth\u00e9rapeutique du plancher pelvien. Veuillez noter qu&rsquo;il est n\u00e9cessaire de suivre une formation compl\u00e9mentaire aupr\u00e8s d&rsquo;une soci\u00e9t\u00e9 d&rsquo;\u00e9ducation \u00e0 la sant\u00e9 pelvienne r\u00e9put\u00e9e avant d&rsquo;essayer les techniques pr\u00e9sent\u00e9es dans cette page. Voir la section Ressources au bas de cette page pour des liens vers des groupes d&rsquo;int\u00e9r\u00eat sp\u00e9cialis\u00e9s dans la sant\u00e9 pelvienne et f\u00e9minine.<\/p>\n<h2><span class=\"mw-headline\" id=\"Clinic_Environment\">L&rsquo;environnement de la clinique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=2\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinic Environment\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=2\" title=\"Edit section: Clinic Environment\">\u00e9diter la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Avant d&rsquo;aborder l&rsquo;\u00e9valuation et le traitement des patientes souffrant de troubles au niveau pelvien, il est utile d&rsquo;examiner l&rsquo;environnement dans lequel se d\u00e9rouleront les s\u00e9ances. Dans la mesure du possible, il est important d&rsquo;\u00eatre attentif \u00e0 l&rsquo;environnement clinique, car il a \u00e9t\u00e9 d\u00e9montr\u00e9 que le cadre du traitement a un impact sur les r\u00e9sultats de sant\u00e9 d&rsquo;un patient.<sup id=\"cite_ref-:6_1-0\" class=\"reference\"><a href=\"#cite_note-:6-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:7_2-0\" class=\"reference\"><a href=\"#cite_note-:7-2\">(2)<\/a><\/sup><sup id=\"cite_ref-:0_3-0\" class=\"reference\"><a href=\"#cite_note-:0-3\">(3)<\/a><\/sup> L&rsquo;environnement physique peut aider un client \u00e0 se sentir d\u00e9tendu, en s\u00e9curit\u00e9 et habilit\u00e9 ou, au contraire, \u00e0 se sentir stress\u00e9, menac\u00e9 et tendu.<sup id=\"cite_ref-:2_4-0\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4) <\/a><\/sup><sup id=\"cite_ref-:1_5-0\" class=\"reference\"><a href=\"#cite_note-:1-5\">(5)<\/a><\/sup> Par exemple :<\/p>\n<ul>\n<li>Il a \u00e9t\u00e9 d\u00e9montr\u00e9 que la lumi\u00e8re du jour et les fen\u00eatres r\u00e9duisent la fatigue et la d\u00e9pression. Si ce n&rsquo;est pas possible, des plantes d&rsquo;int\u00e9rieur, des aquariums ou des \u0153uvres d&rsquo;art sur un th\u00e8me nature peuvent contribuer \u00e0 r\u00e9duire le stress <sup id=\"cite_ref-:0_3-1\" class=\"reference\"><a href=\"#cite_note-:0-3\">(3) <\/a><\/sup><sup id=\"cite_ref-:1_5-1\" class=\"reference\"><a href=\"#cite_note-:1-5\">(5)<\/a><\/sup><\/li>\n<li>Les couleurs utilis\u00e9es peuvent \u00e9galement avoir un impact : <sup id=\"cite_ref-:1_5-2\" class=\"reference\"><a href=\"#cite_note-:1-5\">(5)<\/a><\/sup>\n<ul>\n<li>Le bleu et le vert peuvent favoriser la relaxation et l&rsquo;\u00e9quilibre<\/li>\n<li>Le jaune et l&rsquo;orange peuvent dynamiser ou activer un espace<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Pour plus d&rsquo;informations fond\u00e9e sur des donn\u00e9es probantes au sujet de la conception d&rsquo;un espace ad\u00e9quat dans les \u00e9tablissements de soins de sant\u00e9, veuillez consulter les articles suivants :<\/p>\n<ul>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/1937586719900885\">Environmental needs, barriers, and facilitators for optimal healing in the postoperative process: a qualitative study of patients&rsquo; lived experiences and perceptions<\/a><sup id=\"cite_ref-:6_1-1\" class=\"reference\"><a href=\"#cite_note-:6-1\">(1)<\/a><\/sup><\/li>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0360132312001758\">A review of the impact of physical environmental factors on users<\/a><sup id=\"cite_ref-:7_2-1\" class=\"reference\"><a href=\"#cite_note-:7-2\">(2)<\/a><\/sup><\/li>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.minnesotamedicine.com\/clinical-health-affairs\/creating-optimal-healing-environments-in-a-health-care-setting\/\">Creating optimal healing environments in a health care setting<\/a><sup id=\"cite_ref-:0_3-2\" class=\"reference\"><a href=\"#cite_note-:0-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<p>La cr\u00e9ation d&rsquo;un environnement propice \u00e0 la gu\u00e9rison peut \u00eatre particuli\u00e8rement importante pour les clientes des services de sant\u00e9 f\u00e9minine, car celles-ci peuvent pr\u00e9senter des traumatismes, de la honte, de la g\u00eane ou d&rsquo;autres \u00e9motions li\u00e9es \u00e0 leur \u00e9tat.<sup id=\"cite_ref-:2_4-1\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<h2><span class=\"mw-headline\" id=\"The_Initial_Assessment\">L&rsquo;\u00e9valuation initiale <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=3\" class=\"mw-editsection-visualeditor\" title=\"Edit section: The Initial Assessment\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=3\" title=\"Edit section: The Initial Assessment\">\u00e9diter la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Avant l&rsquo;\u00e9valuation initiale, il peut \u00eatre utile de recueillir quelques informations initiales sur votre patient en lui envoyant d&rsquo;abord :<sup id=\"cite_ref-:2_4-2\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<ul>\n<li>Formulaires et questionnaires<\/li>\n<li>Mesures de r\u00e9sultats valid\u00e9es<\/li>\n<li>Inventaires psychosociaux<\/li>\n<\/ul>\n<p>Il existe de nombreuses mesures des r\u00e9sultats rapport\u00e9s par le patient pour les dysfonctionnements du plancher pelvien. Elles peuvent \u00eatre utilis\u00e9es pour : <sup id=\"cite_ref-6\" class=\"reference\"><a href=\"#cite_note-6\">(6)<\/a><\/sup><\/p>\n<ul>\n<li>D\u00e9pister des affections<\/li>\n<li>D\u00e9terminer l&rsquo;impact de ces conditions sur la qualit\u00e9 de vie d&rsquo;un individu<\/li>\n<li>\u00c9valuer l&rsquo;efficacit\u00e9 d&rsquo;un traitement<\/li>\n<li>D\u00e9terminer si une personne est satisfaite d&rsquo;un traitement<\/li>\n<\/ul>\n<p>Le consortium pour les troubles du plancher pelvien <sup id=\"cite_ref-:8_7-0\" class=\"reference\"><a href=\"#cite_note-:8-7\">(7)<\/a><\/sup> a constat\u00e9 que les mesures de r\u00e9sultats suivantes peuvent \u00eatre utiles :<\/p>\n<ul>\n<li>Pour \u00e9valuer la gravit\u00e9 de l&rsquo;incontinence f\u00e9cale, le score de Cleaveland ou <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.researchgate.net\/figure\/Cleveland-Clinic-Florida-Fecal-Incontinence-Score-CCFFIS_tbl4_311677789\">Cleveland Clinic Florida Incontinence Score<\/a> et le <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.semanticscholar.org\/paper\/Does-the-St.-Mark%E2%80%99s-Incontinence-Score-Reflect-A-of-Maeda-Pares\/e87710847198be092a826d3eb2519ca13fb074a7\">score d&rsquo;incontinence de St. Mark<\/a> peuvent \u00eatre utilis\u00e9s ensemble<\/li>\n<li>pour \u00e9valuer la gravit\u00e9 de la constipation. Le Score PAC ou <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.dovepress.com\/cr_data\/article_fulltext\/s32000\/32684\/img\/DDDT-32684-T03.png\">Patient Assessment of Constipation<\/a> et le score de s\u00e9v\u00e9rit\u00e9 de la constipation <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.semanticscholar.org\/paper\/The-Constipation-Severity-Instrument%3A-A-Validated-Varma-Wang\/37565336421cbac35156c56ee736596738587387\">Constipation Severity Instrument<\/a> peuvent \u00eatre utilis\u00e9s conjointement<\/li>\n<li>Pour \u00e9valuer l&rsquo;incontinence \u00e0 l&rsquo;effort et l&rsquo;incontinence par regorgement, la version abr\u00e9g\u00e9e de l&rsquo;inventaire de d\u00e9tresse urog\u00e9nitale &#8211; <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.thecalculator.co\/health\/Urogenital-Distress-Inventory-Short-Form-(UDI-6)-Calculator-1127.html\">Urogenital Distress Inventory Short Form (UDI-6)<\/a> peut \u00eatre utilis\u00e9e (version finale de l&rsquo;outil IMPACT combin\u00e9 discut\u00e9 par Bordeianou et al. <sup id=\"cite_ref-:8_7-1\" class=\"reference\"><a href=\"#cite_note-:8-7\">(7)<\/a><\/sup>)<\/li>\n<li>La version abr\u00e9g\u00e9e de l&rsquo;inventaire de d\u00e9tresse du plancher pelvien &#8211; <a href=\"\/Pelvic_Floor_Distress_Inventory_(PFDI_-_20)\" title=\"Pelvic Floor Distress Inventory (PFDI - 20)\">Pelvic Floor Distress Inventory (PFDI &#8211; 20)<\/a>, qui figure \u00e9galement dans la version finale de l&rsquo;outil IMPACT, peut \u00eatre utilis\u00e9e pour d\u00e9terminer l&rsquo;impact des dysfonctionnements de l&rsquo;intestin et de la vessie, ainsi que des sympt\u00f4mes de prolapsus des organes pelviens.<\/li>\n<\/ul>\n<p>Pour plus d&rsquo;informations sur ces mesures de r\u00e9sultats, veuillez consulter l&rsquo;article complet <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/journals.lww.com\/fpmrs\/fulltext\/2020\/01000\/measuring_pelvic_floor_disorder_symptoms_using.1.aspx\">ici<\/a>.<\/p>\n<h2><span class=\"mw-headline\" id=\"Subjective_Evaluation\">L&rsquo;\u00e9valuation subjective <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=4\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Subjective Evaluation\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=4\" title=\"Edit section: Subjective Evaluation\">\u00e9diter la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Comme pour toute s\u00e9ance de physioth\u00e9rapie, vous devez d&rsquo;abord proc\u00e9der \u00e0 une \u00e9valuation subjective. Au cours de cette \u00e9valuation, il est n\u00e9cessaire d&rsquo;\u00e9couter activement votre patiente et de comprendre les raisons pour lesquelles elle vient vous voir.<sup id=\"cite_ref-:2_4-3\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<p>Il a \u00e9t\u00e9 sugg\u00e9r\u00e9 que les techniques d&rsquo;entretien motivationnel pouvaient \u00eatre b\u00e9n\u00e9fiques pour les patients en physioth\u00e9rapie p\u00e9rin\u00e9ale. <sup id=\"cite_ref-8\" class=\"reference\"><a href=\"#cite_note-8\">(8)<\/a><\/sup> L&rsquo;entretien motivationnel est d\u00e9fini comme suit :<\/p>\n<blockquote><p><b>\u00ab\u00a0Un style de conversation collaboratif pour renforcer la motivation et l&rsquo;engagement d&rsquo;une personne \u00e0 changer. <\/b><sup id=\"cite_ref-9\" class=\"reference\"><a href=\"#cite_note-9\">(9)<\/a><\/sup><\/p><\/blockquote>\n<p>Il s&rsquo;agit d&rsquo;une intervention fond\u00e9e sur des donn\u00e9es probantes qui contribue \u00e0 encourager les changements de comportement en mati\u00e8re de sant\u00e9. Il a \u00e9t\u00e9 utilis\u00e9 dans des domaines tels que la perte de poids, le sevrage tabagique, la consommation d&rsquo;alcool et le contr\u00f4le de la glyc\u00e9mie. <sup id=\"cite_ref-10\" class=\"reference\"><a href=\"#cite_note-10\">(10)<\/a><\/sup> Il devient \u00e9galement de plus en plus populaire dans la pratique de la physioth\u00e9rapie. <sup id=\"cite_ref-11\" class=\"reference\"><a href=\"#cite_note-11\">(11)<\/a><\/sup> Pour en savoir plus sur l&rsquo;entretien motivationnel, cliquez <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/members.physio-pedia.com\/motivational-interviewing\/\">ici<\/a>.<\/p>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/6t3tU8-OA1M?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-12\" class=\"reference\"><a href=\"#cite_note-12\">(12)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/s3MCJZ7OGRk?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-13\" class=\"reference\"><a href=\"#cite_note-13\">(13)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<p>D&rsquo;autres techniques peuvent \u00eatre utiles au cours de l&rsquo;\u00e9valuation subjective : <sup id=\"cite_ref-:2_4-4\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<ul>\n<li>Poser des questions ouvertes<\/li>\n<li>Faire preuve de curiosit\u00e9 et d&rsquo;ouverture d&rsquo;esprit dans ses questions<\/li>\n<li>Faire un retour vers le patient et r\u00e9sumer ce qui a \u00e9t\u00e9 dit<\/li>\n<li>\u00c9couter sans juger<\/li>\n<li>S&rsquo;efforcer de comprendre les objectifs et ce que le succ\u00e8s signifierait pour la patiente<\/li>\n<li>S&rsquo;enqu\u00e9rir de l&rsquo;impact qu&rsquo;a l&rsquo;\u00e9tat de sant\u00e9 de la patiente sur sa vie, son travail, ses relations, ses \u00e9motions, etc<\/li>\n<li>Poser des questions sur les th\u00e9ories de la patiente afin de mieux comprendre ses croyances sur sa condition<\/li>\n<\/ul>\n<p>\u00c9tablir un bon rapport, cultiver la confiance et le sentiment de s\u00e9curit\u00e9 et permettre \u00e0 la patiente de se sentir \u00e9cout\u00e9e sont des objectifs cl\u00e9s de l&rsquo;\u00e9valuation initiale<sup id=\"cite_ref-:2_4-5\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<h2><span class=\"mw-headline\" id=\"Objective_Evaluation_of_the_External_Body\">L&rsquo;\u00e9valuation objective du corps en externe <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=5\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Objective Evaluation of the External Body\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=5\" title=\"Edit section: Objective Evaluation of the External Body\">\u00e9diter la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&rsquo;\u00e9valuation externe vous aide \u00e0 comprendre comment les syst\u00e8mes ou structures plus \u00e9tendus peuvent \u00eatre li\u00e9s au dysfonctionnement du plancher pelvien. Cela peut \u00e9galement contribuer \u00e0 renforcer la confiance de votre patiente dans la mani\u00e8re dont vous manipulez son corps.<\/p>\n<p>Bien qu&rsquo;il ne soit pas possible de tout faire en une seule s\u00e9ance, vous pouvez choisir d&rsquo;\u00e9valuer : <sup id=\"cite_ref-:2_4-6\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<ul>\n<li>Alignement<\/li>\n<li><a href=\"\/Posture\" title=\"Posture\">Posture<\/a><\/li>\n<li>Patrons de mouvements<\/li>\n<li><a href=\"\/Breathing_Pattern_Disorders\" title=\"Breathing Pattern Disorders\">Strat\u00e9gies de respiration<\/a><\/li>\n<li><a href=\"\/Lumbar_Assessment#Objective\" title=\"Lumbar Assessment\">Aspect neurologique<\/a><\/li>\n<li><a href=\"\/Abdominal_Muscles\" title=\"Abdominal Muscles\">Fonction de la paroi abdominale<\/a><\/li>\n<li>Visc\u00e8res abdominaux<\/li>\n<li>Mouvements et amplitude de mouvement de la colonne vert\u00e9brale, des hanches et du bassin<\/li>\n<li>Force et endurance musculaires<\/li>\n<li><a href=\"\/Assessment_and_Treatment_of_the_Thoracic_Spine\" title=\"Assessment and Treatment of the Thoracic Spine\">Thorax<\/a><\/li>\n<li><a href=\"\/Introduction_to_Myofascial_Pain\" title=\"Introduction to Myofascial Pain\">Qualit\u00e9 myofasciale<\/a><\/li>\n<li>Cicatrices externes<\/li>\n<li>Syst\u00e8me de pression<\/li>\n<li>Strat\u00e9gies de contr\u00f4le moteur<\/li>\n<li>Fonction des muscles du plancher pelvien (par voie externe)<\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Objective_Evaluation_of_the_Pelvic_Floor\">L&rsquo;\u00e9valuation objective du plancher pelvien <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=6\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Objective Evaluation of the Pelvic Floor\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=6\" title=\"Edit section: Objective Evaluation of the Pelvic Floor\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Veuillez noter que chaque pays ou \u00c9tat dispose de r\u00e8gles et de r\u00e9glementations diff\u00e9rentes concernant les personnes habilit\u00e9es \u00e0 effectuer un examen interne. De nombreux domaines requi\u00e8rent une formation post-universitaire sp\u00e9cifique. Veillez \u00e0 vous familiariser avec les r\u00e9glementations et exigences en vigueur dans votre r\u00e9gion avant de proc\u00e9der \u00e0 un examen interne et assurez-vous d&rsquo;avoir suivi la formation n\u00e9cessaire. <\/p>\n<p>Selon Abe-Takahashi et al, <sup id=\"cite_ref-14\" class=\"reference\"><a href=\"#cite_note-14\">(14)<\/a><\/sup> la m\u00e9thode la plus courante pour \u00e9valuer les muscles du plancher pelvien est la p\u00e9n\u00e9tration vaginale digitale, qui sera examin\u00e9e ci-dessous.<\/p>\n<p>D&rsquo;autres m\u00e9thodes existent :<sup id=\"cite_ref-:2_4-7\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<ul>\n<li>L&rsquo;\u00e9chographie en temps r\u00e9el : une technique s\u00e9curitaire, simple, bon march\u00e9 et facilement accessible <sup id=\"cite_ref-15\" class=\"reference\"><a href=\"#cite_note-15\">(15)<\/a><\/sup> qui peut \u00eatre utilis\u00e9e pour \u00e9valuer les contractions du plancher pelvien <sup id=\"cite_ref-16\" class=\"reference\"><a href=\"#cite_note-16\">(16)<\/a><\/sup><\/li>\n<li>Le p\u00e9rin\u00e9om\u00e8tre : un outil simple, peu invasif et peu co\u00fbteux utilis\u00e9 pour mesurer les changements de pression dans le vagin apr\u00e8s une contraction volontaire des muscles du plancher pelvien. <sup id=\"cite_ref-:3_17-0\" class=\"reference\"><a href=\"#cite_note-:3-17\">(17)<\/a><\/sup><\/li>\n<\/ul>\n<p>Avant d&rsquo;\u00e9valuer le plancher pelvien, vous devez discuter avec votre patiente de l&rsquo;objectif de l&rsquo;examen et lui expliquer ce qu&rsquo;il implique, y compris les risques, les avantages et les alternatives, afin d&rsquo;obtenir un <a href=\"\/Informed_Consent\" title=\"Le consentement \u00e9clair\u00e9\">consentement \u00e9clair\u00e9<\/a>. Votre patiente pourrait choisir de refuser une \u00e9valuation interne.<sup id=\"cite_ref-:2_4-8\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/nrt7SqoUSZ4?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-18\" class=\"reference\"><a href=\"#cite_note-18\">(18)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/6VDe8kI2W5c?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-19\" class=\"reference\"><a href=\"#cite_note-19\">(19)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<p>Si votre patiente accepte une \u00e9valuation interne, vous devez l&rsquo;inviter \u00e0 vous faire part de ce qu&rsquo;elle ressentira.<\/p>\n<p>Posez des questions sur : <sup id=\"cite_ref-:2_4-9\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<ul>\n<li>La reproduction des sympt\u00f4mes<\/li>\n<li>La douleur<\/li>\n<li>La sensation de pression<\/li>\n<li>La sensibilit\u00e9<\/li>\n<li>Le patron de r\u00e9f\u00e9rence des sympt\u00f4mes<\/li>\n<\/ul>\n<p>Avant l&rsquo;\u00e9valuation, pr\u00e9parez la table de traitement avec des draps, des gants et du lubrifiant. Il est important de donner \u00e0 votre patiente la possibilit\u00e9 d&rsquo;enlever ses sous-v\u00eatements en priv\u00e9.<sup id=\"cite_ref-:2_4-10\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<p>N&rsquo;oubliez pas de vous laver les mains avant de commencer l&rsquo;\u00e9valuation.<\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width:302px;\"><a href=\"\/File:Muscle_of_the_Female_Perineum.png\" class=\"image\"><img loading=\"lazy\" alt=\"\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/1\/14\/Muscle_of_the_Female_Perineum.png\/300px-Muscle_of_the_Female_Perineum.png\" decoding=\"async\" width=\"300\" height=\"247\" class=\"thumbimage\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/1\/14\/Muscle_of_the_Female_Perineum.png\/450px-Muscle_of_the_Female_Perineum.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/1\/14\/Muscle_of_the_Female_Perineum.png\/600px-Muscle_of_the_Female_Perineum.png 2x\" data-file-width=\"875\" data-file-height=\"720\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><a href=\"\/File:Muscle_of_the_Female_Perineum.png\" class=\"internal\" title=\"Enlarge\"><\/a><\/div>\n<p>Figure 1. Muscles du p\u00e9rin\u00e9e f\u00e9minin.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p><b>Pendant l&rsquo;\u00e9valuation, vous devez : <\/b><sup id=\"cite_ref-:2_4-11\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<ul>\n<li>Observer le p\u00e9rin\u00e9e, les muscles superficiels du plancher pelvien, la vulve, puis observer comment la cliente r\u00e9agit \u00e0 la palpation de ces <a href=\"\/Overview_of_Female_Pelvic_Floor_Muscle_Anatomy_and_Physiology\" title=\"Vue d'ensemble de l'anatomie et de la physiologie des muscles du plancher pelvien f\u00e9minin\">\u00e9l\u00e9ments superficiels du plancher pelvien<\/a>.<\/li>\n<li>Ex\u00e9cuter des tests actifs\n<ul>\n<li>Fournir des indices pour encourager l&rsquo;engagement du plancher pelvien (par exemple, \u00ab\u00a0essayez d&rsquo;arr\u00eater un jet imaginaire de pipi\u00a0\u00bb)<\/li>\n<\/ul>\n<\/li>\n<li>\u00c9valuer le <a href=\"\/Common_Women%27s_Pelvic_Health_Conditions#Pelvic_Organ_Prolapse\" title=\"Affections pelviennes courantes chez la femme\">prolapsus des organes pelviens<\/a>, le cas \u00e9ch\u00e9ant\n<ul>\n<li>Une discussion d\u00e9taill\u00e9e sur l&rsquo;examen et l&rsquo;\u00e9valuation du prolapsus des organes pelviens est disponible <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.intechopen.com\/chapters\/71493\">ici<\/a><\/li>\n<li>En cas de suspicion de prolapsus, un examen pelvien est n\u00e9cessaire pour d\u00e9terminer l&#8217;emplacement et l&rsquo;\u00e9tendue du prolapsus. L&rsquo;\u00e9valuation m\u00e9dicale est d\u00e9crite comme suit par Inglesia et al : <sup id=\"cite_ref-:4_20-0\" class=\"reference\"><a href=\"#cite_note-:4-20\">(20)<\/a><\/sup>\n<ul>\n<li>L&rsquo;ouverture vaginale et le corps p\u00e9rin\u00e9al sont observ\u00e9s pendant que la patiente effectue une <a href=\"\/Valsalva_Test\" title=\"Valsalva Test\">man\u0153uvre de Valsalva<\/a><\/li>\n<li>Un sp\u00e9culum est utilis\u00e9 pour \u00e9valuer l&rsquo;apex vaginal (col de l&rsquo;ut\u00e9rus) et la longueur du vagin est not\u00e9e<\/li>\n<li>La patiente est invit\u00e9e \u00e0 effectuer une nouvelle man\u0153uvre de Valsalva et le sp\u00e9culum est lentement retir\u00e9 afin d&rsquo;\u00e9valuer la descente apicale<\/li>\n<li>Les parois vaginales ant\u00e9rieure et post\u00e9rieure sont ensuite examin\u00e9es<\/li>\n<li>Des mesures peuvent \u00eatre not\u00e9es et le prolapsus peut \u00eatre class\u00e9 (c&rsquo;est-\u00e0-dire \u00e0 l&rsquo;aide de l&rsquo;\u00e9chelle <a href=\"\/Pelvic_Organ_Prolapse_Quantification_(POP-Q)_System\" title=\"Pelvic Organ Prolapse Quantification (POP-Q) System\">POP-Q<\/a>). <sup id=\"cite_ref-:4_20-1\" class=\"reference\"><a href=\"#cite_note-:4-20\">(20)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Introduire ensuite d\u00e9licatement un ou deux doigts dans l&rsquo;introitus et \u00e9valuez les tissus de l&rsquo;int\u00e9rieur, du plus superficiel au plus profond :\n<ul>\n<li>Tonus musculaire<\/li>\n<li>Spasme<\/li>\n<li>Structure<\/li>\n<li>Position<\/li>\n<li>R\u00e9ponse<\/li>\n<li>Qualit\u00e9 des tissus<\/li>\n<li>Texture des tissus<\/li>\n<li>Cicatrices<\/li>\n<li>Zones sensibles<\/li>\n<li>Avulsion partielle ou compl\u00e8te du muscle \u00e9l\u00e9vateur de l&rsquo;anus<\/li>\n<\/ul>\n<\/li>\n<li>\u00c9valuer la fonction musculaire\n<ul>\n<li>\u00c9valuer la r\u00e9activit\u00e9, l&rsquo;amplitude de mouvement, la force, l&rsquo;endurance et la coordination.<\/li>\n<li>Comparer les deux c\u00f4t\u00e9s<\/li>\n<li>Observer le recrutement des muscles accessoires<\/li>\n<li>\u00c9valuer l&rsquo;effet du Valsalva avec contraction du plancher pelvien<\/li>\n<\/ul>\n<\/li>\n<li>Il peut \u00eatre utile de v\u00e9rifier, par voie vaginale ou rectale, l&rsquo;impact de diff\u00e9rentes actions, telles que la respiration, la contraction du muscle <a href=\"\/Transversus_Abdominis\" title=\"Transversus Abdominis\">transverse de l&rsquo;abdomen<\/a> ou la toux, sur le plancher pelvien<\/li>\n<li>La force des muscles du plancher pelvien est \u00e9valu\u00e9e \u00e0 l&rsquo;aide de l&rsquo;\u00e9chelle d&rsquo;Oxford modifi\u00e9e : <sup id=\"cite_ref-:3_17-1\" class=\"reference\"><a href=\"#cite_note-:3-17\">(17) <\/a><\/sup><sup id=\"cite_ref-21\" class=\"reference\"><a href=\"#cite_note-21\">(21)<\/a><\/sup>\n<ul>\n<li>0 = pas de contraction<\/li>\n<li>1 = un d\u00e9but de contraction<\/li>\n<li>2 = une faible contraction<\/li>\n<li>3 = une contraction mod\u00e9r\u00e9e avec soul\u00e8vement<\/li>\n<li>4 = une bonne contraction avec soul\u00e8vement<\/li>\n<li>5 = une forte contraction avec soul\u00e8vement<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>La vid\u00e9o suivante pr\u00e9sente un examen du plancher pelvien. Pour en savoir plus, cliquez ici afin de vous rendre \u00e0 cette vid\u00e9o sur YouTube.<\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/b19x9AVCUgc?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-22\" class=\"reference\"><a href=\"#cite_note-22\">(22)<\/a><\/sup><\/p>\n<p>Lors d&rsquo;un examen interne, votre patiente est g\u00e9n\u00e9ralement couch\u00e9e avec les jambes fl\u00e9chies sur le dos ou sur le c\u00f4t\u00e9.<sup id=\"cite_ref-:2_4-12\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup> Toutefois, vous pouvez \u00e9galement \u00e9valuer des \u00e9l\u00e9ments sp\u00e9cifiques de la fonction des muscles du plancher pelvien en position debout.<sup id=\"cite_ref-:2_4-13\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4) <\/a><\/sup><sup id=\"cite_ref-23\" class=\"reference\"><a href=\"#cite_note-23\">(23)<\/a><\/sup> La position debout \u00e9tant plus fonctionnelle, elle permet de mieux comprendre le fonctionnement du plancher pelvien sous l&rsquo;effet de la gravit\u00e9 et d&rsquo;un port de charge.<\/p>\n<h2><span class=\"mw-headline\" id=\"Treatment\">Traitement<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=7\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Treatment\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=7\" title=\"Edit section: Treatment\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>La strat\u00e9gie de traitement doit \u00eatre li\u00e9e aux objectifs de la patiente et se concentrer sur ce qui est important pour elle. Cela peut contribuer \u00e0 encourager l&rsquo;engagement g\u00e9n\u00e9ral. Il est \u00e9galement important d&rsquo;encourager la patiente \u00e0 se sentir connect\u00e9e \u00e0 son corps et \u00e0 r\u00e9aliser qu&rsquo;elle a le pouvoir de changer son syst\u00e8me.<sup id=\"cite_ref-:2_4-14\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<p>Le traitement initial commence par la prise de conscience somatique et l&rsquo;augmentation de la conscience somatique. Cette strat\u00e9gie de reconnexion corps-esprit est importante car les femmes souffrant de troubles du plancher pelvien peuvent avoir une certaine \u00a0\u00bb d\u00e9connexion \u00a0\u00bb avec leur plancher pelvien. L&rsquo;\u00e9veil \/ la reconnexion du plancher pelvien est donc un point de d\u00e9part n\u00e9cessaire.<sup id=\"cite_ref-:2_4-15\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<p>Apr\u00e8s la reconnexion, il est possible de commencer \u00e0 recr\u00e9er un plancher pelvien souple, dynamique, flexible, sain, sans douleur, fort et r\u00e9sistant.<sup id=\"cite_ref-:2_4-16\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<p>Le traitement peut \u00eatre ax\u00e9 sur les \u00e9l\u00e9ments suivants : <sup id=\"cite_ref-:2_4-17\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<ul>\n<li>L&rsquo;\u00e9ducation<\/li>\n<li>L&rsquo;accroissement de la conscience somatique<\/li>\n<li>LA facilitation neuromusculaire<\/li>\n<li>L&rsquo;am\u00e9lioration de la biom\u00e9canique et des synergies pelviennes<\/li>\n<li>L&rsquo;am\u00e9lioration de la flexibilit\u00e9 et de la mobilit\u00e9 des muscles du plancher pelvien<\/li>\n<li>L&rsquo;augmentation de l&rsquo;endurance et de la force fonctionnelle<\/li>\n<li>Le r\u00e9entra\u00eenement int\u00e9gr\u00e9 des stabilisateurs centraux<\/li>\n<li>L&rsquo;enseignement de strat\u00e9gies de gestion de la pression<\/li>\n<li>La r\u00e9\u00e9ducation de la vessie et de l&rsquo;intestin<\/li>\n<li>Les techniques de th\u00e9rapie manuelle<\/li>\n<li>Le travail myofascial<\/li>\n<li>Le travail respiratoire<\/li>\n<li>L&rsquo;entra\u00eenement du contr\u00f4le moteur<\/li>\n<li>La r\u00e9gulation \u00e0 la baisse du syst\u00e8me nerveux<\/li>\n<li>La reprogrammation du cerveau (remappage)<\/li>\n<li>Les strat\u00e9gies de gestion de la douleur<\/li>\n<li>L&rsquo;acupuncture ou les aiguilles s\u00e8ches<\/li>\n<\/ul>\n<p>Il est important d&rsquo;adopter une optique bio-psycho-sociale et spirituelle lorsque l&rsquo;on travaille avec ces femmes. Explorer l&rsquo;influence de la sant\u00e9 \u00e9motionnelle, de la sant\u00e9 mentale, de la sant\u00e9 relationnelle et de la sant\u00e9 spirituelle sur la sant\u00e9 physique est essentiel pour ces patientes. Parall\u00e8lement, il est important de tenir compte de l&rsquo;interaction de facteurs tels que le sommeil, la nutrition, l&rsquo;hydratation et le mouvement, lorsque l&rsquo;on s&rsquo;efforce de r\u00e9tablir la sant\u00e9 pelvienne.<sup id=\"cite_ref-:2_4-18\" class=\"reference\"><a href=\"#cite_note-:2-4\">(4)<\/a><\/sup><\/p>\n<h2><span class=\"mw-headline\" id=\"Specific_Bladder_and_Bowel_Retraining_Techniques\">Techniques sp\u00e9cifiques de r\u00e9\u00e9ducation de la vessie et de l&rsquo;intestin <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=8\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Specific Bladder and Bowel Retraining Techniques\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=8\" title=\"Edit section: Specific Bladder and Bowel Retraining Techniques\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span class=\"mw-headline\" id=\"Urinary_Incontinence\">Incontinence urinaire <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=9\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Urinary Incontinence\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=9\" title=\"Edit section: Urinary Incontinence\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Les approches conservatrices de gestion de l&rsquo;incontinence urinaire incluent des modifications du comportement et du mode de vie, la r\u00e9\u00e9ducation du plancher pelvien et l&rsquo;utilisation de dispositifs m\u00e9caniques sp\u00e9cifiques.<sup id=\"cite_ref-:5_24-0\" class=\"reference\"><a href=\"#cite_note-:5-24\">(24)<\/a><\/sup><\/p>\n<p>Les techniques sp\u00e9cifiques incluent : <sup id=\"cite_ref-:5_24-1\" class=\"reference\"><a href=\"#cite_note-:5-24\">(24)<\/a><\/sup><\/p>\n<ul>\n<li><a href=\"\/Kegel%27s_Exercise_:_Females\" title=\"Kegel's Exercise : Females\">Les exercices de Kegel<\/a><\/li>\n<li>La stimulation \u00e9lectrique fonctionnelle qui peut \u00eatre un compl\u00e9ment utile \u00e0 la r\u00e9\u00e9ducation du plancher pelvien.<\/li>\n<li>Les c\u00f4nes vaginaux (sp\u00e9cifiquement pour l&rsquo;incontinence \u00e0 l&rsquo;effort)<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/l_PM-wN116Q?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-25\" class=\"reference\"><a href=\"#cite_note-25\">(25)<\/a><\/sup><\/p>\n<h3><span class=\"mw-headline\" id=\"Overactive_Bladder\">Vessie hyperactive <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=10\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Overactive Bladder\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=10\" title=\"Edit section: Overactive Bladder\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Le traitement initial de l&rsquo;hyperactivit\u00e9 v\u00e9sicale inclura une th\u00e9rapie pharmacologique, une r\u00e9\u00e9ducation de la vessie, des exercices du plancher pelvien et une modification du mode de vie. <sup id=\"cite_ref-26\" class=\"reference\"><a href=\"#cite_note-26\">(26)<\/a><\/sup> En particulier, l&rsquo;accent peut \u00eatre mis sur la modification des liquides, l&rsquo;\u00e9vitement des d\u00e9clencheurs potentiels et la r\u00e9\u00e9ducation de la vessie. <sup id=\"cite_ref-27\" class=\"reference\"><a href=\"#cite_note-27\">(27)<\/a><\/sup><\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/14OSCEA0Fgk?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-28\" class=\"reference\"><a href=\"#cite_note-28\">(28)<\/a><\/sup><\/p>\n<h3><span class=\"mw-headline\" id=\"Constipation\">Constipation<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=11\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Constipation\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=11\" title=\"Edit section: Constipation\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Il a \u00e9t\u00e9 constat\u00e9 que l&rsquo;utilisation d&rsquo;un tabouret de pied est une m\u00e9thode efficace pour encourager la d\u00e9f\u00e9cation chez les patients constip\u00e9s. Les patients doivent \u00e9galement \u00eatre encourag\u00e9s \u00e0 adopter une position dans laquelle le haut du corps est pench\u00e9 vers l&rsquo;avant.<sup id=\"cite_ref-29\" class=\"reference\"><a href=\"#cite_note-29\">(29)<\/a><\/sup><\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/QDk93cvZAuk?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-30\" class=\"reference\"><a href=\"#cite_note-30\">(30)<\/a><\/sup><\/p>\n<h2><span class=\"mw-headline\" id=\"Resources_-_Pelvic_Physiotherapy_Special_Interest_Groups\">Ressources &#8211; Groupes d&rsquo;int\u00e9r\u00eat sp\u00e9cialis\u00e9s en physioth\u00e9rapie p\u00e9rin\u00e9ale <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=12\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Resources - Pelvic Physiotherapy Special Interest Groups\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=12\" title=\"Edit section: Resources - Pelvic Physiotherapy Special Interest Groups\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ul>\n<li><b>Australie<\/b>\n<ul>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/australian.physio\/membership\/national-groups\/womens-mens-and-pelvic-health\">Australian Physiotherapy Association &#8211; Women&rsquo;s, Men&rsquo;s and Pelvic Health<\/a><\/li>\n<\/ul>\n<\/li>\n<li><b>Canada<\/b>\n<ul>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.womenshealthcpa.com\/\">Association canadienne de physioth\u00e9rapie &#8211; Sant\u00e9 des femmes<\/a><\/li>\n<\/ul>\n<\/li>\n<li><b>Nouvelle-Z\u00e9lande<\/b>\n<ul>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/pnz.org.nz\/pwmh\">Physiotherapy New Zealand &#8211; Pelvic Womens and Mens Health<\/a><\/li>\n<\/ul>\n<\/li>\n<li><b>Afrique du Sud<\/b>\n<ul>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.saphysio.co.za\/membership-groups\/special-interest-groups\/pelvic-womens-health-physiotherapy-group\/\">South African Society of Physiotherapists &#8211; Pelvic and Women&rsquo;s Health Physiotherapy Group<\/a><\/li>\n<\/ul>\n<\/li>\n<li><b>Royaume-Uni<\/b>\n<ul>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/thepogp.co.uk\/\">Pelvic Obstetric and Gynaecological Physiotherapy<\/a><\/li>\n<\/ul>\n<\/li>\n<li><b>\u00c9tats-Unis<\/b>\n<ul>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/aptapelvichealth.org\/\">American Physical Therapy Assocation &#8211; Pelvic health<\/a><\/li>\n<\/ul>\n<\/li>\n<li><b>World Physiotherapy<\/b>\n<ul>\n<li><a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/world.physio\/subgroups\/pelvic-womens-health\">International Organization of Physical Therapists in Pelvic and Women&rsquo;s Health (IOPTPWH)<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"References\">R\u00e9f\u00e9rences<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;veaction=edit&amp;section=13\" class=\"mw-editsection-visualeditor\" title=\"Edit section: References\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=An_Overview_of_Physiotherapy_Assessment_and_Treatment_of_the_Pelvic_Floor&amp;action=edit&amp;section=13\" title=\"Edit section: References\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-:6-1\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:6_1-0\">1.0<\/a><\/sup> <sup><a href=\"#cite_ref-:6_1-1\">1.1<\/a><\/sup><\/span> <span class=\"reference-text\">Hesselink G, Smits M, Doedens M, Nijenhuis SMT, van Bavel D, van Goor H et al. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/1937586719900885\">Environmental needs, barriers, and facilitators for optimal healing in the postoperative process: a qualitative study of patients&rsquo; lived experiences and perceptions<\/a>. HERD. 2020 Jul;13(3):125-39. <\/span><\/li>\n<li id=\"cite_note-:7-2\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:7_2-0\">2.0<\/a><\/sup> <sup><a href=\"#cite_ref-:7_2-1\">2.1<\/a><\/sup><\/span> <span class=\"reference-text\">Huisman ERCM, Morales E, van Hoof J, Kort HSM. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0360132312001758\">Healing environment: A review of the impact of physical environmental factors on users<\/a>. Building and Environment. 2012;58:70-80.<\/span><\/li>\n<li id=\"cite_note-:0-3\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_3-0\">3.0<\/a><\/sup> <sup><a href=\"#cite_ref-:0_3-1\">3.1<\/a><\/sup> <sup><a href=\"#cite_ref-:0_3-2\">3.2<\/a><\/sup><\/span> <span class=\"reference-text\">Zborowsky T, Kreitzer MJ. Creating optimal healing environments in a health care setting (Internet). Minnesota Medicine (cited 9 January 2022). Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.minnesotamedicine.com\/clinical-health-affairs\/creating-optimal-healing-environments-in-a-health-care-setting\/\">https:\/\/www.minnesotamedicine.com\/clinical-health-affairs\/creating-optimal-healing-environments-in-a-health-care-setting\/<\/a><\/span><\/li>\n<li id=\"cite_note-:2-4\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:2_4-0\">4.00<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-1\">4.01<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-2\">4.02<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-3\">4.03<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-4\">4.04<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-5\">4.05<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-6\">4.06<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-7\">4.07<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-8\">4.08<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-9\">4.09<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-10\">4.10<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-11\">4.11<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-12\">4.12<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-13\">4.13<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-14\">4.14<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-15\">4.15<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-16\">4.16<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-17\">4.17<\/a><\/sup> <sup><a href=\"#cite_ref-:2_4-18\">4.18<\/a><\/sup><\/span> <span class=\"reference-text\">Afolabi I. Physiotherapy Assessment and Treatment of the Pelvic Floor Course. Plus , 2022.<\/span><\/li>\n<li id=\"cite_note-:1-5\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:1_5-0\">5.0<\/a><\/sup> <sup><a href=\"#cite_ref-:1_5-1\">5.1<\/a><\/sup> <sup><a href=\"#cite_ref-:1_5-2\">5.2<\/a><\/sup><\/span> <span class=\"reference-text\">La Torre MA. Creating a healing environment. Perspectives in psychiatric care. 2006;42(4):262-4.<\/span><\/li>\n<li id=\"cite_note-6\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-6\">\u2191<\/a><\/span> <span class=\"reference-text\">Habashy E, Mahdy AE. Patient-reported outcome measures (PROMs) in pelvic floor disorders. 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