Treatments delivered by LSVT-certified clinicians consist of the following: Four LSVT-LOUD or LSVT-BIG sessions a week, for four consecutive weeks Sessions are individual one-hour treatment sessions Daily homework practice (all 30 days of the month) Daily carryover assignments (all 30 days of the month) The goal is for patients to learn to use their “big movements” automatically, in everyday living. This will be a result of long term carry-over of the amplitude training. By maintaining larger movements, patients will move better with more confidence and safety. During the evaluation process, we will collect questions regarding

First, let me just say your evaluation is on your terms. If you are having symptoms that are likely due to a pelvic floor dysfunction: leaking, pain with sex, pelvic heaviness or pelvic organ prolapse; there are always other things going on as well. Posture, weakness, tightness, diet, stress, and body mechanics are all factors that contribute to what’s happening on the pelvic floor. Translation: I look at the entire body, not just the pelvic floor. ​ We are here to listen, without judgment, and discuss your story, history, and goals in order to design a treatment plan to meet your needs. ​ Medical History: During the evaluation process, your therapist will begin by asking you several questions to get a better idea of your pelvic floor experience. After a thorough review of your medical history, you’ll give information about your pelvic floor condition and the reason for seeking treatment. You will also go over details about your pelvic health and may be asked to fill out a questionnaire with specific questions related to bowel, bladder, and sexual function, lifestyle, including your goals for treatment. ​ Physical Assessment: Once we have collected and gone over all pertinent information with your Occupational Therapist, we will begin the physical assessment. This assessment will observe your posture, alignment, and how you move. Tests and measurements of balance, strength, flexibility, range of motion, sensation, and coordination may also take place. Tools that can be used include internal examination and biofeedback to help assess pelvic floor muscle function as well as abdominal and gluteal muscles. ​ Internal Exam: During muscle assessments, an internal exam may be warranted in order to assess internal muscle strength and coordination. First, the examination is explained verbally with visuals such as pictures and a pelvic floor model so you would know exactly what to expect. The therapist will talk you through the entire exam, allowing you to connect to your pelvic floor and work as a team throughout the process. Then in a lying down position, your external pelvic floor is assessed visually and tactilely. Looking for discoloration, movement during active contraction and relaxation, and bearing down of the pelvic floor. The external pelvic floor is then assessed for sensation and pain. The nervous system is then tested for normal reflexes with touch. Then using a water based lubricant, the internal examination begins. ​ This is done with 1-2 fingers based on comfort. Tissue is assessed for elasticity, pain and trigger points. Strength is tested with the patient doing active pelvic floor contractions and relaxations. Prolapse is assessed. Internal exams if tolerated are tested in supine and standing. Therapist may ask you to perform a lunge, squat or functional action to assess how the pelvic floor meets the demand of activity complied with gravity and intra-abdominal pressure. ​ Assessment: Depending upon findings and patient’s tolerance, treatment will also begin at that time. This could be education to correct a dysfunction, manual work to the painful or restricted areas of tension in the pelvic floor, postural training, and coordinating the pelvic floor work with breath and alignment. At the end of the assessment, a treatment plan is made with the patient for the goals moving forward.