While completing her PhD studies in Ireland, Ruth Maher, PT, PhD, DPT, WCS, was shocked to discover one in three women suffer from stress urinary incontinence. This condition causes urinary leakage during laughing, coughing, sneezing and exercise. Though the condition is common, Maher emphasized that it is not normal to leak urine.
“Many of my friends had this condition postpartum,” she said. Most, she added, didn't know what to do about it and they are not alone as the Journal of the American Medical Association reports only about a quarter of women affected seek care from a healthcare provider. Urinary incontinence also affects 45% of women athletes.
“The burden associated with this condition goes far beyond the cost of pads as medical and psychological morbidity, in addition to the quality of life, is profoundly affected for women of all ages. I wanted to do something to educate women about the importance of pelvic floor health across the lifespan and provide an in-home treatment solution,” Maher added.
This desire led Maher to develop a novel device for the treatment of stress urinary incontinence. The device—INNOVO—is a pair of shorts with embedded neuromuscular electrical stimulation. The award-winning invention, Maher explained, uses multipath technology to improve the strength and coordination of the pelvic floor musculature in an effort to ablate the symptoms. Maher’s recent research also shows that using INNOVO for five minutes teaches women how to perform the appropriate pelvic floor contraction.
Now, in her research work at PCOM Georgia and as professor and chair of the Department of Physical Therapy, Maher is using ultrasound imaging technology to further investigate the condition and is working to develop non-invasive interventions that can be used at home to treat the condition. She has integrated hands-on ultrasound imaging experiences into the curriculum so students can learn with the latest portable and wireless ultrasound technology.
During the fall term of their second year, students work in small groups to image a variety of anatomical structures and observe joint motion in an ultrasound imaging lab. During Physical Therapy month in October, Maher solicits student volunteers who are interested in pelvic health and provides them with additional education on pelvic floor dysfunction, which includes how to use ultrasound imaging as an assessment and educational tool in PT practice.
“Students receive several hours of supervised hands-on training using portable ultrasound imaging devices to assess pelvic floor function,” Maher said. “This culminates in offering an annual pro bono pelvic floor screening to our PCOM community.”
Maher hopes to offer this screening to the local community—Suwanee, Georgia—in the near future.
Meanwhile, her focus is ensuring students in the physical therapy program have the opportunity to expand their skills in this area. Results of a survey Maher conducted of her students showed 100% of respondents (97% response rate) agreed that ultrasound was an innovative tool that allowed them to observe musculoskeletal components statically and during dynamic movement. Of those respondents, 94% agreed that ultrasound imaging stimulated their interest, enhanced their assessment skills of all structures imaged, and that the ultrasound units were easy to use.
According to Maher, the additional survey comments were extremely supportive of ultrasound with many students sharing how ultrasound improved their understanding of clinical anatomy and kinesiological principles during dynamic tasks.
As a result, Maher and associate professor Jennifer Wiley, PT, DHSc, DPT, developed an elective course—Musculoskeletal Ultrasound Imaging—focused on the further integration of ultrasound in physical therapy program instruction. In the course, students use state-of-the-art portable wireless ultrasound units. Working in pairs, the students created a portfolio of images for the course using a manual.
While the average time lag between when research translates into practice is 17 years (Hanney et al.), PCOM Georgia Doctor of Physical Therapy students do not have to wait that long to be exposed to findings such as those from Maher’s research.
“In fact, students are involved as participants or investigators in many of the projects,” Maher said.
The research work, she said, is extremely rewarding.
“It's also great to translate my research into the classroom so our DPT students can learn about it before it's presented/published,” Maher added.
Visit the curriculum and course sequence page to learn how the Doctor of Physical Therapy program at PCOM Georgia prepares students to excel in the practice of physical therapy through classroom and clinical experiences.
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