Mora Pluchino is instructing her new course, Pediatric Pelvic Floor Play Skills, which is scheduled to debut on October 22, 2023. This short course is targeted to pelvic health providers looking for specific “child-oriented” treatment techniques for pediatric pelvic health patients. This class will cover some basic challenges and changes for a new or experienced pelvic health provider entering the realm of treating pediatric patients with pelvic floor diagnoses. Pediatric Pelvic Floor Play Skills is intervention focused and does not delve into specific pediatric diagnoses.

As an only child, I have lived my life working to be surrounded by children. From the age of 11 when I could take the Red Cross’s babysitter training, I worked as a mother’s helper, babysitter, and nanny. I never even had a “real” job until beginning my career as a physical therapist in 2009. Before I entered the world of treating pelvic floors, I was a physical therapist who spent the beginning years of my career caring for mostly pediatric and neurological patients. I was in charge of a pediatric program and helped with their specialty programs for kids including cardiopulmonary, feeding, and robotics.

Mora Pluchino is instructing her ethics course, Ethical Considerations from a Legal Lens, which is scheduled for June 3, 2023. This remote course covers ethical considerations from a legal lens for professionals working in the area of Pelvic Health. Health Care Professionals have many day-to-day ethical considerations to “do no harm” including basic decisions for billing, patient care, safety, and compliance. Pelvic Rehabilitation comes with additional layers of vulnerability and ethical challenges, and the legalities of pelvic health can add further complications for patient care, business, and clinical practice decisions.

The patient is a 70 cis-gender female:

• Primary complaints - Painful sitting, terrible tailbone pain x 2 years
• Secondary complaints - SUI, fecal urgency, mild POP
• Prior therapy - multiple, most recent Hospital Based OPPT 3 x per week x 8 weeks (24 visits)
• Progress - minimal to none, the patient actually thinks her symptoms are worsening, pain is unbearable
• Other diagnoses - Parkinson’s Disease, HTN, high cholesterol
• Primary Insurance - Medicare

SEPTEMBER
The patient presents to the provider for specialized pelvic floor therapy. The patient is seen 1 x per week for a total of 6 visits. The patient reports a 75% reduction in symptoms, adheres to her HEP, and attends all scheduled visits.

What is a TA? In the world of the Herman & Wallace Pelvic Rehabilitation Institute, a TA is an abbreviation for teaching assistant. Herman & Wallace has always had teaching assistants (TAs) at lab courses to guide hands-on lab time to be extra hands and helpers for the instructors. Having exemplary instructors and the addition of more people on the teaching team in the room to answer questions, guide, and give clinical pearls is what creates the optimal learning experience through Herman & Wallace.

During COVID, the demand for quality pelvic health education was still high, but COVID limited travel and group gatherings. The Institute was able to pivot and reformat some courses into fully remote offerings. This allowed continuing education to continue but did not answer the question of the core series of pelvic floor courses and all of the other course offerings. This required some creativity. Some labs could be taught virtually, but some educational topics and skills could not be covered without in-person, hands-on learning in which participants got to practice on real bodies..The next pivot was to create a hybrid model of learning, in which some didactic skills were reformatted into pre-recorded content, and the labs were offered in smaller satellites around the country. Herman & Wallace had always been a leader in education because of the hands-on skills provided and learned during in-person labs. The question arose, who would help guide them and be the “boots on the ground” for lab skills?

Mora Pluchino, PT, DPT, PRPC (Faculty member, and Sr. TA) is a graduate of Stockton University with a BS in Biology (2007) and a Doctorate of Physical Therapy (2009). Mora authored and instructs Ethical Concerns for Pelvic Health Professionals and Ethical Considerations from a Legal Lens.

When I used to hear the word “ethics requirement,” I would wrinkle my nose and find the cheapest, quickest course to fulfill my New Jersey requirement. I would sit through it and count down the hours. It was not out of a lack of respect for the continuing educator or the importance of the material. I just felt, no matter how the material was presented it was just dry and did not feel like it applied to my more niched areas of practice.

Faculty member, and Sr. TA, Mora Pluchino, PT, DPT, PRPC is a graduate of Stockton University with a BS in Biology (2007) and a Doctorate of Physical Therapy (2009). Mora authored and instructs Ethical Concerns for Pelvic Health Professionals and  Ethical Considerations from a Legal Lens.

• "I want to start my own practice but I'm not sure if I need to hire a lawyer to help!"
  
• "I have a problematic patient that I want to discontinue seeing, but don't want to be guilty of abandonment of care."
• "I am so confused by the types of clinical insurance that I am required to have!"
• "I want to hire an employee and include a non-compete clause in their employment contract!"
• "I want to start my own cash-based practice and need help with this process!"
• "I plan to market my practice for THIS population, is it legal to exclude THAT group of people?" 

With the end of 2022 approaching, now is the perfect time to take a pelvic health-focused ethics class. For many states, licensed professionals have to fulfill an ethics continuing education requirement, including physical therapists, occupational therapists, mental health, and many other healthcare providers. 

I started writing this series a year ago. I struggled to find a class to meet my biannual ethics requirement for New Jersey that was related to my practice in pelvic health. I soon realized that as a pelvic health provider and educator, the most popular questions that come up for practitioners, secondary only to specific treatment interventions, are ethical in nature. 

H&W is proud to be able to present a new remote course on ethics from new faculty member, and Sr. TA, Mora Pluchino, PT, DPT, PRPC. Mora is a graduate of Stockton University with a BS in Biology (2007) and Doctorate of Physical Therapy (2009). She has been working at Bacharach Institute for Rehabilitation ever since graduation and has experience in a variety of areas and settings, working with children and adults, including orthopedics, bracing, neuromuscular issues, vestibular issues, and robotics training.

Mora began treating Pelvic Health patients in 2016 and has experience treating women, men, and children with a variety of Pelvic Health dysfunction. In 2020, she opened her own "after hours" virtual practice called Practically Perfect Physical Therapy Consulting to help meet the needs of more clients and has been a guest lecturer for Rutgers University Blackwood Campus and Stockton University for their Pediatric and Pelvic Floor modules and has been a TA with Herman & Wallace since 2020 with over 150 hours of lab instruction experience. Mora authored and instructs Ethical Concerns for Pelvic Health Professionals. 

This week The Pelvic Rehab Report is featuring faculty member (and senior TA) Mora Pluchino, teaching assistant Amanda Moe, and faculty member Dawn Sandalcidi on the topic of pediatric issues from infancy through adolescence. Our first guest blogger, Mora Pluchino, PT, DPT, PRPC has published two books. The first of which is titled The Poop Train: Helping Your Child Understand Their Digestive System. This is a rhyming, kid-friendly book to help children understand how their poop is made. It has resources in the back to help parents and caregivers manage a child's digestive system for optimal function including proper voiding positions, ideas for activities to help voiding, fiber recommendations, fiber-filled food options, and belly massage instructions. Her second book, Practically Perfect Pelvic Health 101: A Visual Tour of the Pelvic Floor is a visual tour of the pelvic floor to help all genders and all ages understand general pelvic health. You can find Mora online at https://www.practicallyperfectpt.com/ and on Instagram @practicallyperfectpt.

As a pelvic health specialist, I treat the pelvic floors for all humans of all ages. I am frequently asked the question “Why would a child need pelvic floor therapy?” The response is “So many reasons!” 

From a very young age, I had the passion to be a Physical Therapist, but it was only recently that a hidden passion was revealed, Pelvic Floor Physical Therapy. I graduated from Stockton University with my BS in Biology in 2007 and Doctorate of Physical Therapy in 2009. I have a history of pelvic health issues and had felt extremely uneasy about going to pelvic floor continuing education, so I focused on other areas early in my career like pediatrics, adult neuro, acute care, and wound care.

As a little girl, I dealt with Pelvic Floor Dysfunction due to tight pelvic floor muscles, with frequent urinary tract infections, and an overactive bladder. Then as a teen, I had pain with penetration, from tampons to speculums and later during sexual activities. Luckily, I was treated by a Pelvic Health Specialist who helped me to have a full and active lifestyle without pain and irritation but it took me a long time to find help with the right provider. I have experienced pregnancy (and most of the common complications including morning sickness, preterm labor & pelvic pain) and complicated childbirth that ended in a cesarean section. My daughter also experiences many of the common pediatric pelvic floor issues like constipation, post-void dribbling, and bedwetting.

When a coworker of mine was looking for someone to help her with our company’s Pelvic Floor program, I found the personal courage to go and take Pelvic Floor Level 1 with Herman & Wallace. I had always had the interest and the personal experiences, but I needed to find the right situation to delve into it all; enter Herman & Wallace. I cannot overstate how welcomed, safe, educated, and reassured I felt beginning my journey with Lila Abbate and Dustienne Miller. I signed up for my next course while still attending that first course, and there was no limit to the number of continuing education courses from Herman and Wallace I wished to attend over the next two years. Herman and Wallace had woken up a passion in me I didn’t even know I yearned for. I wanted to know anything, everything about pelvic floors. The next logical step to assure myself and my patients that I was an advanced practitioner in this area was to take my PRPC which I completed in May 2019.