Lesson 1Work and lifestyle assessment: ergonomic risk at computer, sedentary behaviour, exercise habits, daily movement patternsThis section explains how to assess work demands and lifestyle patterns in pregnancy, including computer ergonomics, lifting tasks, sedentary time, exercise habits, and daily movement, to guide tailored activity modification and prevention strategies suitable for Zambian workers.
Desk and computer ergonomics in pregnancyManual handling and lifting risk analysisAssessing sedentary time and breaksEvaluating exercise history and current activityDaily movement patterns and symptom linksEducation on safe work and home modificationsLesson 2Safety screening and risk stratification: identifying high-risk pregnancy signs, when to liaise with obstetric teamThis section details systematic safety screening in pregnancy, focusing on red flags, medical and obstetric risk factors, and clear criteria for when to pause treatment, modify interventions, or urgently liaise with the obstetric team in Zambian health systems.
Key medical and obstetric red flagsScreening for hypertensive disordersBleeding, fluid loss, and fetal movement changesContraindications to exercise and manual therapyWhen and how to liaise with obstetric providersDocumenting and communicating safety concernsLesson 3Key obstetric history questions: pregnancy timeline, previous pregnancies, complications, medications, obstetrician recommendationsThis section outlines essential obstetric history questions, including pregnancy dating, prior pregnancies, mode of delivery, complications, medications, and current obstetric recommendations, to ensure safe, context-aware physiotherapy planning in Zambia.
Establishing gestational age and trimestersPrevious pregnancies, births, and outcomesScreening for obstetric and medical complicationsCurrent pregnancy course and investigationsMedication, supplements, and contraindicationsAligning care with obstetric recommendationsLesson 4Breathing and diaphragmatic assessment: assessment of pattern, rib excursion, cough mechanics and its relation to pelvic floorThis section explains assessment of breathing mechanics in pregnancy, including diaphragmatic excursion, ribcage mobility, accessory muscle use, cough mechanics, and the functional relationship between breathing patterns and pelvic floor behaviour for Zambian patients.
Observation of resting breathing patternPalpation of ribcage and abdominal excursionIdentifying upper chest and accessory breathingCough, sneeze, and load transfer assessmentBreath–pelvic floor coordination strategiesTeaching basic diaphragmatic breathing drillsLesson 5Physical observation: posture analysis (sitting, standing), pelvic alignment, lumbar mobility, hip and ribcage positionThis section covers systematic physical observation of pregnant patients, including static and dynamic posture, pelvic alignment, lumbar and hip mobility, ribcage position, and how these findings inform load management and individualised treatment planning in local contexts.
Standing and sitting posture assessmentPelvic alignment and asymmetry checksLumbar mobility and movement patternsHip range, control, and compensation signsRibcage position and thoracic mobilityLinking observation findings to symptomsLesson 6Symptom-focused intake: pain characteristics, urinary symptoms, bowel function, sleep, activity tolerance, fear/psychosocial factorsThis section focuses on structured, symptom-centred intake, exploring pain characteristics, urinary and bowel function, sleep quality, activity tolerance, and psychosocial factors such as fear, beliefs, and stress that influence pregnancy-related symptoms in Zambia.
Pain location, behaviour, and aggravating factorsUrinary frequency, urgency, and incontinenceBowel habits, straining, and constipationSleep quality, positions, and nocturnal symptomsActivity tolerance and functional limitationsScreening fear, mood, and catastrophisingLesson 7Clinical reasoning: synthesising findings into problem list, documenting goals and shared decision-making with pregnant patientThis section integrates assessment findings into a coherent problem list, prioritises impairments and participation limits, and teaches goal setting, documentation, and shared decision-making with pregnant patients and the wider care team in Zambian practice.
Synthesising subjective and objective findingsFormulating a prioritised problem listSetting SMART, pregnancy-specific goalsCollaborative treatment planning with patientsInterprofessional communication and referralsReassessment and adapting the care planLesson 8Functional tests and outcome measures: validated pregnancy-specific pain and function scales, Pelvic Girdle Questionnaire, Oswestry, 6-minute walk or sit-to-stand adaptationsThis section reviews functional tests and outcome measures suitable for pregnancy, including pelvic girdle and low back pain scales, global disability tools, and adapted walking or sit-to-stand tests to monitor progress and guide treatment in Zambian clinics.
Selecting pregnancy-appropriate questionnairesPelvic Girdle Questionnaire administrationUsing Oswestry and related disability scalesTimed walking and 6-minute walk adaptationsSit-to-stand and transfer test modificationsTracking outcomes and interpreting changeLesson 9Basic pelvic floor assessment: external observation, digital internal assessment principles, contraindications, red flags and when to referThis section introduces basic pelvic floor assessment for pregnant patients, emphasising external observation, principles of digital internal assessment, consent, contraindications, red flags, and clear criteria for referral to specialised providers in Zambia.
Informed consent and trauma-sensitive approachExternal observation and perineal inspectionPrinciples of digital internal assessmentAssessing strength, endurance, and relaxationContraindications and red flag recognitionIndications for referral to specialists
