Active Perineal Rehabilitation Course

Hybrid course for 2 to 6 students.

Online course recorded for 1 student.



  • Course duration: 23 hours (8 hours in-person and 15 hours online recorded)
  • Ongoing support within the RPA Physiotherapists group.
  • Investment of €800.00 per student
  • Dates 2026 - February 28 | May 9 | July 4 | September 26 | November 14
  • Location : Belém, Lisbon
  • The course takes place at the PERÍNEO BY LAIRA RAMOS space.
  • Recorded classes become available after payment.
  • The course is certified by Dr. Laira Ramos after evaluation in the practical class.
  • Course load: 15 hours of online recorded classes.
  • Ongoing support within the RPA Physiotherapists group.
  • Investment of R$ 500.00 for 1 student
  • Recorded classes become available after payment.
  • The course is certified as online training by Dr. Laira Ramos.

The Active Perineal Rehabilitation course aims to train healthcare professionals working in urogynecology so that they are able to promote comprehensive neuromuscular functional rehabilitation of the pelvic floor muscles (PERINEUM) in their patients, whether women or men.

After completing the course, the professional will be able to offer techniques capable of promoting the treatment and prevention of neuromuscular pathologies affecting the urinary, defecatory, sexual, and support systems: urinary incontinence, fecal incontinence, urinary retention, constipation, pelvic organ prolapse, sexual dysfunctions, pelvic pain, preparation for childbirth, and postpartum recovery.

During the course, students will have the opportunity to share knowledge directly with Dr. Laira Ramos, a professional with over 15 years of experience dedicated exclusively to Urogynecological Physiotherapy , understanding the theory and practice of each technique used.

You will also have the privilege of accessing everything she offers her own patients in her clinical practice, obtaining rapid results with a significant positive impact on quality of life, leading to increased autonomy, self-confidence, and self-esteem.

See some testimonials from her patients.

Differential:

Students will have a unique learning opportunity with an internationally recognized professional who has over 15 years of exclusive experience in Urogynecological Physiotherapy, sharing all the theory and practice she has acquired throughout those years.

At the end of the course, professionals will be qualified to use Dr. Laira Ramos ' method, understanding how to rehabilitate the pelvic floor muscles in a comprehensive and functional way, offering the best treatment to their patients, with fast and satisfactory results .

All students will have access to the resources she uses in her own clinical practice and ongoing free support through the Facebook group Fisioterapeutas RPA , where Physiotherapist Laira Ramos offers free mentoring so that her students can continue to always offer the best treatments to their patients.

Methodology:

The entire course is based on the eponymous Active Perineal Rehabilitation (APR) protocol, developed by Dr. Laira Ramos. This is the first, and so far only, scientifically valid protocol that aims at the overall rehabilitation of the pelvic floor muscles, rather than the isolated treatment of each pathology.

This protocol began to be developed between 2009 and 2011, when she was pursuing her Master's degree in Rehabilitation Sciences at the Faculty of Human Movement, Lisbon, Portugal.

Her scientific results were verified in her doctoral thesis (2014-2018) at the Department of Gynecology of the Paulista School of Medicine (UNIFESP), São Paulo, Brazil. This thesis was supervised by Prof. Dr. Manoel Joao Batista Castello Girão and co-supervised by Dr. Ricardo Mendes Alves Pereira. The examining board was composed of Prof. Dr. Zsuzsanna Ilona Katalin De Jarmy Di Bella, Prof. Dr. Jorge Milhem Haddad, Prof. Dr. Walter Antonio Prata Pace, and Prof. Dr. Octacilio Figueiredo Netto.

Link to the thesis: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6810829

The Active Perineal Rehabilitation protocol consists of 14 individual sessions, each lasting approximately 50 minutes, during which the patient undergoes kinesiotherapy with electromyography biofeedback and electrostimulation. Both are performed using an intracavitary probe. The difficulty of the exercises gradually increases session by session, with the protocol divided into 3 phases: sessions 1 to 4 are for teaching contraction and relaxation; sessions 5 to 8 are for training agility and muscle coordination; sessions 9 to 14 are for promoting muscle hypertrophy. At the end of each session, patients are instructed to perform exercises at home, and women are instructed on the use of vaginal cones.

The protocol is described in the book Active Perineal Rehabilitation, written by Dr. Laira Ramos and reviewed by Dr. Hélio Fernandes Retto and Dr. Eliana Cristina Hilberath Moreira, and is available to students of the course. Dr. Laira Ramos holds the intellectual property rights to this protocol, enabling and authorizing her students to use the method. Only professionals trained by her may use the Active Perineal Rehabilitation protocol.

General Objective:

To equip trainees with the theoretical and practical knowledge necessary to assess, plan, and intervene appropriately in all neuromuscular dysfunctions of the pelvic floor in men and women, aiming at global neuromuscular functional rehabilitation, using an innovative and scientifically valid method.

Specific Objectives:

  • To empower trainees to offer an improved quality of life for patients.
  • To train professionals to be respected and valued in the market.
  • Understanding the principles of Active Perineal Rehabilitation
  • To learn about the latest scientific evidence in urogynecological physiotherapy.
  • Teaching physical assessment and anamnesis
  • Identifying the various dysfunctions of the pelvic floor.
  • Selecting the appropriate methodology and intervention tools for each case.
  • Properly perform kinesiotherapy exercises for pelvic floor pathologies.
  • Understanding the importance of biofeedback and the best way to apply each technique.
  • To have a broader view of electrostimulation in perineal rehabilitation, understanding its use not only in the neuromuscular pathway, but also in the sensory pathway.
  • Using vaginal cones correctly
  • To properly prescribe home exercises in a way that ensures patient adherence.
  • Knowing how to set up and manage a urogynecological physiotherapy service in order to attract more patients.
  • Knowing how to work in an interdisciplinary team, always aiming for the best treatment for each patient in an individualized way.

Benefits:

  • Training and authorization to use the Active Perineal Rehabilitation protocol.
  • Access to the materials that Physiotherapist Laira Ramos uses in her clinical practice.
  • Constant and free support after the course through the RPA Physiotherapists Facebook group.
  • Exclusive access to the book Active Perineal Rehabilitation, second edition.
  • Access to recorded classes to reinforce the content.
  • Opportunity to work directly with Physiotherapist Laira Ramos

Trainer:

Dr. Laira Ramos http://www.perineo.info/quem-somos/laira-ramos/

She chose the field of urogynecology from the beginning of her physiotherapy studies and has since been involved in internships and training in the area. Her father and sister, both gynecologists, have had a great influence on her career, always encouraging her.

After graduating, she dedicated herself exclusively to perineal rehabilitation, continuously updating her knowledge to offer the best treatment to her patients. This passion for the field led her to develop the Active Perineal Rehabilitation & Series concept.

Since perineal rehabilitation is still a little-known treatment, she gives lectures with the aim of publicizing these treatments and making them more accessible to the population.

She also provides training and consulting services for physiotherapists, teaching them how to work with her techniques.

  • Physiotherapist in Brazil and Portugal
  • Doctor of Urogynecology from the Federal University of São Paulo, Brazil
  • Master of Science in Physiotherapy from the Faculty of Human Movement, Portugal
  • Founder and owner of PERÍNEO www.perineo.info
  • Creator of the Active Perineal Rehabilitation concept & Series www.rpaeserie.com
  • Author of the book Active Perineal Rehabilitation and the practical guide Passive Perineal Rehabilitation.
  • Instructor of the Active Perineal Rehabilitation and Passive Perineal Rehabilitation courses.
  • International speaker

Program:

RPA Protocol
•Techniques:
-kinesiotherapy
-pressure biofeedback
-biofeedback via electromyography
-electrostimulation
- vaginal cones
-homework exercises
•Phase I - sessions 1 to 4
•Phase II - sessions 5 to 8
•Phase III - sessions from 9 to 14
•Materials to get started

• How to set up and manage a urogynecological physiotherapy service

CLINICAL CASES
• Mild stress urinary incontinence in women
•Moderate mixed urinary incontinence in women
• Severe urge urinary incontinence in men
• Mild or moderate prolapse
•Severe prolapse
•Post-prostatectomy with urinary incontinence and erectile dysfunction
•Post-operative care for prolapse and incontinence correction
•Preparation for childbirth
•Postpartum
•Vaginismus
• Dyspareunia and decreased libido
•Improve pleasure - wide vagina

PELVIC FLOOR
•Anatomy
• Muscle neurophysiology
•Physiology of urination
•Physiology of defecation
•Physiology of sexuality
•Physiology of pregnancy

•Pelvic floor dysfunctions

•Biomechanics

ASSESSMENT
Anamnesis
Physical examination
• vaginal examination
•anal touch
• electromyography
• pressure (perineometer)
•ultrasound
Additional tests