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APR course - 2 students

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  1. Personalized course for 2 students
    1. 2 days | 22 hours
      1. 7 am in person
      2. 15h online recorded
    2. maximum 2 students
    3. investment of 800.00 euros for the course
    4. flexible date to be defined by the availability
    5. for professionals with all experience levels

The main objective of Active Perineal Rehabilitation is to educate the health care professionals that work with urogynecology to be able to promote a global pelvic floor muscle neuromuscular rehabilitation in their patients, women, or men.

After the course, the professionals will be prepared to provide treatment and prevention for neuromuscular dysfunction in urinary, defecatory, sexual, and pelvic support systems: urinary incontinence, fecal incontinence, obstipation, urinary retention, pelvic organ prolapse, sexual dysfunctions, pelvic pain, during pregnancy and postpartum.

During the course, the professionals will have the opportunity to share knowledge directly with Dr. Laira Ramos, she has more than 15 years of experience working exclusively with Urogynecologic Physiotherapy, understanding theory and practical application of each technique.

They also will have the privilege of accessing what she offers to her patients in her clinic, getting fast results with a great positive impact on her patients' quality of life, increasing their autonomy, self-esteem, and confidence.

See here her patients’ reviews


The students will have the unique opportunity to learn with an international professional with more than 15 years of experience working exclusively with Urogynecologic Physiotherapy, sharing all she learned over all these years.

At the end of the course, the professionals are prepared to apply Laira Ramos´ method, understanding how to make a global and functional pelvic floor muscle rehabilitation, offering to their patients fast and great results.

They will have access to all resources that she uses in her practice and free continuo support on FaceBook group Fisioterapeutas RPA, where she will be available to answer the questions in a mentoring process to follow and to support them to offer the best treatment to their patients.


This course is based on the Active Perineal Rehabilitation homonym protocol developed by Dra. Laira Ramos. It is the first, and still now the unique, protocol with scientific validation to promote a global pelvic floor muscle rehabilitation, and not to treat any isolated pathologies.

She started developed it during her Marter Degree (2009-2011) in Physiotherapy Sciences by the Faculty of Human Motricity, Lisbon, Portugal.

Its scientific validation was obtained in Laira Ramos´ Ph.D. study, in the Gynecology Department of the Federal University of Sao Paulo. This theses had Dr. do Prof. Doutor Manoel Joao Batista Castello Girão supervision and Dr. Ricardo Mendes Alves Pereira co-supervision. Its examining commission was composed of Prof. Doutora Zsuzsanna Ilona Katalin De Jarmy Di Bella, Prof. Doutor Jorge Milhem Haddad, Prof. Doutor Walter Antonio Prata Pace, and Prof. Doutor Octacilio Figueiredo Netto.

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

Active Perineal Rehabilitation protocol consists of 14 individual sessions, each session has around 50 minutes duration, where the patient performs kinesiotherapy with electromyography biofeedback and electrical stimulation. Both with an intracavitary probe. The exercises challenge increases session by session and the protocol is divided into 3 phases: sessions 1 to 4- pelvic floor muscle consciousness; sessions 5 to 8- pelvic floor muscle agility; sessions 9 to 14- pelvic floor muscle hypertrophy. At the end of each session, the patients are orientated about home exercises and women are instructed about the vaginal weights.

The protocol is described in the book Active Perineal Rehabilitation, write by Dra. Laira Ramos, and reviewed by Dr. Helio Fernandes Retto and Dra. Eliane Cristina Hilberath Moreira, available for the course students. Dra. Laira Ramos has all intellectual property rights and only those who are authorized by her can use the Active Perineal Rehabilitation protocol.

General objective:

Provide the professionals all necessary theoretical and practical knowledge to properly evaluate and treat all pelvic floor muscle dysfunctions, in men and women, aiming for a global functional neuromuscular rehabilitation, using an innovative and scientific method.

Specific objectives:

  • To enable the professional to offer a treatment to increase the patient´s quality of life
  • To train professionals to be respected in the field
  • To teach the Active Perineal Rehabilitation protocol concept
  • To share a scientific update in pelvic floor muscles rehabilitation
  • To teach physical examination and anamnesis
  • To identify pelvic floor muscle disfunction
  • To understand the best treatment in each pathology
  • To understand pelvic floor muscle exercises and how to apply the best technique
  • To understand biofeedback and how to use the different types
  • To understand how to use electrostimulation in pelvic floor muscle rehabilitation not only in neuromuscular via; but also sensitive via.
  • To prescribe vaginal cones
  • To prescribe home exercises properly and with the patients' adherence
  • To know how to start pelvic floor muscle rehabilitation in your space and how to raise more patients
  • To know to work in an interdisciplinary team to offer the best treatment to each patient


  • Training and authorization to use Active Perineal Rehabilitation protocol
  • Access to Dr. Laira Ramos resources
  • Exclusive access to Active Perineal Rehabilitation 2ºEd book
  • Access to online classes
  • Potential to work directly with Dr. Laira Ramos

Professor: Dra. Laira Ramos https://www.linkedin.com/in/lairaramos/

She chose to work in the field of urogynecology when she started university at Universidade Estadual de Londrina (Londrina State University) in 2002 and she has been involved in several traineeships since then. Her father and sister strongly influenced my career choice as both of them are gynecologists and have always encouraged her.

After graduating in 2005, she specializes exclusively in Pelvic Floor Muscles Rehabilitation and continually keeps up-to-date with the best and latest treatments, practices, and procedures for her patients.

She loves what she does and she works hard to balance her practice, her courses, and her study and research.

Part of her work is dedicated to increasing awareness of this area. She organizes and promotes several talks to inform the general population and healthcare professionals about the importance of pelvic floor muscle rehabilitation.


APR protocol

-pressure biofeedback
-electromyography biofeedback
-electrical stimulation
-vaginal cones
-home exercises
•phase I - sessions de 1 to 4
•phase II - sessions de 5 to 8
•phase III - sessions de 9 to 14
•materials to start

•how to launch and manage

•stress urinary incontinence in woman
•mixed urinary incontinence in woman
•urge urinary incontinence in man
•prolapse grade I or II
•prolapse grade III or IV
•postprostatectomy urinary incontinence and erectile dysfunction
•post prolapse and urinary incontinence surgery
•dispareunia and e less desire
•less pressure and flaccid vagina

• anatomy
• muscle neurophysiology
• physiology of micturition

•physiology of defecation

•physiology of sexuality

• physiology of pregnancy

• pelvic floor muscle dysfunction
• biomechanics


•physical examination (internal and external techniques)

-vaginal palpation
-anal palpation


•complementary exams