Physical Therapy Evaluation for Incontinence Education
When a physical therapist performs a physical therapy evaluation for stress incontinence, several factors are taken into account. A
history will be taken to review when your incontinence started, how
long it has been present, how severe it is and under what
circumstances it occurs. Your medical records will be reviewed during
or after communicating with the referring physician. A physical examination
will be performed that could
include the use of two types of incontinence devices; a device that
monitors the strength of the contraction and/or a device that
monitors the electrical activity of the pelvic floor muscles.
Both of types of devices can be used during the evaluation phase of
treatment as well as in the physical therapy incontinence education education
stage of treatment. One type of device (as represented by the PFX2
and Peritron Perinometer) measures the actual strength of the
contraction when you squeeze the pelvic floor muscles. During the
evaluation, the strength of the contraction (strength of squeeze) is
noted as the baseline reading for how strong your pelvic floor
muscles are. And, over time with training and practice you will be
able to see progress in building the strength of the pelvic floor
muscles.
The other type of device (as represented by the U-Control or MyoTrac
Infinity) measures
the electrical activity generated by the muscles (Surface
Electromyography or EMG) and this is used to determine precisely the
amount of electrical activity produced by the muscle fibers during a
contraction.
Both types of measurements contribute to the diagnostic picture and
the baseline readings help determine the future course of your
therapy. The type and duration of your physical therapy will be
shaped according to the diagnostic findings and your progress.
Ultimately, the goal of therapy is to strengthen the pelvic floor
muscles, allowing for greater control of the flow of urine. If nerve
damage is present for whatever reason, the use of EMG during therapy
would be most useful. Since and EMG can measure the electrical
activity of muscles and note an increase in activity even before
movement is apparent in the muscle it is the perfect instrument to
use for rehabilitation of extremely weak muscles or muscles that do
not function properly due to nerve damage.
If physical therapy is determined to be helpful, a recommendation will be
made to the referring physician for ongoing physical therapy. During a
course of physical therapy treatment and education, the physical therapist
will prescribe and supervise pelvic floor strengthening exercises
and may also recommend that you
purchase an incontinence product for home training device to be used for in-home practice. Practicing at home you will speed your improvement
and enable you to maintain the progress you have made during
your physical therapy sessions.
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