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 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) 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.
