A BEHAVIORAL-APPROACH TO THE TREATMENT OF URINARY-INCONTINENCE IN A DISABLED POPULATION

Although the literature has indicated that incontinence can be successfully treated with nonsurgical methods in the able-bodied population, there has been Little research performed in the disabled population. Fifty-four patients with various disabilities were treated with pelvic muscle exercises, using biofeedback in conjunction with adjustments in their bowel program, caffeine intake, fluid intake, toileting schedules, transfer training, and medications. The average number of incontinent episodes before intervention was 3.6 per day, which was reduced to 0.8 per day after interventions (p <.001). The characteristics associated with treatment success and failure were evaluated and are discussed in this article, In addition, the change in amplitude and duration of the pelvic muscle surface electromyograph were analyzed. A statistical trend (p =.07) was discov ered between an increase in amplitude and a positive outcome. There was a statistical association between increased pelvic floor contraction duration and a good or excellent outcome (p <.05). In conclusion, a behavioral approach to treatment of urinary incontinence is efficacious in the disabled population who can volitionally void and can voluntarily contract their pelvic muscles. (C) 1995 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation