Effect of Verbal Instruction on Pelvic Floor Muscle Contraction in Post Stroke Patients

The aim of this study is to investigate which verbal instruction will lead to the most efficient contraction of pelvic floor muscles in post stroke patients. Pelvic floor muscle contraction will be evaluated via transabdominal ultrasound. ultrasound.

Sub-acute stroke patients during the rehabilitation period in the rehabilitation hospital will be examined. Each participant will be asked to contract the pelvic floor muscles using three different verbal instructions: (1) "contract your pelvic floor - all sphincters"; (2) "contract your anus"; (3) "contract your pelvic floor as if you're trying to stop urinating". Those who will not be able to contract will be taught by the ultrasound as a biofeedback. The assessment of pelvic floor contraction will be measured by measuring bladder displacement via abdominal ultrasound. A curved linear array transducer will be placed in the transverse plane immediately suprapubically over the lower abdomen angled at 15-30 degrees from the vertical. An on screen caliper and measurement tool will be used to measure bladder displacement.

The participants will be verbal instructed to contract the pelvic floor muscle with the following sentences: (1) "contract your pelvic floor - all sphincters"; (2) "contract your anus"; (3) "contract your pelvic floor as if you're trying to stop urinating". Those who will not be able to contract will be taught by the ultrasound as a biofeedback.

Verbal instruction for pelvic floor contraction will be given to participants. Ultrasound examination will be conducted to asses urinary bladder displacement being a marker for pelvic floor muscle function.

questionnaire regarding symptoms of urinary incontinence,scale range 0-21 points. higher values represent worse outcome

assess and grade the functional status of a person based on the level of assistance he or she requires

Inclusion Criteria: one to 6 months post first stroke understand the language and simple instruction willing to participate in the study mini mental assessment >21 Exclusion Criteria: Aphasia side neglect active urinary tract infection has been treated before for pelvic floor rehabilitation

the result of the study will be analysed. a paper will be submitted to international journal with study description including methods, examination protocol results.

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