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(Stroke. 2007;38:2745.)
© 2007 American Heart Association, Inc.

Original Contributions

Urinary Incontinence After Stroke

Identification, Assessment, and Intervention by Rehabilitation Professionals in Canada

From the Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, and the Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (C.D., N.-K.B.); and the Faculty of Medicine, University of Montreal, and the Centre de recherche de l’Institut Universitaire de Gériatrie De Montréal (C.T.), Montreal, Canada.

Correspondence to Chantale Dumoulin, PhD, School of Physical and Occupational Therapy, McGill University, 3630 Promenades Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada. E-mail chantal.dumoulin{at}mail.mcgill.ca

Background and Purpose— Urinary incontinence (UI) is a common and distressing problem after stroke. Although there is evidence of new, effective UI poststroke rehabilitation intervention, it is unknown whether occupational therapists (OTs)’ and physical therapists (PTs)’ actual practices reflect best practices. We sought to determine the extent to which OTs and PTs identify, assess, and treat UI after stroke and to identify personal and organizational predictors of UI problem identification, best-practice assessment, and intervention.

Methods— Six hundred sixty-three OTs (93% participation rate) and 656 PTs (87% participation rate) working in stroke rehabilitation in Canada were randomly selected and interviewed with a telephone-administered questionnaire. Each responded to a series of open-ended questions related to a generated case (vignette) of a typical client with stroke who was experiencing UI.

Results— Only 39% of OTs and 41% of PTs identified UI after stroke as a problem. Fewer than 20% of OTs and 15% of PTs used best-practice assessments, and only 2% of OTs and 3% of PTs used best-practice interventions. Working in Ontario, having allocated learning time, and doing university teaching were among the variables explaining between 6% and 9% of the variability in UI identification and assessment.

Conclusions— Canadian OTs and PTs do not routinely identify poststroke UI as a problem, and best-practice assessments and interventions are underused.

Key Words: evidence-based practice • rehabilitation • stroke • urinary incontinence

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