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Bladder training is used for physically and cognitively able adults to achieve continence by accelerating the timed interval between voids (Roe, Milne, & et al., 2007; Sanders & Bray, 2013). Over the past decades bladder training, prompt voiding, habit retraining, and time voiding have been used in nursing practice to manage urinary incontinence in adults in institutional and community setting. Habit training and time voiding are used with individuals having physical and cognitive problems who need to be assisted by motivated staff who make it occur at similar times (Roe et al., 2007).

Behavioral treatment interventions, which include mandatory voiding schedules and self-monitored voiding records, are first line treatment for most patients with urinary incontinence (Publicover & Bear, 1997). Self-monitoring is one of the outstanding aspects in BT. A voiding record determines progress and serves as the basis for ensuring changes in the voiding schedule. In addition, Publicover and Bear (1997) report that, in a BT training program, positive reinforcement and a therapeutic relationship are crucial components. Ultimately, success in therapeutic programs and bladder training depends on the degree and involvement of the patients and caregivers.

According to research, pelvic floor muscle (PFM) exercise is the most common physical therapy treatment that is used for different types of urinary incontinence (Ferreira et al., 2012; Hsiu-Chuan et al., 2011; Lin et al., 2011; McClurg, Lowe-Strong, & Ashe, 2008; Rosqvist et al., 2008 ). Based on early research studies, PFM has no adverse effects and it is recommended that it is offered as first-line therapy to all women with stress, urge, or mixed urinary incontinence (Ferreira et al., 2012; Rosqvist et al., 2008; Sangsawang & Serisathien, 2012). Pelvic floor muscle training involves a program to educate patients along with a scheduled voiding regimen that gradually progresses the voiding interval (Rosqvist et al., 2008). Pelvic floor muscle training includes repetitive selective voluntary contraction and relaxation of specific muscles. The goal is to strengthen the non-optimally functioning pelvic floor by improving the force generation, incorrect timing, or coordination of the PFMs (McClurg et al., 2008). Strengthening of the PFM is commonly used to treat stress urinary incontinence since Kegel introduced this kind of exercise (McClurg et al., 2008). Pelvic floor muscle strengthening is thought to accelerate muscle size and stiffness and to stabilize the bladder neck during the high pressure in intra-abdominal (Hsiu-Chuan et al., 2011). Pelvic floor muscles are the most important anatomical structures that control urinary continence. They keep the pelvic support in place by slow contraction of fibers and prevent urinary incontinence during sudden increases in intra-abdominal cavity pressure (Ferreira et al., 2012).

The effectiveness of PFM training on urinary incontinence in people with disease, pregnancy, and increased age is well established. Pelvic floor muscle exercise is not only helpful for the treatment and prevention of stress urinary incontinence during pregnancy, but also it relieves stress urinary incontinence symptoms. Since 50% of people with Multiple Sclerosis develop bladder dysfunction, PFM training can be used to decrease the devastating symptoms of this condition (McClurg et al., 2008). Pelvic floor muscle and BT programs are perceived as acceptable and feasible and following these programs in daily life can be quite easy (Rosqvist et al., 2008).

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Doc James (talk · contribs · email) 15:38, 18 April 2016 (UTC)

WP:MEDHOW
Explains how to format the refs. Also per WP:MEDRS we only typically use reviews or other high quality secondary sources. Best Doc James  (talk · contribs · email) 15:39, 18 April 2016 (UTC)