Pelvic Floor Physiotherapy for Female Stress Urinary Incontinence

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1. 1

   Which presentation most clearly describes stress urinary incontinence?

   A Leakage preceded by a sudden, difficult-to-defer urge B Leakage during coughing, sneezing, exercise, or physical exertion C Continuous leakage caused by an abnormal urinary tract connection
2. 2

   The image shows a patient visibly squeezing the buttocks while attempting a pelvic floor contraction. Which substitution pattern is present?

   

   A Isolated urethral closure B Pelvic floor relaxation C Gluteal muscle substitution
3. 3

   What does a grade of 3 indicate on the Modified Oxford Scale for pelvic floor muscle strength?

   A Moderate contraction with lift against resistance B No detectable muscle contraction C Strong contraction against maximal resistance
4. 4

   In the PERFECT assessment scheme, what does the letter P represent?

   A Pelvic organ position B Power of the pelvic floor contraction C Pain during bladder filling
5. 5

   Which information is most appropriate for a patient to record in a bladder diary?

   A Only the total amount of water consumed each week B Only the number of pelvic floor contractions completed C Fluid intake, voiding times and volumes, leakage, and associated activities
6. 6

   What is an appropriate first-line physiotherapy intervention for uncomplicated female stress urinary incontinence?

   A A supervised pelvic floor muscle training program lasting at least three months B Routine avoidance of all lifting and aerobic activity C Electrical stimulation without first assessing voluntary contraction
7. 7

   The illustrated sequence shows pelvic floor activation immediately before a cough. Which continence strategy is being demonstrated?

   

   A Bladder suppression training B The Knack C Post-void relaxation
8. 8

   What is the primary purpose of pelvic floor surface electromyographic biofeedback?

   A To directly increase muscle strength without active effort B To measure the exact force produced by the pelvic floor C To provide information about muscle activation and improve motor learning
9. 9

   Which reported symptom requires medical investigation rather than being managed solely with routine pelvic floor exercises?

   A Visible blood in the urine B Leakage during repeated coughing C Difficulty remembering an exercise schedule
10. 10

    Which symptom is more characteristic of urgency urinary incontinence than stress urinary incontinence?

    A Leakage when jumping B Leakage associated with a sudden compelling urge to void C Leakage during a forceful sneeze
11. 11

    Which breathing strategy is illustrated to help manage pressure while lifting?

    

    A Hold the breath throughout the lift B Take repeated rapid breaths before lifting C Exhale during the effort while coordinating pelvic floor support
12. 12

    Why should pelvic floor relaxation be assessed as well as contraction?

    A Incomplete relaxation can impair coordination and contribute to pelvic symptoms B Relaxation permanently reduces the ability to support the urethra C Relaxation determines urine production by the kidneys
13. 13

    Which limitation should be considered when interpreting surface electromyography of the pelvic floor?

    A It can only detect activity when the patient is standing B Its signal may include cross-talk and does not directly equal muscle force C It provides a direct image of urethral movement
14. 14

    The image shows an absorbent pad being weighed before and after standardized physical activity. What does this test primarily quantify?

    

    A Pelvic floor contraction endurance B The pressure inside the bladder C The amount of urine lost during the test period
15. 15

    Which sequence best demonstrates appropriate functional progression of pelvic floor muscle training?

    

    A Supported positions followed by upright tasks and symptom-provoking activities B Maximal jumping practice before confirming a correct contraction C Supine contractions only, regardless of the patient's goals
16. 16

    Which finding is a reason to defer an internal vaginal pelvic floor examination?

    A A history of childbirth B An active vaginal or pelvic infection C Leakage during coughing
17. 17

    Which approach is most likely to improve long-term adherence to pelvic floor muscle training?

    A Giving the same maximal program to every patient B Avoiding follow-up until the program is complete C Linking an individualized program to routines, reminders, and meaningful goals
18. 18

    The image shows downward movement of the bladder neck during coughing. Which mechanism most directly contributes to this finding in stress urinary incontinence?

    

    A Insufficient urethral and pelvic floor support B Excessive urine production by the kidneys C Involuntary contraction of the detrusor muscle
19. 19

    What does the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form primarily assess?

    A Pelvic floor muscle electrical activity B Leakage frequency, leakage amount, and impact on quality of life C Bladder pressure during urodynamic filling