Guiding Pelvic Floor Muscle Training: A Mixed Methods Study on the Use and Effectiveness of Verbal Cues in Females With Urinary Incontinence

Background: Urinary incontinence (UI) is a common and distressing condition impacting between 53% and 61.8% of females in the United States over 20 years of age. Pelvic floor muscle training (PFMT) is an effective intervention strategy to address UI. Verbal cueing is often used during PFMT to aid contraction. However, the effect of verbal cues to optimize pelvic floor contractions is inadequately researched. Methods: A mixed-methods survey was conducted to explore expert opinion on effective verbal cues commonly used during PFMT. A survey was disseminated to licensed physical and occupational therapists with specialized training in treating pelvic health conditions. Participants rated their likelihood of use and their perceived effectiveness of verbal cues and provided open-ended responses about their preferred verbal cues. Results: A total of 105 responses met inclusion criteria and were analyzed. Quantitative results revealed significant differences in perceived effectiveness and likelihood to use specific verbal cues during PFMT ( P = < .0001). Four themes emerged from qualitative analysis: imaginative language, command-based cues, cues related to stopping bowel/bladder function, and breathing cues. The most endorsed cues included “squeeze and lift your pelvic floor muscles” “imagine stopping the flow of urine” and “take a moderate breath in, let the breath out, and draw in and lift the pelvic floor.” Discussion: This research highlights the importance of diverse verbal cueing strategies during PFMT. The findings provide valuable insights for clinical practice and inform future research on optimal verbal cues on pelvic floor muscle contractions during the treatment of UI in females.