IntroductionUrinary incontinence as defined by the International Continence Society is the complain of any involuntary leakage of urine [1][2][3]. The world Health Organization (WHO) has classified UI as one of the ten major health problems of present times among women [4]. Causes of UI can be divided into: dysfunction of the bladder or urethra, and neurological or gynecological causes. Gynecological components include: the weakening of pelvic floor muscles, gynecological and obstetrical operations and pelvic organ prolapse [5]. Existing evidence indicates that both natural delivery, as well as the pregnancy itself [6] has a prominent impact on the functioning of pelvic floor muscles and the occurrence of urinary incontinence. SUI occurs when intra-vesical pressure exceeds urethral closure pressure in the absence of a detrusor contraction. SUI may be due to bladder neck hyper-mobility or poor urethral closure pressure [7]. The pelvic floor muscles (PFM) function to elevate the bladder, preventing descent of the bladder neck during rises in intra-abdominal pressure and to occlude the urethra. The theoretical basis for physical therapy to treat SUI is to improve PFM function by increasing strength, coordination, speed and endurance [5] in order to maintain an elevated position of bladder neck during raised intra-abdominal pressure with adequate urethral closure force [8]. Since 1992, conservative management of SUI has been promoted by the US Department of Health and Human Services (AHCPER) as first -line treatment for SUI for its efficacy, low cost and low risk [9].According to Boyle [10], up to a third of women have urinary incontinence while about a 10 th of them have stool incontinence after delivery. Urinary incontinence is a major clinical problem with profound effects on the quality of life and day-to-day activities of the affected women. It's physically debilitating and socially incapacitating, with loss of self-confidence, helplessness, depression and anxiety all related to its occurrence. Affected women suffer social stigma and are withdrawn socially. As a result their productivity is significantly reduced and may lose interest in life.Chiarelli P [11] indicates that the prevalence of urinary incontinence among women increases during young adult life: a study with over 40000 women estimated a prevalence of 12.8% in women aged 18-22 years, 36.1% in women aged 40-49, and 35% in women aged 70-74 years.The severity of urinary incontinence varies in severity ranging from mild, moderate to severe forms. These levels of incontinence require different approaches in management in terms of duration and intensity. AbstractBackground: Urinary incontinence is a common symptom observed in modern times, which may affect 7-37% of women aged 20-39 and 9-39% after the age of 60. Pregnancy and natural delivery are important risk factors increasing the likelihood of incontinence. Conservative intervention such as pelvic floor muscle training (PFMT) is superior in preventing and treating urinary incontinence.
BACKGROUND Nearly nine months have passed since the emergence of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which caused the rapidly spreading Coronavirus Disease 2019 (COVID-19) pandemic. In Saudi Arabia, unprecedented precautionary strict measures were applied to prevent virus entry to the country or to mitigate its impact when it arrives. The physical rehabilitation is the 3rd largest profession in the area of healthcare and is the most representative profession in the area of rehabilitation in Saudi Arabia. Physical rehabilitation services provide the development, maintenance, and recovery of people’s movement and functional ability, improving their quality of life. In this way, many hospitalized patients in the acute phase of COVID-19, as well as chronic patients, need physical rehabilitation services. This study aimed to determine the number of therapists/ clinicians who interrupted their services because of the COVID-19 pandemic and to verify the procedures adopted by the therapists/clinicians to continue serving and supporting their patients. METHODS The sample comprised 46 therapists/clinicians who worked in King Faisal Specialist Hospital and Research Center (KFSH&RC), 19 (41.4%) males and 27 (58.6%) females. The measurement instrument was an on-line survey questionnaire applied mid-July to mid-August 2020 through email. The questionnaires consisted of four primary sections. The first section gathered information on respondents' sociodemographic characteristics. The second section assessed respondents ' years of professional experience and area of specialty. The third section assessed respondents ' work load on daily bases pre/post COVID-19 crisis. The final section of the questionnaire assessed the benefits and barriers of telehealth, therapist opinion about how was the department/organization handled this pandemic issue, and to add their recommendation to improve the service. RESULTS Out of the 46 therapists/clinicians, 37 (80.4%) interrupted their work activities because of the pandemic and 9 (19.6%) continue with the existing daily practice. The number of patients seen/day before pandemic decreased compare to pre pandemic by21.7%, in arrange of 15 patients/day to zero patient/day by 26.1%, that led to change the way of therapists daily practice such as seven therapists shifted their clinics to virtual clinics, and almost most of the therapists (n= 32) continue working in inpatient ward, taking in their considerations the main measures that was adopted by the organization, when they deal with the direct patient contact which included: hand washing, mask use, material disinfection and gloves. The three administrative respondents work on quality issues, managerial guidelines and research. While the four orthotics/ prosthetics clinicians shifted their work to fabricate medical supportive devices to be used for the patients. Seven therapists shift their clinics to virtual visits, and they found it very convenient to the patients. CONCLUSIONS Our result revealed that most of the therapists/clinicians interrupted their regular work , impact number patient seen per day and face-to-face practices because of the COVID-19 pandemic, due to several reason such as spread of infection and the patients are afraid to come and they cancelled their appointment, however, half of the respondents continue with their existing work and taking into their considerations the measured that were adapted by the organization, the others who did not follow up their patients’ treatment in person, most of them adapted to monitor their patients from a distance by using virtual visits.
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