title: Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence.
abstract: The aim of the study was to determine the immediate effect of timing a pelvic muscle contraction with the moment of expected leakage (the Knack maneuver) to preempt cough-related stress incontinence. Women performed a standing stress test using three hard coughs without and then with the Knack maneuver. Volume of urine loss under both conditions was quantified with paper-towel test. Two groups of women were tested: nonpregnant women (n = 64) and pregnant women (n = 29). In nonpregnant women, wetted area decreased from a median (range) of 43.2 (0.2-183.7) cm2 without the Knack maneuver to 6.9 (range of 0 to 183.7 cm2) with it (p < 0.0001); while in pregnant women it decreased from 14.8 (0-169.7) cm2 to 0 (0-96.5) cm2, respectively (p = 0.001). This study confirms the effect from the Knack maneuver as immediate and provides a partial explanation for early response to widely applied pelvic muscle training regimens in women with stress incontinence.
authors.affiliation: School of Nursing, University of Michigan, Ann Arbor, MI, USA. janismm@umich.edu
authors.forename: Janis M
authors.initials: JM
authors.lastname: Miller
authors.forename: Carolyn
authors.initials: C
authors.lastname: Sampselle
authors.forename: James
authors.initials: J
authors.lastname: Ashton-Miller
authors.forename: Gwi-Ryung Son
authors.initials: GR
authors.lastname: Hong
authors.forename: John O L
authors.initials: JO
authors.lastname: DeLancey
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007537:Isometric Contraction; D008875:Middle Aged; D011247:Pregnancy; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000517:prevention & control*; D014554:Urination / Q000502:physiology