Many sequelae are secondary to a cerebrovascular accident (CVA) and are directly addressed in rehabilitation. Among these sequelae, urinary incontinence (present in 26% to 44% of people admitted into rehabilitation) is often left out and remains problematic. The main symptoms are urge urinary incontinence, an increase in nighttime urinary frequency and difficulty urinating. There are many biopsychosocial consequences. They are correlated with long in-patient stays and a potential factor of institutionalization (Dumoulin et al. 2007 and McDowell 2007). Perineal and pelvic rehabilitation (PPR) is a physiotherapy speciality that offers treatments that aim to improve the functioning of the pelvic floor to treat several problems including urinary incontinence. PPR has been shown to be effective in treating urinary incontinence in women who have suffered a CVA (Tibaek et al. 2005, Shin et al. 2016). Paradoxically, rehabilitation rarely targets urinary problems. In order to address this problem, we have integrated a continence management plan that includes PPR into the intensive functional rehabilitation (IFR) program. Training on the criteria for referral to the PPR program was offered to various professionals in the interdisciplinary team in order to make sure care was standardized. When the user has urinary incontinence and can be admitted to the program, a referral is made to specialized physiotherapists. The physiotherapist conducts an evaluation, draws up a treatment plan, provides instruction and recommendations to the user, her family and/or the care team.
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