Stroke incontinence study

Intervention Group will receive daily physiotherapy stroke rehabilitation. As well as this, they will receive specifically designed: Continence promotion intervention that will be tailored to patient's requirements and might include: Bladder training, Pelvic floor muscle exercises, Real Time Ultrasound Biofeedback for pelvic floor and transversus abdominis muscles. Pelvic floor muscle exercises will be encouraged at each physiotherapy intervention. Bladder training protocols will need to be repeated daily since stroke patients often have problems with short term memory deficits. Real time ultrasound provides images of muscles as they actually contract. Biofeedback using real time ultrasound will be used to teach patients how to contract pelvic floor muscles and abdominal muscles. It will be used daily until patients are aware of the muscle contraction and no longer require biofeedback. This will differ between patients Information booklet based on succesfully developed continence promotion booklets previously produced by Dr Chiarelli aimed at different clinical groups e.g postpartum women, older people following surgery for fractured hip. The "Waterworks after Stroke" information booklet will be designed using health promotion principles and with the assistance of speech pathologists who have special expertise in management of stroke patients. Booklet will be given to patients and their carers. Acceptability, understandability and relevance of the contents of the booklet will be tested in both patient and carer groups Intervention progressed as required for the duration of patient's stay in Rehabiliation Unit