{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T15:43:05Z","timestamp":1779291785218,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Questions<\/jats:title><jats:p>Do women with stress urinary incontinence (SUI) who receive instruction to perform the knack maneuver as part of a 12\u2010week pelvic floor muscle training (PFMT) program perform it during voluntary coughing without specific instruction to do so, and are subjective and objective outcomes better among those who do than among those who do not demonstrate the knack during voluntary coughing?<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of a prospective interventional cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Women with SUI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>12\u2010week PFMT intervention including instruction to perform the knack.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measures<\/jats:title><jats:p>Performance of the knack before a voluntary cough as confirmed through ultrasound imaging. SUI severity determined subjectively (International Consultation on Incontinence Modular Questionnaire\u2010Female Lower Urinary Tract Symptoms\u00a0[ICIQ\u2010FLUTS] overall score, ICIQ\u2010FLUTS UI subscale score, 3\u2010day bladder diary) and objectively (30\u2010min\u00a0pad test).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Outcome data were available from 69 participants. At baseline, no participants performed the knack when asked to cough. At follow\u2010up, more participants performed the knack during a voluntary cough [18\/69 (26%), 95% confidence interval [CI] 15%\u201335%] than at baseline. The extent of improvement in SUI symptoms was not different between participants who did and did not demonstrate the knack during a voluntary cough [FLUTS\u2010UI subscale score (<jats:italic>d<\/jats:italic>\u2009=\u20090.31, 95% CI \u20130.78 to 2.77, <jats:italic>n<\/jats:italic>\u2009=\u200969), FLUTS overall score (<jats:italic>d<\/jats:italic>\u2009=\u20090.26, 95% CI \u22121.52\u20134.23, <jats:italic>n<\/jats:italic>\u2009=\u200969), 30\u2010min\u00a0pad test (<jats:italic>d<\/jats:italic>\u2009=\u20090.03, 95% CI \u22129.35 to 10.32, <jats:italic>n<\/jats:italic>\u2009=\u200969), 3\u2010day bladder diary (<jats:italic>d<\/jats:italic>\u2009=\u20090.03, 95% CI \u22124.07 to 3.60, <jats:italic>n<\/jats:italic>\u2009=\u200951)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Approximately one in four women appear to adopt the knack as a motor response to a cough command, however, adopting the knack was not independently associated with greater improvements in SUI.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25196","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T17:12:38Z","timestamp":1683047558000},"page":"1290-1298","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["One in four women with stress urinary incontinence who are taught \u201cthe knack\u201d maneuver adopt this motor pattern while coughing: A prospective interventional cohort study"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5630-4244","authenticated-orcid":false,"given":"Fl\u00e1via I.","family":"Ant\u00f4nio","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, School of Rehabilitation Sciences University of Ottawa Ottawa Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, 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