Urinary incontinence (UI) is defined as the involuntary flow of urine and is a social and public health problem. Urinary incontinence not only leads to perineal rashes, pressure sores and urinary tract infections, but also causes embarrassment and negative self-perceptions. In groups with urinary incontinence, they experience reduced social interaction, poorer self-evaluation of health, low emotional and psychological status, sexual relationship disorders, reduced quality of life and depressive symptoms. I. Types of urinary incontinence There are three main types of incontinence: stress incontinence, urge incontinence and mixed incontinence. Stress incontinence is the involuntary flow of urine that occurs during work or exertion, or when coughing and sneezing. During work and exertion, the intra-abdominal pressure increases and the urethral sphincter is unable to maintain a pressure higher than that of the bladder. Urinary overflow can also occur during daily activities such as lifting heavy objects, laughing, jumping, sneezing or coughing. Urge incontinence refers to the leakage of urine on or immediately after the onset of the urge to urinate. During bladder filling, the bladder contracts abnormally, so the sensation of urination becomes more intense, making it difficult to ignore and eventually leading to the onset of leakage. Urge incontinence may be associated with overactive bladder disorder, which is characterized by frequent, urgent and nocturnal urination, with or without urge incontinence. Mixed incontinence is associated with involuntary urine leakage with urgency and is also associated with exertion, work, sneezing or coughing. II. Treatment of urinary incontinence In female patients with urinary incontinence, physical therapy options include physical therapy of the pelvic floor, lifestyle and behavioral therapy, and pharmacotherapy, and also patient education. 1. Pelvic floor physiotherapy The most common treatment for stress incontinence is pelvic floor muscle training (PFME), or specific strength training for the piriformis muscle. The theory behind this treatment is that strong contraction of the detrusor muscle improves urethral closure and increases support for the intrapelvic organs. If the contraction of the pelvic floor muscles is strong enough and timely, then the urethra can be compressed and the leakage interrupted. In women with stress urinary incontinence, the effectiveness of PFME training depends on the frequency and intensity of training. For example, previous studies have suggested that in women with mild to moderate stress incontinence, a program of 2 to 4 seconds of muscle contraction per session, repeated 15 times for 1 set of 3 sets per day for 8 weeks, provides significant relief from incontinence. The treatment is more effective when women have been trained for at least 3 months. 2. PFME combined with biofeedback therapy The biofeedback or palpation can clarify whether the patient’s muscle contractions are correct. In women, feedback can be obtained by placing small electrode pads around the anus or by applying electrodes built into the vagina. The application of biofeedback techniques allows the patient to feel the muscle output immediately during the training. PFME combined with biofeedback is not as effective as PFME alone. However, PFME combined with biofeedback may be an effective and acceptable treatment option. A practical treatment strategy is to combine biofeedback with PFME training at the start of PFME training in patients who have difficulty understanding how to contract or are unable to contract the pelvic floor muscles. 3. PFME combined with electrical stimulation Physical therapists can also use electrical stimulation therapy to reduce the incidence of incontinence. The goal of electrical stimulation is to increase muscle volume, normalize reflex activity in the lower urinary tract, and improve circulation in the muscles and capillary system. Stimulation of the pubic nerves can improve urethral closure by activating the pelvic floor muscles. In cases of improved incontinence, the efficacy of electrical stimulation is comparable to that of sham stimulation or PFME. However, in patients who are initially unable to contract the pelvic floor muscles on their own, electrical stimulation may be the preferred treatment. 4. The preventive effect of pelvic floor muscle training Enhancing the strength of the pelvic floor muscles through specific training can prevent the occurrence of stress urinary incontinence and pelvic organ prolapse. If the pelvic floor has a certain strength, then muscle contraction has the potential to counteract the increase in abdominal pressure during physical activity. 5. Barriers to successful implementation of physical therapy In general, women with stress incontinence receive physical therapy once a week for 4 to 8 weeks. Home therapy combined with physical therapy is an effective treatment option for urinary incontinence. In addition, the patient’s education, activity level, number of births, smoking status, type of birth, and pelvic pain may affect the patient’s ability to properly complete PFME. In summary, in women with urinary incontinence, an individualized physical therapy program should be developed and include standard physical therapy interventions. These interventions reduce pain, PFME with/without combined biofeedback or electrical stimulation improves pelvic floor muscle strength and coordination, stability training improves abdominal and/or lumbar stabilizing muscle strength, and patient education includes bladder and/or rectal training, fluid management, and diet programs.