Incontinence improves in older women after intensive pelvic floor muscle training: An assessor-blinded randomized controlled trial (original) (raw)
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Who will benefit from pelvic floor muscle training for stress urinary incontinence?
American Journal of Obstetrics and Gynecology, 2004
Objective: The purpose of this study was to determine which patient characteristics are predictive of outcome before pelvic floor muscle training for stress urinary incontinence. Study design: This was an observational study at a single-center outdoor patient clinic in Brussels, Belgium, that comprised 447 women, aged 26 to 80 years (mean, 52.7 years), who had urinary stress incontinence. All the women received individual pelvic floor muscle training under the guidance of the same physiotherapist. Twenty-two patient characteristics were considered for outcome measurements.
Bju International, 2006
OBJECTIVESTo assess the efficacy and cost-effectiveness of pelvic floor muscle therapies (PFMT) in women aged ≥ 40 years with urodynamic stress incontinence (USI) and mixed UI.To assess the efficacy and cost-effectiveness of pelvic floor muscle therapies (PFMT) in women aged ≥ 40 years with urodynamic stress incontinence (USI) and mixed UI.PATIENTS AND METHODSIn a three-arm randomized controlled trial in Leicestershire and Rutland UK, 238 community-dwelling women aged ≥ 40 years with USI in whom previous primary behavioural intervention had failed were randomized to receive either intensive PFMT (79), vaginal cone therapy (80) or to continue with primary behavioural intervention (79) for 3 months. The main outcome measure was the frequency of primary UI episodes, and secondary measures were pad-test urine loss, patient perception of problem, assessment of PF function, voiding frequency, and pad usage. Validated scales for urinary dysfunction, and impact on quality of life and satisfaction were collected at an independent interview.In a three-arm randomized controlled trial in Leicestershire and Rutland UK, 238 community-dwelling women aged ≥ 40 years with USI in whom previous primary behavioural intervention had failed were randomized to receive either intensive PFMT (79), vaginal cone therapy (80) or to continue with primary behavioural intervention (79) for 3 months. The main outcome measure was the frequency of primary UI episodes, and secondary measures were pad-test urine loss, patient perception of problem, assessment of PF function, voiding frequency, and pad usage. Validated scales for urinary dysfunction, and impact on quality of life and satisfaction were collected at an independent interview.RESULTSAll three groups had a moderate reduction in UI episodes after intervention but there was no statistically significant difference among the groups. There were marginal improvements in voiding frequency for all groups, with no statistically significant difference among them.All three groups had a moderate reduction in UI episodes after intervention but there was no statistically significant difference among the groups. There were marginal improvements in voiding frequency for all groups, with no statistically significant difference among them.CONCLUSIONSIn women who have already had simple behavioural therapies (including advice on PFM exercises) for urinary dysfunction, the continuation of these behavioural therapies can lead to further improvement. The addition of vaginal cone therapy or intensive PFMT does not seem to contribute to further improvement. The improvement in pelvic floor function was significantly greater in the PFMT arm than in the control arm although this did not translate into changes in urinary symptoms.In women who have already had simple behavioural therapies (including advice on PFM exercises) for urinary dysfunction, the continuation of these behavioural therapies can lead to further improvement. The addition of vaginal cone therapy or intensive PFMT does not seem to contribute to further improvement. The improvement in pelvic floor function was significantly greater in the PFMT arm than in the control arm although this did not translate into changes in urinary symptoms.
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.10\_Oct2017/IJHSR\_Abstract.019.html, 2017
Background: Urinary Incontinence is widely prevalent in females but poorly diagnosed. Several studies all around the world have already proven the effect of physiotherapy management in females with stress urinary incontinence. In India, since last 10 years the awareness and education regarding physiotherapy in SUI has increased. Still limited evidences in India, and acceptance of this problem by majority of females lead to low level of evidence based practice. The cultural, economic and religious scenario of Indian women is very different than that of western or other developed countries. So there is immense need to work on these areas, define a protocol of exercise for them and to see the efficacy of this protocol on incontinence episodes in women with SUI. Aim: To evaluate the effect of Pelvic Floor Muscle Training (PFMT) based on severity of incontinence on incontinence episodes in women with Stress Urinary Incontinence. Materials and Methods: Total 65 subjects were recruited according to inclusion criteria for an experimental study which was set up at SBB College of Physiotherapy, V.S.General Hospital Campus and Shruti nursing home, Naranpura, Ahmedabad. Each subject received 6 weeks of home based PFMT based on severity of incontinence which was decided by Incontinence Severity Index. Pre and post data were taken and further analysis was done using SPSS 21.0. The outcome measure used was voiding diary (Number of incontinence episodes per week and frequency of micturition per day). Results and Discussion: Level of significance was set at 5%. Wilcoxon test was used to compare the pre and post data for all the subjects. The hypothesis is proven with Z =-5.566 and Z =-6.167 for frequency and number of leakages respectively. p < 0.001 shows highly significant difference between two groups. Conclusions: Six weeks home based PFMT based on severity of incontinence is effective in reducing no. of leakages per week and frequency of micturition per day in female with SUI.
International Urogynecology Journal, 2009
Introduction and hypothesis Pelvic floor muscle training (PFMT) is a treatment for stress urinary incontinence (SUI) that can be done individually or in a group. The aim of this study was to compare these two types of treatment. Methods Sixty women 30 to 75 years old with SUI were randomly assigned to participate in the two groups. They were evaluated before and after the treatment with the Oxford grading system, pad test, voiding diary, and the King’s Health Questionnaire. Results Both groups experienced significant reductions in urinary leakage as measured by the pad test and bladder diary. A negative pad test was observed in about 50% of patients in both groups. There were statistically significant improvements in both muscle strength and quality of life. When the groups were compared, there were no differences in the results between them. Conclusions Individual treatment and group PFMT appear to be equally effective for improving SUI.
Urogynaecologia
Pelvic Floor Muscle Training (PFMT) is an effective, non-invasive, and cost-effective treatment for Stress Urinary Incontinence (SUI). However, its success rate varies. We evaluated the factors predicting success in PFMT, such as age, initial urinary leakage, initial pelvic floor muscle contraction strength, urethral hypermobility, and myostatin level. A nested case-control study was conducted at Dr. Cipto Mangunkusumo hospital between February and October 2021. We evaluated demographic characteristics, UDI-6 and IIQ-7 questionnaire scores, physical exam, pad weight test, urethral hypermobility ultrasound, perineometry, myostatin level, and we instructed the subjects in PFMT according to a guidebook. After 12 weeks of PFMT, we evaluated therapy success, defined as less than 3g on the pad weight test. The study involved 58 women: 5 subjects dropped out, 47 subjects reached treatment success, and 6 subjects did not reach treatment success. Following bivariate analysis, we found that i...
Journal of physiotherapy, 2013
What evidence is there for alternative exercises to specific pelvic floor muscle training for treatment of stress urinary incontinence in women? A systematic review was conducted with searches of PubMed and PEDro to January 2013. The quality of randomised trials was evaluated using the PEDro scale. Each type of exercise was classified as being in a Development Phase, Testing Phase, or Refinement and Dissemination Phase. Women with stress or mixed urinary incontinence with predominantly stress urinary incontinence. Exercise regimens other than pelvic floor muscle training. The primary outcome was urinary leakage. Seven randomised controlled trials were found: three on abdominal training, two on the Paula method, and two on Pilates exercise. The methodological quality score ranged between 4 and 8 with a mean of 5.7. There was no convincing evidence for the effect of these exercise regimens so they remain in the Testing Phase. Because no randomised trials were found for posture correct...
Severe stress urinary incontinence: pelvic floor muscle training program
International guidelines recommend a first line therapy in the treatment of female stress urinary incontinence (SUI), the pelvic floor muscle (PFM) training. This case report assesses the effects of the PFM training program in treating women with severe SUI. The urodynamic parameters allow diagnosed intrinsic sphincter deficiency and urethral hypermobility. The subjective and objective parameters were assessed at the beginning and after six-month of PFM training program. This case report confirms the efficiency of the intensive training program in severe SUI. The medical implications of the PFM training as first treatment option reflect favourable individual results and additionally contribute to the selection of the non-invasive treatment, the reduction of the incidence collateral effects, low costs and that does not prevent future treatment options.
International Urogynecology Journal, 2010
Introduction and hypothesis Pelvic floor muscle training (PFMT) is considered to be the first-line treatment for female stress urinary incontinence (SUI). There are few studies that have tested the efficacy of unsupervised PFMT. The aim of this study was to compare the effectiveness of intensive supervised PFMT to unsupervised PFMT in the treatment of female SUI. Methods Sixty-two women with SUI were randomized to either supervised or unsupervised PFMT after undergoing supervised training sessions. They were evaluated before and after the treatment with the Oxford grading system, pad test, quality of life questionnaire, subjective evaluation, and exercise compliance. Results After treatment, there were no differences between the two groups regarding PFM strength (p=0.20), International Consultation on Incontinence Questionnaire-Short Form score (p=0.76), pad test (p=0.78), weekly exercise compliance (p=0.079), and subjective evaluation of urinary loss (p=0.145). Conclusions Both intensive supervised PFMT and unsupervised PFMT are effective to treat female SUI if training session is provided.
BMC women's health, 2006
Stress urinary incontinence (SUI) is a prevalent and costly condition which may be treated surgically or by physical therapy. The aim of this review was to systematically assess the literature and present the best available evidence for the efficacy and effectiveness of pelvic floor muscle training (PFMT) performed alone and together with adjunctive therapies (eg biofeedback, electrical stimulation, vaginal cones) for the treatment of female SUI. All major electronic sources of relevant information were systematically searched to identify peer-reviewed English language abstracts or papers published between 1995 and 2005. Randomised controlled trials (RCTs) and other study designs eg non-randomised trials, cohort studies, case series, were considered for this review in order to source all the available evidence relevant to clinical practice. Studies of adult women with a urodynamic or clinical diagnosis of SUI were eligible for inclusion. Excluded were studies of women who were pregn...
Pelvic floor muscle training protocol for stress urinary incontinence in women: A systematic review
Revista da Associacao Medica Brasileira (1992), 2017
Strengthening exercises for pelvic floor muscles (SEPFM) are considered the first approach in the treatment of stress urinary incontinence (SUI). Nevertheless, there is no evidence about training parameters. To identify the protocol and/or most effective training parameters in the treatment of female SUI. A literature research was conducted in the PubMed, Cochrane Library, PEDro, Web of Science and Lilacs databases, with publishing dates ranging from January 1992 to March 2014. The articles included consisted of English-speaking experimental studies in which SEPFM were compared with placebo treatment (usual or untreated). The sample had a diagnosis of SUI and their age ranged between 18 and 65 years. The assessment of methodological quality was performed based on the PEDro scale. Seven high methodological quality articles were included in this review. The sample consisted of 331 women, mean age 44.4±5.51 years, average duration of urinary loss of 64±5.66 months and severity of SUI r...