Effects of individual pelvic floor muscle training vs individual training progressing to group training vs group training alone in women with stress urinary incontinence: A randomized clinical trial

Abstract

Aims To assess the effects of individual pelvic floor muscle (PFM) training vs individual training (IT) progressing to group training (GT) vs group‐only training in women with stress urinary incontinence (SUI). Methods Randomized controlled and pragmatic clinical trials with 90 women with SUI. Participants were randomly allocated to one of three groups: IT, GT, or four individual sessions progressing to group training (IPGT). The intervention included 12 sessions, once a week, with direct supervision by a physical therapist. Primary outcome: severity according to the King's Health Questionnaire. Secondary outcomes: PFM function by palpation and manometer, bladder and exercise diaries, PFM training adherence, and self‐efficacy. Reassessments were conducted at the end of the intervention, 3 and 6 months after the intervention. Intra‐ and intergroup analysis for all outcomes was performed using a multivariate analysis of variance. In the mixed‐effects model used, the evaluation groups and times and their interactions were considered. A significance level of 5% was adopted. Results After the intervention, the severity measure improved in all three groups (P < .001), without difference between them (P = .56). The benefits of the intervention were maintained 3 and 6 months after the end of the supervised training (P < .001). The IPGT group had a significant improvement in PFM function when compared to the other groups posttreatment (P < .001). Conclusion PFM training improved the severity of urinary incontinence in all groups after 12 sessions of training supervised by a physical therapist. IT progressing to GT improved the function of upper PFM when compared to the other groups.

Clinical Efficacy of Supervised Pelvic Floor Muscle Training - assisted Biofeedback on Quality of Life and Functional Outcomes in patients with Fecal Incontinence

“…It is worth noting that other recent RCT supported the beneficial effect of pelvic floor muscle exercise combined with feedback in reducing incontinence severity based on Wexner FI SI [28,29] . In addition, biofeedback combined with pelvic floor exercises is better than pelvic exercises alone, for alleviating FI symptoms in nearly three forth of patients after12sessions of supervised training [30][31][32]. accordance with Lee and colleagues.…”

Responsiveness of Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) after pelvic floor muscle training in women with stress and mixed urinary incontinence

“…Similarly to our study, Sanchez et al [9] evaluated the responsiveness of the Spanish version of the PFIQ-7 after PFMT in women with PFM dysfunction (68.2 % of the women had UI, 27.1 % had prolapse and 29.4 % had anal incontinence) and found a moderate responsiveness. Besides, the primary outcome of RCT conducted and published previously [18] was related to urinary symptoms, fact that may be influenced the responsiveness of other subscales of both questionnaires that were not related to urinary symptoms. This is a limitation also commented by Barber et al [31] that reported a poor responsiveness of subscales of PFDI-20 and PFIQ-7 that were not related to the primary outcome evaluated in previous researchers conducted with another population.…”

“…This prospective observational study performed according STROBE checklist is secondary to a multicentre randomized clinical trial (RCT) that aimed to evaluate the effects of individual PFMT versus group PFMT for women with SUI. The RCT protocol and results of the study were previously published [17,18].…”

Fisioterapia pélvica na bexiga neurogênica

“…O treinamento auxilia na inibição do desejo, da sensação, ou urgência urinária. Além de melhorar a força da musculatura do assoalho pélvico, os exercícios desta musculatura incrementam a resistência e pressão de fechamento uretral, podendo ser realizados várias vezes ao dia 40,42,43 . Vale ressaltar que para a prática regular dos exercícios de modo ativo é necessário que a inervação dos músculos do assoalho pélvico esteja íntegra para a ativação do reflexo de Mahony.…”