Pelvic‐Floor‐Muscle Training Adherence: Tools, Measurements and Strategies—<i>2011 ICS State‐of‐the‐Science Seminar Research Paper II of IV</i>

Dumoulin, Chantale; Alewijnse, Dianne; Bø, Kari; Hagen, Suzanne; Stark, Diane; Kampen, Marijke Van; Herbert, Julia; Hay‐Smith, Jean; Frawley, Helena; McClurg, Doreen; Dean, Sarah

doi:10.1002/nau.22794

Cited by 53 publications

(56 citation statements)

References 58 publications

(173 reference statements)

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“…These strategies may include personalized exercise calendars in easy‐to follow, written form; audio or video recordings of instructions; and/or periodic progress visits every 3‐6 months. Such strategies may also alleviate the boredom that sometimes interferes with performing the home program …”

Section: Discussionsupporting

confidence: 93%

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Factors influencing long‐term adherence to pelvic floor exercises in women with urinary incontinence

Venegas

Carrasco

Casas-Cordero

2017

Neurourology and Urodynamics

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Background and Objectives To ensure the effectiveness of Physical Therapy for urinary incontinence (UI), it is crucial that patients adhere to treatment in both the long and the short term. Treatment adherence may prevent symptom progression and the need for surgery, which is associated with higher costs and potential complications. Adherence is defined as carrying out a recommended behavioral modification or change. The World Health Organization (WHO) has established that adherence is a multifactorial phenomenon determined by the interaction of five dimensions, which include diverse factors that affect long‐term adherence on many levels. Aim To identify the factors that influence long‐term adherence to pelvic floor exercises in women with UI. Methods Observational, descriptive, cross‐sectional study. The sample was recruited from the “Centro Integral de Reeducación de Piso Pélvico” (CIREP), and included 61 women treated for UI at the center in 2014 and 2015. Participants completed a self‐administered, 28‐item questionnaire developed for this study based on the WHO five dimensions. Data analysis was performed using STATA 13.0 software. Results Having performed pelvic floor home exercises after discharge from Physical Therapy was significantly associated with self‐rated treatment adherence (P < 0.001). Patient‐related factors were significantly associated with long‐term adherence to the pelvic floor exercise program (P < 0.001). Conclusion Patient‐related factors, exerted the strongest influence on long‐term adherence to pelvic floor exercises in women with UI; forgetting to do the exercises and boredom with the exercises were the factors most strongly related to low treatment adherence, while motivation and commitment were associated with high adherence in this population.

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Section: Discussionsupporting

confidence: 93%

“…Finally, the methodology used is limited in that the instrument only addressed the perceptions of the patient. Complementing a subjective instrument with more objective evaluations to measure improvement, such as a symptom‐tracking tool, may provide valuable findings …”

Section: Discussionmentioning

confidence: 99%

Factors influencing long‐term adherence to pelvic floor exercises in women with urinary incontinence

Venegas

Carrasco

Casas-Cordero

2017

Neurourology and Urodynamics

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“…Literature on PFPT adherence is scant. This is likely due to the challenges of measuring short‐ and long‐term patient follow‐up, as well as inability to widely standardize “compliance” terminology [13]. Physical therapists, even within the same practice, do not necessarily report on patient progress similarly.…”

Section: Discussionmentioning

confidence: 99%

Attendance at Prescribed Pelvic Floor Physical Therapy in a Diverse, Urban Urogynecology Population

Shannon

Genereux

Brincat

et al. 2017

PM&R

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“…Three preconditions of effective PFMT are: (i) a correct pelvic floor muscle (PFM) contraction; (ii) sufficient exercise dose to achieve desired physiological muscle response (e.g., hypertrophy); and (iii) treatment adherence, to achieve the exercise dose. Adherence rates in PFMT trials vary; considerably . Some variability reflects the difficulty in measuring adherence and the different measures used .…”

Section: Introductionmentioning

confidence: 99%

“…Adherence rates in PFMT trials vary; considerably . Some variability reflects the difficulty in measuring adherence and the different measures used . Other influences on PFMT adherence include differences in supervision intensity (more contact supports adherence), whether patients know adherence is being measured, and measurement timing (i.e., during, immediately after or well after supervised treatment) …”

Section: Introductionmentioning

confidence: 99%

Pelvic‐floor‐muscle‐training adherence “modifiers”: A review of primary qualitative studies—2011 ICS State‐of‐the‐Science Seminar research paper III of IV

Hay‐Smith

Dean

Burgio

et al. 2015

Neurourology and Urodynamics

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AimsThis review aims to locate and summarize the findings of qualitative studies exploring the experience of and adherence to pelvic floor muscle training (PFMT) to recommend future directions for practice and research. MethodsPrimary qualitative studies were identified through a conventional subject search of electronic databases, reference-list checking, and expert contact. A core eligibility criterion was the inclusion of verbatim quotes from participants about PFMT experiences. Details of study aims, methods, and participants were extracted and tabulated. Data were inductively grouped into categories describing "modifiers" of adherence (verified by a second author) and systematically displayed with supporting illustrative quotes. ResultsThirteen studies (14 study reports) were included; eight recruited only or predominantly women with urinary incontinence, three recruited postnatal women, and two included women with pelvic organ prolapse. The quality of methodological reporting varied. Six "modifiers" of adherence were described: knowledge; physical skill; feelings about PFMT; cognitive analysis, planning, and attention; prioritization; and service provision. ConclusionsIndividuals' experience substantial difficulties with capability (particularly knowledge and skills), motivation (especially associated with the considerable cognitive demands of PFMT), and opportunity (as external factors generate competing priorities) when adopting and maintaining a PFMT program. Expert consensus was that judicious selection and deliberate application of appropriate behavior change strategies directed to the "modifiers" of adherence identified in the review may improve PFMT outcomes. Future research is needed to explore whether the review findings are congruent with the PFMT experiences of antenatal women, men, and adults with fecal incontinence.

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Pelvic‐Floor‐Muscle Training Adherence: Tools, Measurements and Strategies—2011 ICS State‐of‐the‐Science Seminar Research Paper II of IV

Cited by 53 publications

References 58 publications

Factors influencing long‐term adherence to pelvic floor exercises in women with urinary incontinence

Factors influencing long‐term adherence to pelvic floor exercises in women with urinary incontinence

Attendance at Prescribed Pelvic Floor Physical Therapy in a Diverse, Urban Urogynecology Population

Pelvic‐floor‐muscle‐training adherence “modifiers”: A review of primary qualitative studies—2011 ICS State‐of‐the‐Science Seminar research paper III of IV

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