Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a cochrane systematic review abridged republication

Abstract

Background: Pelvic floor muscle training is the most commonly used physical therapy treatment for women with urinary incontinence. Objectives: To assess the effects of Pelvic floor muscle training for women with urinary incontinence in comparison to a control treatment and to summarize relevant economic findings. Methods: Cochrane Incontinence Group Specialized Register (February 12, 2018). Selection criteria: Randomized or quasi-randomized trials in women with stress, urgency or mixed urinary incontinence (symptoms, signs, or urodynamic). Data collection and analysis: Trials were independently assessed by at least two reviewers authors and subgrouped by urinary incontinence type. Quality of evidence was assessed by adopting the Grading of Recommendations, Assessment, Development and Evaluation approach. Results: The review included thirty-one trials involving 1817 women from 14 countries. Overall, trials were small to moderate size, and many were at moderate risk of bias. There was considerable variation in the intervention's content and duration. Based on data available, we can be confident that Pelvic floor muscle training can cure or improve symptoms of stress and all other types of urinary incontinence. It may reduce the number of leakage episodes and the quantity of leakage, while improving reported symptoms and quality of life. Women were more satisfied with Pelvic floor muscle training, while those in control groups were more likely to seek further treatment. Long-term effectiveness and cost-effectiveness of Pelvic floor muscle training needs to be further researched. ଝ This paper is part of a Special Issue on Women's Health Physical Therapy. ଝଝ This article is based on a Cochrane Review published in the Cochrane Database of Systematic Reviews (CDSR)

Exercise and Quality of Life in Women with Menopausal Symptoms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Similar to the main findings of three included studies using PFMT, Cacciari et al [ 69 ] indicated that PFMT can reduce the number of urinary leakage episodes and improve all types of urinary incontinence issues as well as QoL in women with urinary symptoms. Furthermore, Carcelen-Fraile et al [ 58 ] found that PFMT was the most common type of exercise used in studies investigating the effects of physical exercise programs on quality of sexual life related to menopausal symptoms, and it seems most beneficial for sexual function in perimenopausal or postmenopausal women.…”

The Rolf Method of Structural Integration and Pelvic Floor Muscle Facilitation: Preliminary Results of a Randomized, Interventional Study

“…Hypertonia (increased muscle tension at rest), characteristic of the dysfunctions mentioned above, may contribute to the incorrect sliding of actin and myosin myofilaments, responsible for muscle contraction and relaxation, and may disrupt the generation of muscular strength and endurance [ 36 ]. A current, comprehensive review of PFMsT indicates that women with impaired contraction (impaired motor control) are excluded from studies on PFMsT [ 37 ], reinforcing the fact that contraction influences PFM force generation. Thus, can the decrease in the bioelectric activity of PFMs translate into the improvement of their functions and restoration of motor control in the case of various types of pelvic floor dysfunction?…”

Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy

“…Pelvic floor muscle training (PFMT) is a well-described, effective, and most commonly used method of physiotherapeutic UI treatment which has been recognized and recommended as the first line of conservative SUI treatment [47]. For the first time, PFM exercises were described in 1948 by Arnold Kegel as a behavioral method in the treatment of UI [48].…”