Women report sustained benefits from attending group-based education about pelvic floor muscles: a longitudinal qualitative study

Fernandes, Ana Carolina Nociti Lopes; Palacios‐Ceña, Domingo; Hay‐Smith, Jean; Pena, Caroline Caetano; Sidou, Mayra Feltrin; Alencar, Amanda Lima de; Ferreira, Cristine Homsi Jorge

doi:10.1016/j.jphys.2021.06.010

Cited by 13 publications

(14 citation statements)

References 30 publications

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“…The more knowledgeable and insightful the women were about their pelvic floor and pelvic health, and the more they experienced an effect on their symptoms, the more they adhered to PFMEs [ 49 ]. These findings agree with those of other studies conducted in women with urinary incontinence [ 15 , 50 , 51 ].…”

Section: Discussionsupporting

confidence: 93%

Women’s Experiences with Compliance with Pelvic Floor Home Exercise Therapy and Lifestyle Changes for Pelvic Organ Prolapse Symptoms: A Qualitative Study

Torres-Lacomba

Navarro-Brazález

Yuste-Sánchez

et al. 2022

JPM

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In this study, we aimed to investigate women’s experiences with compliance with prescribed pelvic floor muscle exercises (PFMEs) and lifestyle changes 6–12 months after completing an individual pelvic floor physiotherapy program. This study was targeted to understanding factors affecting adherence to PFMEs and lifestyle changes to deal with pelvic organ prolapse (POP) symptoms. We designed this research as a descriptive qualitative study. We conducted this study from December 2016 to September 2017 in Madrid, Spain. Twenty-six women with symptomatic POP selected using a purposive sampling method participated in six focus groups and three one-to-one semi-structured interviews. Three authors coded and inductively analyzed transcript contents with iterative theme development. A thematic analysis revealed three main themes: (1) symptoms change; (2) PFMEs and lifestyle changes performance; and (3) a health practitioner–patient relationship. Women identified as adherent reported improvement in physical symptoms and emotional and general state as a result of the new knowledge achieved. Fear also promoted compliance with performing PFMEs and adopting lifestyle changes. Likewise, PFMEs preference and routine, integration of PFMEs and lifestyle changes into activities of daily living, support guides, therapeutic alliance, individual supervision, follow-up, and feedback were also identified as adherence facilitators. One of the biggest barriers that we identified was responsibility. Compliance with prescribed PFMEs and lifestyle changes can be improved with effective individual, women-centered, and supervised physiotherapy programs reducing symptoms, including exercises aligned with women’s preferences that are easy to integrate in daily living, promoting knowledge and awareness of their condition, providing written or electronic guidelines, with routine follow-up visits offering both positive feedback and clear and consistent messages, and enhancing therapeutic alliance.

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Section: Discussionsupporting

confidence: 93%

Women’s Experiences with Compliance with Pelvic Floor Home Exercise Therapy and Lifestyle Changes for Pelvic Organ Prolapse Symptoms: A Qualitative Study

Torres-Lacomba

Navarro-Brazález

Yuste-Sánchez

et al. 2022

JPM

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“…Community-dwelling women experienced positive outcomes from group PF education sessions including better awareness of symptoms,62 63 improved help-seeking behaviour,63 commencement of PFMT and a decrease in PF symptoms 62. Asymptomatic women reported benefit from attending alongside those with symptoms; many women shared the knowledge with family/friends outside the group 63. Providing all women, group education on common PF symptoms, verbal instruction of PFMT and lifestyle changes, may promote help-seeking behaviour and positive engagement with conservative therapies, prior to sport and exercise cessation.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Women’s preferences for pelvic floor screening in sport and exercise: a mixed-methods study integrating survey and interview data in Australian women

Dakic,

Hay-Smith,

Lin

et al. 2023

Br J Sports Med

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ObjectivesOne in two women experiencing pelvic floor (PF) symptoms stop playing sport or exercising. The study examines the perspective of women with PF symptoms to inform acceptable screening practices within sport and exercise settings.MethodsExplanatory, sequential, mixed-methods design. Phase 1: survey of 18–65 years, symptomatic, Australian women (n=4556). Phase 2: semistructured interviews with a subset of survey participants (n=23). Integration occurred through connection of phases (study design, sampling) and joint display of data.ResultsFindings are represented in three threads: (1) ‘women (not) telling’; a majority of women had told no-one within a sport or exercise setting about their PF symptoms due to shame/embarrassment, lack of pelvic health knowledge and not wanting to initiate the conversation, (2) ‘asking women (screening for PF symptoms)’; women endorsed including PF symptom questions within existing sport and exercise screening practices but only when conducted in a respectful and considered manner and (3) ‘creating safety’; professionals can assist women to disclose by demonstrating expertise, trustworthiness and competency. If health and exercise professionals are provided with appropriate training, they could raise pelvic health awareness and promote a supportive and safe sport and exercise culture.ConclusionWomen with PF symptoms support health and exercise professionals initiating conversations about PF health to normalise the topic, and include PF symptoms among other pre-exercise screening questions. However, women should be informed on the relevance and potential benefits of PF screening prior to commencing. Safe screening practices require building trust by providing information, gaining consent, displaying comfort and genuine interest, and being knowledgeable within one’s scope of practice to the provision of advice, exercise modifications and referral as appropriate.

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“…Brazilian women’s knowledge about PFM function and dysfunction is low [ 22 , 23 ]. PFMT protocol must include an education component about PFM function not only to increase women’s knowledge about it but also to improve their adherence to treatment [ 24 , 25 ]. We will also have the chance to identify barriers and facilitators related adherence to the proposed interventions.…”

Section: Discussionmentioning

confidence: 99%

Effect of pelvic floor muscle training on reports of urinary incontinence in obese women undergoing a low-calorie diet before bariatric surgery — protocol of a randomized controlled trial

Mendes,

Fretta,

Camargo

et al. 2023

Trials

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Background Obesity represents a growing threat to health with multiple negative impacts including urinary incontinence. Pelvic floor muscle training (PFMT) is the first line of treatment for urinary incontinence. Both surgical and conservative weight loss results in improvement of urinary incontinence reports in obese women and we hypothesize that a low-calorie diet in combination with PFMT would result in additional beneficial effects to urinary symptoms in women with UI compared would with weight loss alone. Objective To assess the effect of a low-calorie diet plus PFMT protocol in obese women’s urinary incontinence reports. Methods This is a protocol for a randomized controlled trial that will include obese women reporting UI and being able to contract their pelvic floor muscles. The participants will be randomly allocated in two groups: group 1 will participate in a 12-week protocol of low-calorie diet delivered by a multi-professional team at a tertiary hospital; group II will receive the same low-calorie diet protocol during 12 weeks and will additionally participate in 6 group sessions of supervised PFMT delivered by a physiotherapist. The primary outcome of the study is self-reported UI, and severity and impact of UI on women’s quality of life will be assessed by the ICIQ-SF score. The secondary outcomes will be adherence to the protocols assessed using a home diary, pelvic floor muscle function assessed by bidigital vaginal palpation and the modified Oxford grading scale, and women’s self-perception of their PFM contraction using a questionnaire. Satisfaction with treatments will be assessed using a visual analog scale. The statistical analysis will be performed by intention to treat and multivariate analysis of mixed effects will be used to compare outcomes. The complier average causal effects (CACE) method will be used to assess adherence. There is an urgent need for a high-quality RCT to investigate if the association of a low-calorie diet and PFMT can provide a larger effect in the improvement of urinary incontinence reports in women with obesity. Trial registration Clinical Trials NCT04159467. Registered on 08/28/2021.

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Women report sustained benefits from attending group-based education about pelvic floor muscles: a longitudinal qualitative study

Cited by 13 publications

References 30 publications

Women’s Experiences with Compliance with Pelvic Floor Home Exercise Therapy and Lifestyle Changes for Pelvic Organ Prolapse Symptoms: A Qualitative Study

Women’s Experiences with Compliance with Pelvic Floor Home Exercise Therapy and Lifestyle Changes for Pelvic Organ Prolapse Symptoms: A Qualitative Study

Women’s preferences for pelvic floor screening in sport and exercise: a mixed-methods study integrating survey and interview data in Australian women

Effect of pelvic floor muscle training on reports of urinary incontinence in obese women undergoing a low-calorie diet before bariatric surgery — protocol of a randomized controlled trial

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