Adherence to Behavioral Interventions for Stress Incontinence: Rates, Barriers, and Predictors

Borello‐France, Diane; Burgio, Kathryn L.; Goode, Patricia S.; Ye, Wen; Weidner, Alison C.; Lukacz, Emily S.; Jelovsek, J. Eric; Bradley, Catherine S.; Schaffer, Joseph I.; Hsu, Yvonne; Kenton, Kimberly; Spino, Cathie

doi:10.2522/ptj.20120072

Cited by 67 publications

(61 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, one study of women who had UI after giving birth concluded that the most common reasons provided for not performing the exercises, or stopping the exercise program within six months after giving birth, included: feeling that the exercises were unnecessary if symptoms were no longer present; forgetting to do the exercises; being too busy to do the exercises; feeling that the exercises were not important; not understanding how to do exercises; or experiencing pain when performing the exercises . Other study, factors associated with poor adherence to pelvic floor exercises in women with UUI included insufficient time or trouble remembering to do the exercises …”

Section: Discussionmentioning

confidence: 82%

See 1 more Smart Citation

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

Venegas

Carrasco

Casas-Cordero

2017

Neurourology and Urodynamics

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 82%

“…Predictors of PFE adherence include demographic variables (age and education level), general physical status, severity of UI, and self‐efficacy for performing the PFE . Prior studies have shown that older age has a modest positive effect on adherence.…”

Section: Introductionmentioning

confidence: 99%

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

Venegas

Carrasco

Casas-Cordero

2017

Neurourology and Urodynamics

View full text Add to dashboard Cite

show abstract

“…The first‐line treatment for SUI is pelvic floor muscle training (PFMT), but there is no clear consensus on whether the training must be supervised . Adherence to PFMT is a key factor in its effectiveness, but many barriers to exercise exist, including forgetting, not prioritising, and not perceiving the benefits of training …”

Section: Introductionmentioning

confidence: 99%

Mobile app for treatment of stress urinary incontinence: A randomized controlled trial

Asklund

Nyström

Sjöström

et al. 2016

Neurourology and Urodynamics

140

315

View full text Add to dashboard Cite

show abstract

“…1–9 Current first-line treatment consists of behavioral strategies such as pelvic floor exercises that can be difficult for women to practice effectively without one-on-one training with specialized healthcare practitioners. 10–13 Second-line treatments such as anticholinergic medications have side effects that limit their safety and tolerability. 14–17 As a result, there is a need for alternate management strategies that are not only effective, but also better tolerated and more accessible.…”

Section: Introductionmentioning

confidence: 99%

A group-based yoga program for urinary incontinence in ambulatory women: feasibility, tolerability, and change in incontinence frequency over 3 months in a single-center randomized trial

Huang

Chesney

Lisha

et al. 2019

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

Structured Abstract Background: Due to the limitations of existing clinical treatments for urinary incontinence, many women with incontinence are interested in complementary strategies for managing their symptoms. Yoga has been recommended as a behavioral self-management strategy for incontinence, but evidence of its feasibility, tolerability, and efficacy is lacking. Objectives: To evaluate the feasibility and tolerability of a group-based therapeutic yoga program for ambulatory middle-aged and older women with incontinence and examine preliminary changes in incontinence frequency as the primary efficacy outcome after 3 months. Study Design: Ambulatory women aged 50 years or older who reported at least daily stress-, urgency-, or mixed-type incontinence, were not already engaged in yoga, and were temporarily willing to forgo clinical incontinence treatments were recruited into a randomized trial in the San Francisco Bay area. Women were randomly assigned to take part in a program of twice weekly group classes and once weekly home practice focused on Iyengar-based yoga techniques selected by an expert yoga panel (yoga group) or a non-specific muscle stretching and strengthening program designed to provide a rigorous time-and-attention control (control group) for 3 months. All participants also received written, evidence-based information about behavioral incontinence self-management techniques (pelvic floor exercises, bladder training) consistent with usual first-line care. Incontinence frequency and type were assessed by validated voiding diaries. Analysis of covariance models examined within- and between-group changes in incontinence frequency as the primary efficacy outcome over 3 months. Results: Of the 56 women randomized (28 to yoga, 28 to control), mean age was 65.4 (±8.1) years (range 55–83 years), mean baseline incontinence frequency was 3.5 (±2.0) episodes/day, and 37 (66%) had urgency-predominant incontinence. Fifty women completed their assigned 3-month intervention program (89%), including 27 in the yoga and 23 in the control group (P=0.19). Of those, 24 (89%) in the yoga and 20 (87%) in the control group attended at least 80% of group classes. Over 3 months, total incontinence frequency decreased by an average of 76% from baseline in the yoga and 56% in the control group (P=0.07 for between-group difference). Stress incontinence frequency also decreased by an average of 61% in the yoga group and 35% in controls (P=0.045 for between-group difference), but changes in urgency incontinence frequency did not differ significantly between groups. Forty-eight non-serious adverse events were reported, including 23 in the yoga and 25 in the control group, but none were directly attributable to yoga or control program practice. Conclusions: Findings demonstrate the feasibility of recruiting and retaining incontinent women across the aging spectrum into a therapeutic yoga program and provide preliminary evidence of reduction in total and stress-type incontinence frequency after 3 months of yoga practic...

show abstract

Adherence to Behavioral Interventions for Stress Incontinence: Rates, Barriers, and Predictors

Abstract: Adherence to PFM exercises and bladder control strategies for SUI can be high and sustained over time. However, behavioral interventions to help women link exercise to environmental and behavioral cues may only be beneficial over the short term.

Cited by 67 publications

References 44 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

Mobile app for treatment of stress urinary incontinence: A randomized controlled trial

A group-based yoga program for urinary incontinence in ambulatory women: feasibility, tolerability, and change in incontinence frequency over 3 months in a single-center randomized trial

Contact Info

Product

Resources

About