An ideal e‐health system for pelvic floor muscle training adherence: Systematic review

Objective: The primary objective was to evaluate the impact of app use on urinary incontinence control through pelvic floor muscle training when compared to the postal treatment plan. The secondary objectives were to evaluate how app use may affect the quality of life (QoL) of users and treatment adherence. Material and Methods: Eight databases (PubMed, SciELO, Embase, Web of Science, LILACS, Open Gray, Open Thesis, and OATD) were used as research sources. The protocol was registered in PROSPERO (CRD 42020145709).Randomized controlled trials assessing urinary incontinence (UI) control with app use, with no restriction of year, language, and status of publication were included. The JBI Systematic Reviews Checklist for Randomized Controlled Trials assessed the risk of bias of the studies selected. The mean scores of QoL between the pre-and postintervention periods were compared through standardized mean differences, which were weighted according to the number of months between the two periods. Results: Only three studies met the eligibility criteria and were included. The methodological quality of the studies was from "low" to "moderate" risk of bias.The full sample included 203 patients with app-based treatment e 203 controls of postal treatment. All studies showed the reduction of urinary symptoms. In addition, two studies showed a reduction of QoL scores specific for the condition, while one study presented increased scores.Conclusion: Reminder therapy seems to be a promising strategy for controlling UI. K E Y W O R D Smobile app, pelvic floor, pelvic floor muscle training, urinary incontinence 1038 | LEME NAGIB ET AL.

Section: Discussionmentioning

confidence: 99%

Use of mobile apps for controlling of the urinary incontinence: A systematic review

Nagib

Riccetto

Martinho

et al. 2020

“…Very few studies have efficacy data or adherence data based on a recent review. 25 As technology improves, the quality of mHealth UI treatment apps will also improve. To inform the next steps and improve content delivery and adherence, the qualitative evaluation of the women's experiences completing these types of apps are also important.…”

Section: Discussionmentioning

confidence: 99%

“…Both of these studies, along with our data, provide early efficacy data that could inform future studies and broader dissemination of these types of self‐management programs for stress and urgency UI. Very few studies have efficacy data or adherence data based on a recent review …”

Section: Discussionmentioning

confidence: 99%

A mobile telehealth program for behavioral treatment of urinary incontinence in women veterans: Development and pilot evaluation of MyHealtheBladder

Goode

Markland

Echt

et al. 2019

Aim: To develop and pilot test an interactive mobile telehealth program (mHealth) for behavioral treatment of women veterans with urinary incontinence (UI). Methods: We developed an evidence-based 8-week behavioral mHealth program, MyHealtheBladder, with input from women veterans, behavioral medicine and health education experts, and clinical providers treating UI in the VA system. The program was story-based and included pelvic floor muscle exercises, bladder control strategies, fluid management, risk factor reduction, and self-monitoring. Participants were women veterans seeking outpatient treatment for UI occurring at least twice weekly. The primary efficacy estimate was the change in UI frequency, volume and impact on the quality of life as measured by the validated International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF; range: 0-21, 2.5 points for minimal clinically important difference [MCID]). Results:We enrolled 29 women veterans (ages 29-77 years; mean = 54.4 ± 10.4), including 15 (52%) African-American women, 13 (45%) women with high school education, and 16 (55%) with a college degree. Twenty of 29 women (69%) completed all 8 weeks of the intervention with a 97% adherence rate to the daily sessions among completers. We found reductions in ICIQ-SF scores from a mean 12.6 ± 3.9 at baseline to 10.4 ± 4.11 at 5 weeks, to 8.7 ± 4.0 at the end of the 8-week intervention. Conclusions: Women veterans using an 8-week behavioral mHealth program for the treatment of UI had symptom improvements that exceeded the MCID for the ICIQ-SF. Our next step involves comparing the effectiveness of MyHealtheBladder to usual care in a larger clinical trial. K E Y W O R D Sbehavioral therapy, mobile health, pilot study, telehealth, urinary incontinence, women veterans

“…[1][2][3] With recent technological advances, there has been a rapid rise in the availability and popularity of at-home devices (home trainers) and mobile applications (MApps) for PFM training. [4][5][6][7][8][9] These tools may be recommended either as an adjunct to, or a substitute for clinically-supervised instruction. [4][5][6] There is currently level 2 evidence for PFM MApps as an intervention for improving UI symptoms, 4 and recent work conceived of a ranking system of PFM MApps to guide clinician Mapp recommendations to patients.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7][8][9] These tools may be recommended either as an adjunct to, or a substitute for clinically-supervised instruction. [4][5][6] There is currently level 2 evidence for PFM MApps as an intervention for improving UI symptoms, 4 and recent work conceived of a ranking system of PFM MApps to guide clinician Mapp recommendations to patients. 5 MApps and home trainers may enhance women's adherence and motivation to undertake a PFM training regime 4 ; however, the exact MApp feature(s) tied to this enhancement is (are) unknown.…”

Section: Introductionmentioning

confidence: 99%

Reliability and validity of a mobile home pelvic floor muscle trainer: The Elvie Trainer

Czyrnyj

Bérubé

Brooks

et al. 2020

Aims Reliability and validity of force measurement and task detection by the Elvie Trainer were evaluated against an intravaginal dynamometer (IVD) and ultrasound (US) imaging. Methods Women were recruited from local physiotherapy clinics. At the first visit, pelvic floor muscle (PFM) strength and tone were assessed manually. Women performed two sets of three repetitions of rest, PFM maximal voluntary contraction (MVC), and maximal Valsalva maneuver (MVM) tasks in supine and standing, with the Elvie Trainer in situ. Women performed another set of rest and MVC repetitions with a custom IVD in situ. At the second visit, PFM strength and tone were reassessed manually. Women performed two sets of three repetitions of the rest, PFM MVC, and MVM tasks in supine and standing, with the Elvie Trainer in situ. Concurrent US imaging was then acquired during a final set of PFM MVC and MVM repetitions in supine and standing, while the Elvie Trainer remained in situ. Reliability was evaluated using intraclass correlation coefficients. Validity was evaluated using Spearman's/Pearson's correlations and receiver operator characteristic curves. Results Thirty women participated in the study. The Elvie Trainer MVC force outcomes exhibited excellent within‐day and good between‐day reliability, but were significantly lower than IVD measures, and exhibited poor relationships with IVD force outcomes. The Elvie Trainer was able to specify correct/incorrect performance of a PFM MVC. Conclusions The Elvie Trainer exhibits acceptable within‐day and between‐day reliability and can detect the correct performance of PFM MVCs; however, force measurements are not valid indicators of PFM strength and should not be used to measure outcomes.