Intensive supervised versus unsupervised pelvic floor muscle training for the treatment of stress urinary incontinence: a randomized comparative trial

Felicíssimo, Mônica Faria; Carneiro, Márcia Mendonça; Saleme, Cristina Said; Pinto, Rafael Zambelli; Fonseca, Adelaida Pallavicini; Silva-Filho, Agnaldo L.

doi:10.1007/s00192-010-1125-1

Cited by 77 publications

(111 citation statements)

References 20 publications

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“…Adherence was expressed as the average of series of exercises patients did monthly during the treatment period. 19 Outpatient attendance at sessions was monitored by the physiotherapist accompanying the patients during treatment and expressed as an average at the end of the three-month treatment.…”

Section: Adherence To the Pfm Training Programmentioning

confidence: 99%

Pelvic floor muscle training for overactive bladder symptoms – A prospective study

Fitz

Sartori

Girão

et al. 2017

Rev. Assoc. Med. Bras.

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Introduction: Pelvic floor muscle training (PFMT) involves the contraction of the puborectal, anal sphincter and external urethral muscles, inhibiting the detrusor contraction, what justify its use in the treatment of overactive bladder (OAB) symptoms. Objective: To verify the effects of isolated PFMT on the symptoms of OAB. Method: Prospective clinical trial with 27 women with mixed urinary incontinence (MUI), with predominance of OAB symptoms and loss ≥ 2 g in the pad test. It was evaluated: pelvic floor muscles (PFMs) function (digital palpation and manometry); urinary symptoms (nocturia, frequency and urinary loss); degree of discomfort of OAB symptoms; and quality of life (Incontinence Quality-ofLife Questionnaire [I-QoL]). The PFMT program consisted of 24 outpatient sessions (2x/week + home PFMT). The Mann-Whitney and Wilcoxon tests (with a significance level of 5%) were used to analyse the data. Results: There was a significant improvement of the urinary symptoms to the pad test (5.8±9.7, p<0.001), urinary loss (0.7±1.1, p=0.005) and nocturia (0.8±0.9, p=0.011). Reduction in the degree of discomfort of urinary symptoms was observed according to OAB-V8 questionnaire (10.0±7.7, p=0.001). There were also significant results in PFMs function: Oxford (3.6±0.9, p=0.001), endurance (5.2±1.8, p<0.001), fast (8.9±1.5, p<0.001) and manometry (26.6±15.8, p=0.003).In addition, quality of life had a significant improvement in the three domains evaluated by I-QoL. Conclusion: The PFMT without any additional guidelines improves the symptomatology, the function of PFMs and the quality of life of women with OAB symptoms.

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Section: Adherence To the Pfm Training Programmentioning

confidence: 99%

Pelvic floor muscle training for overactive bladder symptoms – A prospective study

Fitz

Sartori

Girão

et al. 2017

Rev. Assoc. Med. Bras.

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“…Another study used the ICIQ-SF scale and demonstrated an equivalent improvement in both groups (final median in the intensive group ¼ 8 points (5 to 13) / in the home PFMT group ¼ 8 points (6 to 12); p ¼ 0.7). 24 The third study, on the other hand, demonstrated better results in the intensive PFMT group using the I-QoL scale for assessment, in which higher scores represent a better quality of life (median in the intensive group ¼ 89 points / in the home PFMT group ¼ 79 points; p ¼ 0.04).…”

Section: Home Pfmt Versus Intensive Pfmt With Physiotherapistmentioning

confidence: 91%

“…• Incontinence-specific quality of life -three studies reported this outcome, [24][25][26] but the combination of individual results through meta-analysis was not possible. One of them assessed the outcome using the Ditrovie scale (higher scores represent a worse quality of life) 25 The study estimate was not sufficiently precise to determine if intensive PFMT was more effective, less effective or no different from home PFMT.…”

Section: Home Pfmt Versus Intensive Pfmt With Physiotherapistmentioning

confidence: 99%

Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials

Moroni

Magnani

Haddad

et al. 2016

Rev Bras Ginecol Obstet

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We performed a systematic review and meta-analysis of randomized controlled trials that studied the conservative management of stress urinary incontinence (SUI). There were 1058 results after the initial searches, from which 37 studies were eligible according to previously determined inclusion criteria. For the primary outcomes, pelvic floor muscle training (PFMT) was more efficacious than no treatment in improving incontinence-specific quality of life (QoL) scales (SMD ¼ À1.24SDs; CI 95% ¼ À1.77 to À0.71SDs). However, its effect on pad tests was imprecise. Combining biofeedback with PFMT had an uncertain effect on QoL (MD ¼ À4.4 points; CI 95% ¼ À16.69 to 7.89 points), but better results on the pad test, although with elevated heterogeneity (MD ¼ 0.9g; 95%CI ¼ 0.71 to 1,10g); group PFMT was not less efficacious than individual treatment, and home PFMT was not consistently worse than supervised PFMT. Both intravaginal and superficial electrical stimulation (IES and SES) were better than no treatment for QoL and pad test. Vaginal cones had mixed results. The association of IES with PFMT may improve the efficacy of the latter for QoL and pad test, but the results of individual studies were not consistent. Thus, there is evidence of the use of PFMT on the treatment of SUI, with and without biofeedback.

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“…However, another study observed that after the treatment with PFME there were no differences between the two groups, and the conclusion was that the supervised PFME is not efficient to treat for stress UI if the patient in the control group is trained correctly to perform PF contraction. According to the authors, this detailed instruction before the randomization made a difference in the final result between the two groups 10 (LE 1; DR A).…”

Section: (Le 1; Dr A)mentioning

confidence: 99%

“…The approach is minimally invasive and practically has no adverse effects. Success depends on the motivation and effort both from the patient and the involved multidisciplinary team 10 .…”

Section: Introductionmentioning

confidence: 99%

Análise dos recursos para reabilitação da musculatura do assoalho pélvico em mulheres com prolapso e incontinência urinária

Filho

Fonseca

Camillato³

et al. 2013

Fisioter. Pesqui.

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| This review aimed to assess the capabilities and effectiveness of pelvic floor rehabilitation in the treatment of genital prolapse and urinary incontinence. The research was conducted in MEDLINE/PubMed, LILACS/ SciELO and Cochrane Library. There were found 886 articles, of which were used 34 relevant clinical trials that answered the questions constructed by the authors. The studies analyzed showed that pelvic floor training can be used in prolapse treatment, but further randomized studies are necessary to support this evidence. For urinary incontinence pelvic floor, rehabilitation is effective and should be the treatment of first choice.Keywords | rehabilitation; pelvic floor; women; prolapse; urinary incontinence. RESUMO | Esta revisão teve como objetivo analisar os recursos e sua eficácia na reabilitação do assoalho pélvi-co no tratamento dos prolapsos genitais e incontinência urinária. ser usado no tratamento dos prolapsos, porém são necessários mais estudos randomizados para sustentar essa evidência. Para a incontinência urinária a reabilitação do assoalho pélvico é eficiente e deve ser o tratamento de primeira escolha.Descritores | reabilitação; diafragma da pelve; mulheres; prolapso; incontinência urinária. RESUMEN | Esta revisión tiene como objetivo analizar los recursos y su eficacia en la rehabilitación del suelo pélvico en el tratamiento de los prolapsos genitales y la incontinencia urinaria. Las búsquedas fueron realizadas en las bases de datos Medline/Pubmed, LILACS/SciELO y Cochrane. Fueron encontrados 886 artículos, de los cuales fueron utilizados 34 estudios clínicos relevantes y que respondían las preguntas construidas por los autores. Los estudios analizados mostraron que el entrenamiento del suelo pélvico puede ser usado en el tratamiento de los prolapsos, sin embargo, son necesarios más estudios randomizados para sustentar esta evidencia. Para la incontinencia urinaria la rehabilitación del suelo pélvico es eficiente y debe ser el tratamiento de primera opción.Palabras clave | rehabilitación; suelo pélvico; mujeres; prolapso; incontinencia urinaria. 91Silva Filho et al. Pelvic floor: prolapse and urinary incontinence

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Intensive supervised versus unsupervised pelvic floor muscle training for the treatment of stress urinary incontinence: a randomized comparative trial

Abstract: Both intensive supervised PFMT and unsupervised PFMT are effective to treat female SUI if training session is provided.

Cited by 77 publications

References 20 publications

Pelvic floor muscle training for overactive bladder symptoms – A prospective study

Pelvic floor muscle training for overactive bladder symptoms – A prospective study

Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials

Análise dos recursos para reabilitação da musculatura do assoalho pélvico em mulheres com prolapso e incontinência urinária

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