Pelvic floor muscle training in groups versus individual or home treatment of women with urinary incontinence: systematic review and meta-analysis

Paiva, Luciana Laureano; Ferla, Lia; Darski, Caroline; Catarino, Bruna Maciel; Ramos, José Geraldo Lopes

doi:10.1007/s00192-016-3133-2

Cited by 48 publications

(46 citation statements)

References 30 publications

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“…[15][16][17] The evidence from these studies was inconclusive and researchers have highlighted the need for additional studies in this area. 18 Thus, this study aims to assess the effect of home-based PFMT in comparison to a group of subjects with no training, on decreasing the severity of symptoms of SUI, improving QOL, and strengthening PFM among Omani women.…”

Section: Introductionmentioning

confidence: 99%

Effects of home‐based pelvic floor muscle training on decreasing symptoms of stress urinary incontinence and improving the quality of life of urban adult Omani women: A randomized controlled single‐blind study

Belushi

Kiyumi

Al-Mazrui

et al. 2020

Neurourology and Urodynamics

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Aim This study aims to determine the effectiveness of home‐based pelvic floor muscle training (PFMT) on decreasing the severity of symptoms and improving the quality of life (QOL) among Omani women with stress urinary incontinence (SUI). Methods A randomized controlled single‐blind trial was conducted in three primary health care centers in Muscat. Eligible women who were diagnosed with SUI (from a concurrent phase‐I study which was a cross‐sectional study to determine the prevalence of urinary incontinence in Oman) were invited to take part. The consenting subjects were randomly allocated to either an intervention group (unsupervised PFMT) or a control group (lecture with no PFMT). Baseline and 12‐week assessment of both groups was carried out for the primary outcome using the validated Arabic version of the International Consultation on Incontinence Questionnaire (ICIQ)‐short form and the secondary outcome by blinded measures of pelvic floor muscle (PFM) strength using the modified Oxford grading system (MOGS), endurance, and perineometer. Results A total of 73 subjects were included in the study. They were randomly divided into two groups. Both groups were similar at the baseline in terms of sociodemographic characteristics, ICIQ score, and PFM strength. At the 12‐weeks assessment, there was a significant difference in the ICIQ score (P < .001) between the intervention group and the control one. There was no statistical difference between the two groups in MOGS, endurance, or perineometer values. Conclusions The home‐based PFMT is an effective treatment in reducing the severity of symptoms and improving the QOL in women with SUI.

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Section: Introductionmentioning

confidence: 99%

Effects of home‐based pelvic floor muscle training on decreasing symptoms of stress urinary incontinence and improving the quality of life of urban adult Omani women: A randomized controlled single‐blind study

Belushi

Kiyumi

Al-Mazrui

et al. 2020

Neurourology and Urodynamics

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“…5 A meta-analysis found improvement in UI symptoms following individual or group PFMT under the supervision of a physical therapist. 6 The benefits of group interventions may be related to biopsychosocial aspects. 7 On the other hand, individual PFMT can improve awareness of pelvic floor muscle (PFM) contraction.…”

Section: Introductionmentioning

confidence: 99%

“…A meta‐analysis found improvement in UI symptoms following individual or group PFMT under the supervision of a physical therapist 6 . The benefits of group interventions may be related to biopsychosocial aspects 7 .…”

Section: Introductionmentioning

confidence: 99%

Effects of individual pelvic floor muscle training vs individual training progressing to group training vs group training alone in women with stress urinary incontinence: A randomized clinical trial

Figueirêdo

Nascimento²,

Martinez

et al. 2020

Neurourology and Urodynamics

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Aims To assess the effects of individual pelvic floor muscle (PFM) training vs individual training (IT) progressing to group training (GT) vs group‐only training in women with stress urinary incontinence (SUI). Methods Randomized controlled and pragmatic clinical trials with 90 women with SUI. Participants were randomly allocated to one of three groups: IT, GT, or four individual sessions progressing to group training (IPGT). The intervention included 12 sessions, once a week, with direct supervision by a physical therapist. Primary outcome: severity according to the King's Health Questionnaire. Secondary outcomes: PFM function by palpation and manometer, bladder and exercise diaries, PFM training adherence, and self‐efficacy. Reassessments were conducted at the end of the intervention, 3 and 6 months after the intervention. Intra‐ and intergroup analysis for all outcomes was performed using a multivariate analysis of variance. In the mixed‐effects model used, the evaluation groups and times and their interactions were considered. A significance level of 5% was adopted. Results After the intervention, the severity measure improved in all three groups (P < .001), without difference between them (P = .56). The benefits of the intervention were maintained 3 and 6 months after the end of the supervised training (P < .001). The IPGT group had a significant improvement in PFM function when compared to the other groups posttreatment (P < .001). Conclusion PFM training improved the severity of urinary incontinence in all groups after 12 sessions of training supervised by a physical therapist. IT progressing to GT improved the function of upper PFM when compared to the other groups.

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“…However, the authors suggested that PFMT performed in group may be a viable option for the public health system, since it is possible to treat more women during a shorter period of time with low cost. 25 The present study was initiated in January 2016 and is currently active. The results of this study can guide physical therapists in choosing the treatment format of stress urinary incontinence, indicating whether the training of the pelvic floor muscles, which starts individualized and progresses to group treatment, would be more effective than only individual or only group treatment.…”

Section: Discussionmentioning

confidence: 99%

The effects of individual pelvic floor muscle training versus individual treatment with progression to group versus group training for women with stress urinary incontinence: protocol for a randomized controlled trial

2016

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Background: Pelvic floor muscle training can be practiced in an individual format or in a group. The research question for this randomised, controlled trial will be: pelvic floor muscle training format including individualized and group training, would be more effective than an individualized training only or groups only? Additionally, it will be evaluated the adherence and follow up (results after 3 and 6 months of the end of training). Methods: This is a randomized clinical trial. Data collection will be performed at the Women's Health Research Laboratory, allocated in the Department of Physical Therapy of Federal University of São Carlos, from January 2016 to December 2016. It will be included, women with stress urinary incontinence, older than 18 years old. The participants will be will be allocated into three groups. In Group 1 sessions will be only individualized and Group 2 will perform individualized treatment and then the volunteer will be referred to join the group training sessions. Group 3 only group treatment. Later, all volunteers will be reassessed after 12 sessions, three months and six months from the discharge date. The primary outcome is the severity measures of the King's Health Questionnaire. The secondary outcomes are miccional diary, PERFECT scheme, perineometry, self-efficacy scale for pelvic floor exercises practice, exercise diary and presence of the participants in the surpevisioned sessions. Data normality will be tested by the Shapiro-Wilk test. The comparison between the evaluations will be performed by ANOVA, and the comparison between groups will be performed by Student t-test (independent Measures). In order to measure the practical significance of the date, the size effect and the confidence interval will be calculated. A 5% significance level will be assumed. The data are presented as mean ± standard deviation. Conclusions: A combined treatment format including individualized and group training, would be more effective than an individualized training only or groups only.

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Pelvic floor muscle training in groups versus individual or home treatment of women with urinary incontinence: systematic review and meta-analysis

Abstract: PFMT is an efficient technique for the improvement of the symptoms of female UI. When PFMT was supervised by a physiotherapist, no significant difference was noted when comparing group with individual approaches.

Cited by 48 publications

References 30 publications

Effects of home‐based pelvic floor muscle training on decreasing symptoms of stress urinary incontinence and improving the quality of life of urban adult Omani women: A randomized controlled single‐blind study

Effects of home‐based pelvic floor muscle training on decreasing symptoms of stress urinary incontinence and improving the quality of life of urban adult Omani women: A randomized controlled single‐blind study

Effects of individual pelvic floor muscle training vs individual training progressing to group training vs group training alone in women with stress urinary incontinence: A randomized clinical trial

The effects of individual pelvic floor muscle training versus individual treatment with progression to group versus group training for women with stress urinary incontinence: protocol for a randomized controlled trial

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