Pelvic floor muscle training: Novel versus traditional remote rehabilitation methods. A systematic review and meta‐analysis on their effectiveness for women with urinary incontinence

Abstract

To investigate the effectiveness of supervised remote rehabilitation programs comprising novel methods of pelvic floor muscle (PFM) training for women with urinary incontinence (UI).Design: A systematic review and meta-analysis including randomized controlled trials (RCTs), involving novel supervised PFM rehabilitation programs as intervention groups (e.g., mobile applications programs, webbased programs, vaginal devices) versus more traditional PFM exercise groups (acting as control); both sets of groups being offered remotely.Methods: Data have been searched and retrieved from the electronic databases of Medline, PUBMED, and PEDro using relevant key words and MeSH terms. All included study data were handled as reported in the Cochrane Handbook for Systematic Reviews of Interventions and the evaluation of their quality was undertaken utilizing the Cochrane risk-ofbias tool 2 (RoB2) for RCTs. The included RCTs, involved adult women with stress UI (SUI) or mixed urinary incontinence, where SUI were the most predominant symptoms. Exclusion criteria involved pregnant women or up to 6-month postpartum, systemic diseases and malignancies, major gynecological surgeries or gynecological problems, neurological dysfunction or mental impairments. The searched outcomes included subjective and objective improvements of SUI and exercise adherence in PFM exercises. Metaanalysis was conducted and included studies pulled by the same outcome measure.

Effectiveness of web-based interventions for women with urinary incontinence: protocol for a systematic review and meta-analysis of randomised controlled trials

“…WBIs have drawn great attention from the medical and hygiene fields due to their advantages of high accessibility and efficiency 17 25 26. Recently, some researchers have attempted to use WBIs to manage UI for women, but the effectiveness of WBIs among this crowd has remained inconclusive,27–31 and even the existing relevant systematic reviews failed to arrive at a consensus on this matter,21–24 32 which impedes clinical decision-making and limits the widespread application of WBIs. Accordingly, this paper presents a protocol for a systematic review and meta-analyses that will summarise the related evidence by systematically reviewing previous RCTs regarding the effectiveness of WBIs in women with UI.…”

“…Web-based interventions (WBIs), referring to achieving specific health objectives via web-connected devices such as smartphones, computers,and laptops,17 21 might be an effective complement and alternative to narrow the aforementioned gaps and manage women’s UI more effectively through an innovative delivery mode. The benefits of interventions that are delivered via the web include anonymity, relatively low cost and convenience because they enable individuals to receive interventions at anytime and anywhere without face-to-face contact with professionals,22–24 thereby reducing stigma, transportation costs and waiting time for treatments, which are particularly suitable for those with busy schedules or who require flexibility owing to work and family responsibilities. Recent systematic reviews have demonstrated that WBIs can enhance health outcomes among patients with chronic diseases such as diabetes25 and dementia 26…”

Case Report: Effect of rTMS on urinary incontinence in major vascular neurocognitive disorder

“…The cerebral cortex and pontine nucleus coordinate the activities of sympathetic and parasympathetic networks with the somatic nervous system through spinal cord conduction tracts. 8 To relieve symptoms of UI, many methods have emerged in past decades, such as physiotherapy, psychological care, manual assistance, behavior therapy, drug therapy, urethral catheterization, and surgical treatment. 1,2 Among those invasive methods, pelvic floor muscle training (PFM) was proven to be effective and recommended as the first option, [3][4][5] and a novel PFM program was launched.…”

Effect of Fluid and Caffeine Management on Quality of Life in Older Women with Overactive Bladder in Rural Korea: A Pilot Study

“…Depending on the severity of their OAB, some participants experienced the effect of the intervention within 2 weeks and up to 3 months or longer. 36 , 37 Therefore, future studies need to consider a longer follow-up period to better measure the effects of PFMT and the fluid moderation intervention. Moreover, to avoid confounding effects, the current study excluded older women who had a urinary tract infection, had more than 100 mL of post-void residual urine, or were taking medication for lower urinary tract symptoms.…”