Hakim S, Mistivani I, Tambunan D, Santoso B I, Djusad S, Priyatini T, et al . Optimal Duration for Supervised Pelvic Floor Muscle Training in Stress Urinary Incontinence Women: A Prospective Study. Iranian Rehabilitation Journal 2023; 21 (1) :107-116
URL:
http://irj.uswr.ac.ir/article-1-1646-en.html
1- Department of Obstetrics and Gynecology Clinic, Faculty of Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia.
2- Department Physical Medicine and Rehabilitation, Faculty of Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia.
Abstract: (2275 Views)
Objectives: We evaluated the optimal duration of pelvic floor muscle training (PFMT) in stress urinary incontinence (SUI) patients.
Methods: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from November 2018 to June 2019. We recruited 55 subjects diagnosed with SUI based on the questionnaire for urinary incontinence diagnosis (QUID) score >4 and more than 2 grams of 1-hour pad test. Considering the inclusion and exclusion criteria, we taught and supervised them for PFMT and evaluated them every four weeks to observe the urogenital distress inventory-6 (UDI-6), incontinence impact questionnaire-7 (IIQ-7), 1-hour pad test, and perineometer score. We used the Wilcoxon test to evaluate the improvement at a significance level of P<0.05.
Results: Our subjects were mostly obese (65%), 30-55 years old (60%), and had >2 children (90%). There were improvements in UDI-6 and IIQ-7 for every four weeks up to 12 weeks of PFMT (P<0.05, 95% CI). Pelvic floor muscle strength only improved significantly (P=0.001 and P=0.006, respectively) after eight weeks of PFMT. Also, the 1-hour pad test score decreased significantly after four weeks of training (P<0.001).
Discussion: SUI distress and symptoms decrease after four weeks of Kegel exercises and continue to improve until 12 weeks of therapy. However, the 1-hour pad test reaches clinical and statistical significance during the first month of exercise with no further improvement clinically. Pelvic floor muscle strength increased significantly after eight weeks of training.
Full-Text [PDF 664 kb]
(767 Downloads)
| |
Full-Text (HTML) (409 Views)
• Pelvic floor muscle training improves symptoms of stress urinary incontinence every four weeks up to twelve weeks.
• Patients with stress urinary incontinence improved significantly by doing 1-hour pad test after one month of pelvic floor muscle training.
• Pelvic floor muscle strength improvements are only seen after eight weeks of pelvic floor muscle training.
Plain Language Summary
Sometimes, women feel an involuntary loss of urine during coughing, sneezing, or doing an activity called stress urinary incontinence. Pelvic floor muscle training (PFMT) is the mainstay treatment for women with stress urinary incontinence to improve their quality of life (QoL). However, 12 weeks of pelvic floor muscle training seems too long for women to comply. We evaluated the optimum duration needed to reach the optimal effect of therapy. We recruited some women with stress urinary incontinence and measured the symptoms using questionnaires (UDI-6 and IIQ-7), a 1-hour pad test, and a perineometer. After teaching them PFMT, we evaluated the women every four weeks up to 12 weeks. This research found that symptoms improved significantly based on questionnaires and objectively based on a 1-hour pad test after four weeks of training. At last, the muscle in the pelvis started to strengthen after eight weeks of training. It is recommended to do pelvic floor muscle training for eight weeks minimally for a significant improvement in such aspects.
Article type:
Original Research Articles |
Subject:
Physiotherapy Received: 2022/04/7 | Accepted: 2022/12/21 | Published: 2023/03/1
Send email to the article author