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Adherence and effectiveness of a single instruction of pelvic floor exercises: a randomized clinical trial

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Introduction and hypothesis In Brazil there are limited knowledge and education about preventative exercises for pelvic floor muscles (PFMs). We hypothesised that a single pelvic floor muscle exercise (PFME) session… Click to show full abstract

Introduction and hypothesis In Brazil there are limited knowledge and education about preventative exercises for pelvic floor muscles (PFMs). We hypothesised that a single pelvic floor muscle exercise (PFME) session immediately postpartum would be effective in preventing urinary incontinence (UI) in a 3-month postpartum period with good adherence rates. Methods Two hundred two women were approached for this randomised controlled trial and randomly assigned to two groups: the control group and experimental group. The intervention comprised a visual assessment of PFM contraction, a single PFME instruction session supervised by a physical therapist, and an educational approach through distribution of brochures about home-based PFME exercises (without supervision). Involuntary urinary loss and quality of life (QoL) were evaluated using the International Consultation on Incontinence Questionnaire Short Form (main outcome). Sociodemographic and clinical information was collected. Adherence and barriers were assessed via telephone/mobile phone surveys (secondary outcomes). Results The adherence rate was 85.1%; only 37% of the women reported having some knowledge about PFME prior to participating in this study. The main barriers to PFME mentioned were forgetfulness (61.2%), lack of time (52.2%), and the need to take care of the baby (56.7%). One instruction session on postnatal PFME delivered in the immediate postpartum period was ineffective for improving urinary symptoms such as frequency of leakage ( p  = 0.821), amount of leakage ( p  = 0.746), and influence of leakage on QoL ( p  = 0.823). In addition, there was no difference in QoL 3 months post-partum ( p  = 0.872). Conclusions Although the proposed intervention did not prevent UI symptoms, the adherence rate to PFME was high.

Keywords: instruction; pfme; pelvic floor; trial; adherence

Journal Title: International Urogynecology Journal
Year Published: 2019

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