Involuntary reflexive pelvic floor muscle training in addition to standard training versus standard training alone for women with stress urinary incontinence : a randomized controlled trial

Radlinger, Lorenz; Lehmann, Corinne; König, Irene; Bürgin, Reto Arthur; Kuhn, Annette (26 June 2019). Involuntary reflexive pelvic floor muscle training in addition to standard training versus standard training alone for women with stress urinary incontinence : a randomized controlled trial In: Annual Congress gynécologie suisse 2019. St. Gallen. 26.06.2019-28.06.2019.

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Introduction: Even though fast involuntary reflexive pelvic floor muscle (PFM) contractions seem crucial during stress urinary incontinence (SUI) provoking situations the focus of PFM training so far is on voluntary PFM contractions. Training procedures for involuntary reflexive muscle contractions are widely implemented in rehabilitation and sports but not yet in PFM rehabilitation. Therefore, the research group developed two PFM training protocols, one including standard physiotherapy (PT) and one additionally focusing on involuntary reflexive PFM contractions. The study aim was to compare the two PT programs regarding their effect on SUI. Material and Methods: The present study was designed as a prospective, triple-blinded (participant, investigator, outcome assessor) randomized controlled trial (intention to treat) with two PT intervention groups: CON = control group (standard PT), EXP = experimental group (standard PT + involuntary reflexive PFM training). The primary outcome was the International Consultation on Incontinence Modular Questionnaire Urinary Incontinence short form (ICIQ-UIsf). This trial was registered on clinicaltrials.gov (NCT02318251) and the study protocol published in Trials (2015). Ninety-six participants were included (48 per group). To analyze group differences (CON vs. EXP) and the development over time (pre, PT1, …, PT9, post) concerning the primary outcome, mixed effect regression models were used, which allow to account for within-participant correlations by random effects. The significance level was P≤0.05. Results: The analysis of intervention effects revealed that the total score of the primary outcome decreased significantly over time (pre/post) by about 3 points for both groups (EXP: 10.3/7.4; CON: 10.0/7.0), however, did not differ between groups. Conclusion: This study showed clinically relevant improvements in SUI in the CON as well as in the EXP group. However, there was still moderate SUI present in both groups after the intervention. These results are comparable to former physiotherapy intervention studies. Future studies should, on the one hand, investigate criteria oriented and not time-oriented PFM training programs, i.e. individualize PFM training protocols. And, on the other hand, training methods for PFM hypertrophy, intramuscular coordination and (involuntary reflexive) force development rate, which are comparable to conventional skeletal muscle training, i.e. performed with higher intensities and workout, should be tested.

Item Type:	Conference or Workshop Item (Speech)
Division/Institute:	School of Health Professions School of Health Professions > Physiotherapy School of Health Professions > G Teaching
Name:	Radlinger, Lorenz0000-0002-0326-6264; Lehmann, Corinne; König, Irene0000-0002-6032-0255; Bürgin, Reto Arthur and Kuhn, Annette
Subjects:	R Medicine > RG Gynecology and obstetrics
Language:	English
Submitter:	Helena Luginbühl
Date Deposited:	04 Dec 2019 07:44
Last Modified:	18 Dec 2020 13:29
ARBOR DOI:	10.24451/arbor.9345
URI:	https://arbor.bfh.ch/id/eprint/9345