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Exercise Adherence to Pelvic Floor Muscle Strengthening Is Not a Significant Predictor of Symptom Reduction for Women With Urinary Incontinence

Published:March 26, 2012DOI:https://doi.org/10.1016/j.apmr.2012.03.010

      Abstract

      Hung H-C, Chih S-Y, Lin H-H, Tsauo J-Y. Exercise adherence to pelvic floor muscle strengthening is not a significant predictor of symptom reduction for women with urinary incontinence.

      Objective

      To explore the predictors of treatment effectiveness for women with urinary incontinence (UI) receiving pelvic floor muscle (PFM) strengthening.

      Design

      Four-month cohort study.

      Setting

      Laboratory.

      Participants

      Volunteers (N=68; mean age ± SD, 50.5±6.0y) with UI.

      Intervention

      Four-month daily PFM strengthening exercise program at home.

      Main Outcome Measures

      Outcome measures included self-reported improvement, Severity Index score, 3-days diary, strength of PFM, and quality of life. The participants' recall of the amount of exercise after the 4-month exercise period was used to assess the exercise adherence.

      Results

      Fifty-one (75%) of 68 women reported that their condition improved after 4 months of exercise. There were significant reductions in Severity Index score, number of voidings per day, number of leakages per day, and impact on quality of life (P<.05). In addition, the score of PFM strength was significantly improved (P=.001). There were no significant correlations between the change score of the Severity Index and age, body mass index, parity, type of UI, duration of UI, menopausal status, and amount of exercise (all P>.10). Multiple regression analysis revealed that initial severity of symptoms and improvement of PFM strength predicted 51.3% of variance in 4-month exercise effectiveness (change score of the Severity Index).

      Conclusions

      The effectiveness of the 4-month PFM strengthening program was influenced by the severity of symptoms and the improvement score of PFM strength instead of exercise adherence. Women who had more significant symptoms of leakage (higher score on the Severity Index at baseline) and who had more improvement of PFM strength showed more improvement of symptoms after PFM strengthening.

      Key Words

      List of Abbreviations:

      BMI (body mass index), MUI (mixed urinary incontinence), PFM (pelvic floor muscle), PFMT (pelvic floor muscle training), SUI (stress urinary incontinence), UI (urinary incontinence)
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