Premium
Pelvic floor morphometrical and functional changes immediately after pelvic floor muscle training and at 1‐year follow‐up, in older incontinent women
Author(s) -
Cacciari Licia P.,
Morin Mélanie,
Mayrand MarieHélène,
Tousignant Michel,
Abrahamowicz Michal,
Dumoulin Chantale
Publication year - 2021
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.24542
Subject(s) - medicine , pelvic floor , pelvic floor muscle , urinary incontinence , physical therapy , randomized controlled trial , stress incontinence , rehabilitation , physical medicine and rehabilitation , surgery
Abstract Aims To compare the effects of group‐based and individual physiotherapy for stress or mixed urinary incontinence (UI) on pelvic floor morphometry, pelvic floor muscle (PFM) function, and related self‐efficacy, immediately after treatment and at 1 year. Methods This is a planned secondary analysis of the group rehabilitation or individual physiotherapy study, an assessor‐blinded, randomized, noninferiority trial. Eligible participants included 362 community‐dwelling older women with symptoms of stress/mixed UI. After learning how to contract PFMs, participants completed 12 weeks of PFM training, either individually (one‐on‐one) or as part of a group (eight women). Pelvic floor transperineal ultrasound volumes (morphometry), PFM intravaginal dynamometric data (function), and self‐efficacy in performing PFM exercises were acquired at baseline, posttreatment, and at 1 year. Results Groups were comparable at all time points. Immediately posttreatment, both groups demonstrated significant changes in pelvic floor morphometry during coughs, and in PFM function during contractions and coughs. Participants also reported improved self‐efficacy in performing PFM exercises. Results were sustained at 1 year. When participants coughed, pelvic floor structures were better supported (reflected by less caudal movement of the puborectalis sling and a smaller opening of the levator hiatus) in a pattern consistent with the “knack” strategy. Furthermore, both interventions resulted in stronger, faster, more coordinated, and more endurant PFMs. Conclusion In older women with stress or mixed UI, both individual and group‐based PFM training resulted in comparable improvements in overall PFM function, pelvic floor morphometry during coughs, and related self‐efficacy in performing PFM exercises, which were sustained at 1 year.