Effectiveness of pelvic floor muscle training on quality of life of women with urinary incontinence: A randomized clinical trial

Abstract

Background: Urinary incontinence (UI) is an important public health & social problem predominantly in women. According to the International Incontinence Society (ICS), UI is defined as an involuntary loss of urine which affects in all ages especially in fifth decade of life. Objective: The aim of this study was to investigate the effectiveness of pelvic floor muscle training on quality of life (QOL) of women with Urinary Incontinence (UI). Methods: Prospective clinical trial with 41 women (21 in experimental group and 21 in the control group) with a diagnosis of UI confirmed by urinary distress inventory (UDI). Women with neuromuscular diseases, using hormone replacement therapy, and with history of prolapse were not included. The exercise protocol for the PFMT group consisted of slow contractions (according to muscle power or strength) followed by rapid contractions (participants’ endurance capacity) followed by PFM contraction with coughing, sneezing for 4 weeks, 2 times per week and supervised abdominal strengthening exercise. Control group received only supervised abdominal strengthening exercise. We evaluated the impact of supervised PFMT on QOL using the King’s Health Questionnaire (KHQ), 24hours voiding diary for the measurement of incontinence episodes during the initial evaluation and after 8 sessions of treatment. Data were analyzed by parametric test of Independent t test and paired t test. Results: There was a significant decrease in the mean scores of the domains assessed by the KHQ regarding the perception of health, impact of the incontinence, limitations of daily activities, physical limitations, social limitations, personal relationships, emotions, sleep/disposition, and measures of severity. Also decrease the episodes of daily incontinence after treatment than initial score of experimental group than control group. After the independent ‘t’ test in v between group analysis is significantly higher for supervised PFMT group (p˂ 0.05). But in within group analysis by paired sample ‘t’ statistic both group showed significant improvement on QOL in KHQ domain accept one. So, supervised pelvic floor muscle training along with supervised abdominal strengthening exercise statistically significant to decreases daily incontinence episodes and improve quality of life of women with UI. Conclusion: PFM training resulted in significant improvement in reduction of involuntary urinary leakage. Therefore improve the quality of life of women with UI and also their family members. Trial Registration: CTRI/2020/07/026729 [Registered on: 22/07/2020] - Trial Registered Retrospectively Key words: Pelvic Floor Muscle Training (PFMT), Quality of life (QOL), King’s Health Questionnaire (KHQ), Urinary Incontinence (UI)