Abstract
Background: Despite strong evidence for supervised pelvic floor muscle training (PFMT) for women with urinary incontinence (UI), and weight loss and exercise for overweight and obese women with UI, implementation literature on these combined interventions is limited. This paper aimed to describe the rigorous and systematic processes involved in the collaborative development, implementation, refinement and evaluation of a novel, holistic 12 week exercise training and healthy eating group program (ATHENA) for overweight and obese women with UI. Methods/Design: This intervention description paper is part of a larger mixed-methods feasibility study of implementing the ATHENA intervention within a physiotherapy service at a public hospital in Australia. The collaborative intervention design had input from clinicians, researchers and a consumer representative. Results: The intervention involved four evidence-based components—(1) supervised PFMT; (2) general exercise training; (3) pelvic health education; and (4) healthy eating education—delivered face to face over a 12 week period. Supporting resources developed included a Facilitator’s Guide and Participant Workbook. Conclusion: ATHENA is an evidence-based, multifaceted, group-based intervention targeting exercise training and healthy eating for management of UI for overweight and obese women. The structured development process and transparency of intervention content and resources aims to enhance practical application and success in future studies.
Highlights
Urinary incontinence (UI) is the occurrence of involuntary loss of urine [1]
Prior to attending the group intervention, participants were assessed for correct PFM contraction technique at their one-on-one physiotherapy appointment and were provided with an individualised pelvic floor muscle training (PFMT) program to complete as part of a home exercise program
This aimed to increase participants’ confidence in correctly activating pelvic floor muscles during the supervised PFMT component of the ATHENA intervention, which ran for 10–20 min at the physiotherapy outpatient gym during the warm up and cool down of the general exercise training session
Summary
Urinary incontinence (UI) is the occurrence of involuntary loss of urine [1]. It affects up to 25% of women aged 14–21 years [2]; 30–57% of middle-aged and post-menopausal women [3]; and 75% of elderly women aged ≥75 [4,5]. Healthcare 2020, 8, 575 well-being, and socio-economic aspects of a woman’s life [6] It places a large economic burden on health care systems [5,7]; in Australia, the estimated cost of UI treatment was projected to be. This paper aimed to describe the rigorous and systematic processes involved in the collaborative development, implementation, refinement and evaluation of a novel, holistic 12 week exercise training and healthy eating group program (ATHENA) for overweight and obese women with. Results: The intervention involved four evidence-based components—(1) supervised PFMT; (2) general exercise training; (3) pelvic health education; and (4) healthy eating education—delivered face to face over a 12 week period. Conclusion: ATHENA is an evidence-based, multifaceted, group-based intervention targeting exercise training and healthy eating for management of UI for overweight and obese women. The structured development process and transparency of intervention content and resources aims to enhance practical application and success in future studies
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