Comparison of Group and Individual Physiotherapy for Female Urinary Incontinence in Primary Care: Pilot study

Abstract

Objective To compare the effectiveness of group versus individual management on physical symptoms and quality of life in female urinary incontinence (FUI). Design A pragmatic randomised controlled trial with blinded assessment. Setting A community physiotherapy department accepting primary and tertiary referrals. Participants Forty-four women (mean age 50 years) with clinical symptoms of stress and/or urge incontinence (median duration of symptoms 3 years 7 months) presenting to physiotherapy. Interventions Three educational group sessions or one 45-minute individual treatment. Main outcome measures Blinded assessments at baseline and at 12-14 weeks after treatment included a perineal pad test, seven-day bladder chart, incontinence impact questionnaire and symptom severity index and visual analogue scale (VAS). Results At baseline there were no statistically significant differences between the two treatment arms. After treatment both groups had, on average, improved over baseline on all outcome measures. Group treatment (which was more cost-effective) appeared better for self-rated symptoms than individual sessions, but this did not reach statistical significance. Conclusion Physiotherapy for FUI appears effective. The trends in favour of group intervention seen in this study may reach statistical significance in larger studies. Such studies are feasible, but should also assess the cost-effectiveness and acceptability to women of the two approaches. To compare the effectiveness of group versus individual management on physical symptoms and quality of life in female urinary incontinence (FUI). A pragmatic randomised controlled trial with blinded assessment. A community physiotherapy department accepting primary and tertiary referrals. Forty-four women (mean age 50 years) with clinical symptoms of stress and/or urge incontinence (median duration of symptoms 3 years 7 months) presenting to physiotherapy. Three educational group sessions or one 45-minute individual treatment. Blinded assessments at baseline and at 12-14 weeks after treatment included a perineal pad test, seven-day bladder chart, incontinence impact questionnaire and symptom severity index and visual analogue scale (VAS). At baseline there were no statistically significant differences between the two treatment arms. After treatment both groups had, on average, improved over baseline on all outcome measures. Group treatment (which was more cost-effective) appeared better for self-rated symptoms than individual sessions, but this did not reach statistical significance. Physiotherapy for FUI appears effective. The trends in favour of group intervention seen in this study may reach statistical significance in larger studies. Such studies are feasible, but should also assess the cost-effectiveness and acceptability to women of the two approaches.