Pelvic Floor Muscle Training Research Articles

Maintaining A Long-Term Practice of Daily Pelvic Floor Muscle Exercises: What Do Childbearing Women Think?

To be effective, pelvic floor muscle therapy (PFMT) exercises should be intense, be practiced consistently, and include clinical support. Many women do not adhere to a consistent PFMT program, compromising the resolution or prevention of urinary incontinence (UI). This study aimed to answer 2 key questions: What prevents women from performing PFMT long term, and what can health care providers do to support women to perform them? Postpartum women from 4 sites in the United States completed a questionnaire about experiences with PFMT or Kegel exercises during and after pregnancy. This study focused on one of the 7 open-ended questions: What would prevent you from performing Kegels lifelong? Thematic analysis was implemented via an inductive approach using Braun and Clarke's 6-phase process. Three salient themes emerged that help explain factors that prevent women from adhering to a daily PFMT routine: (1) life gets in the way, (2) inadequate PFMT education and instruction, and (3) disconnect exists about long-term consequences. The sample included 368 participants. The themes were congruent with the limited body of qualitative literature on experience with PFMT exercises. This study was able to identify areas of need in the US maternal health care system to help childbearing people adopt daily PFMT, such as (1) inadequate parental leave and childcare support, (2) no formalized education related to UI and PFMT and a lack of pelvic health promotion, (3) lacking prioritization of long-term PFMT, and (4) the need to dispel the acceptance that UI postbirth is normal. Health care providers should prioritize interactive education, emphasizing how to correctly perform PFMT and the importance and effectiveness of integrating clinical support. To adequately encompass pelvic floor health care and education up to one year postbirth, changes are needed to the US perinatal health care system, providing sufficient insurance reimbursement and parental social support programs.

Feasibility of transcranial direct current stimulation (tDCS) combined with pelvic floor muscle training (PFMT) in female urinary incontinence: randomized controlled trial

INTRODUCTION: Pelvic floor muscle training (PFMT) is widely regarded as the most conservative and effective non-pharmacological treatment option for women suffering from urinary incontinence (UI). Transcranial direct current stimulation (tDCS) is a non-invasive, non-pharmacological neuromodulation technique that has demonstrated promising results in a variety of medical conditions. However, there has been little research into the feasibility of tDCS as an adjunct therapy to PFMT in improving symptoms in women with UI. OBJECTIVE: To explore the feasibility (recruitment and retention) of tDCS as an adjunct therapy to PFMT to relieve symptoms of female UI. METHODS AND MATERIALS: Eleven female patients were randomly assigned to receive 12 non-consecutive sessions of PFMT combined with 20 minutes (2mA) of anodal (Cz) or sham tDCS for 4 weeks. Feasibility (primary outcome) was assessed through recruitment and retention rates. Secondary outcomes included four domains: (1) urinary leakage, (2) severity of incontinence, (3) impact on quality of life, and (4) symptoms and adverse events. RESULTS: Eleven patients were evaluated, and nine women completed the treatment protocol. The recruitment rate was 100%, and retention was 81.8%. Clinical results showed that anodal tDCS is viable as adjunctive therapy to PFMT protocol and may result in minimal clinically important differences (MCID) in UI symptoms. CONCLUSION: The high rate of recruitment and retention indicates that tDCS in combination with PFMT is a feasible adjunct therapy for female UI treatment. This research supports the recommendation for a full RCT, with prioritization of outcomes required for hypothesis testing.

The relation between usage of an eHealth intervention for stress urinary incontinence and treatment outcomes: an observational study

BackgroundStress urinary incontinence (SUI), though a prevalent condition among women, is undertreated in primary care. EHealth with pelvic floor muscle training is an evidence-based alternative to care-as-usual. It is unknown, however, how eHealth usage is related to treatment outcome, and this knowledge is required for general practitioners to implement eHealth in their practice. This study examines the relation between usage of eHealth for SUI and treatment outcomes by examining log data. Baseline factors were also explored for associations with treatment success.MethodIn this pre-post study, women with SUI participated in “Baasoverjeblaas.nl”, a web-based intervention translated from the Swedish internet intervention "Tät®-treatment of stress urinary incontinence". Usage was based on log data and divided into three user groups (low, intermediate and high). Online questionnaires were sent before, after treatment and at six-months follow-up. The relation between usage and the primary outcome − treatment success (PGI-) − was studied with a binomial logistic regression analysis. Changes in the secondary outcomes − symptom severity (ICIQ-UI SF) and quality of life (ICIQ-LUTSqol) − were studied per user group with linear mixed model analysis.ResultsIncluded were 515 users with a mean age of 50.5 years (12.0 SD). The majority were low users (n = 295, 57.3%). Treatment success (PGI-I) was reached by one in four women and was more likely in high and intermediate users than in low users (OR 13.2, 95% CI 6.1–28.5, p < 0.001 and OR 2.92, 95% CI 1.35–6.34, p = 0.007, respectively). Symptom severity decreased and quality of life improved significantly over time, especially among high users. The women’s expected ability to train their pelvic floor muscles and the frequency of pelvic floor muscle exercises at baseline were associated with treatment success.ConclusionThis study shows that usage of eHealth for SUI is related to all treatment outcomes. High users are more likely to have treatment success. Treatment success is more likely in women with higher expectations and pelvic floor muscle training at baseline. These findings indicate that general practitioners can select patients that would be more likely to benefit from eHealth treatment, and they can enhance treatment effect by stimulating eHealth usage.Trial registrationLandelijk Trial Register NL6570; https://onderzoekmetmensen.nl/nl/trial/25463.

Influence of game therapy on urinary incontinence patients: a systematic review

This study performed a systematic review of game therapy effects on urinary incontinence patients. Eleven databases (PubMed, SCOPUS, SciELO, LILACS, Web of Science, EMBASE, Cochrane library, LIVIVO, OpenGrey, OpenThesis, and OATD) were used as research sources. The search was conducted in January 2021 with the following keywords: urinary incontinence, urinary stress incontinence, pelvic floor muscle, pelvic floor training, virtual reality, game therapy, virtual reality exposure, and virtual reality therapy. The review included only clinical studies using game therapy for treating urinary incontinence in women without restrictions on language, year, and publication status. Only three studies fulfilled the eligibility criteria. The extracted data comprised sample characteristics (the number of patients in each study and average age) and treatment characteristics (game type, associated therapies, treatment duration, evaluated objectives, and result-measuring methods). The methodological quality of the articles showed a low risk of bias. One-hour pad test values decreased in all studies, and ICIQ-SF scores reduced in two articles. One study reported treatment adherence (92%), and another showed neuropsychological index improvements. The reduction of urinary symptoms was similar between the group associating game therapy with treatment and the group using only conventional pelvic floor muscle training. Game therapy, as a resource of pelvic floor muscle training, seems beneficial to urinary incontinence, including decreased urinary symptoms, lower one-hour pad test scores, and neuropsychological index improvements.

Analyze, design, develop, implement, and evaluate approach to develop a pelvic floor muscle training guidebook to treat stress urinary incontinence in women.

Stress urinary incontinence (SUI) is a common problem that affects the quality of life of women worldwide. Pelvic floor muscle training (PFMT) is an effective conservative first-line treatment for SUI. However, low compliance with PFMT is one of the main reasons for therapeutic failure. Indirect supervision using a guidebook may improve PFMT outcomes. To develop a PFMT guidebook using the analyze, design, development, implementation, and evaluation (ADDIE) method. A guidebook was developed from July 2020 to April 2021 using the ADDIE method. This prospective study used mixed methods, namely qualitative analysis, focus group discussions, and in-depth interviews, and involved various experts from urogynecology, urology, medical rehabilitation, and physiotherapy departments. A pilot study was conducted on patients with SUI to evaluate the effectiveness of the guidebook. The ADDIE method was successfully implemented to develop the PFMT guidebook. The formative evaluation of the ADDIE steps mainly focused on the PFMT technique, content clarity, illustration, design, and color choice of the book. After the pilot study, the guidebook significantly improved Incontinence Impact Questionnaire, Short Form, 1-hour pad test, and perineometer scores. However, the pilot study showed no significant improvement in Urogenital Distress Inventory, Short Form scores. The PFMT guidebook developed using the ADDIE method improved outcomes in patients with SUI.

Predominant Incontinence After Internal Anal Sphincter Division Is Urge and Flatus Incontinence, and These Can Be Reversed by Kegel Exercises.

Predominant Incontinence After Internal Anal Sphincter Division Is Urge and Flatus Incontinence, and These Can Be Reversed by Kegel Exercises.

Awareness of urinary incontinence in pregnant women as a neglected issue: a cross-sectional study.

Pregnancy and labor are independent risk factors for the development of urinary incontinence (UI). Although UI is common during pregnancy, it is a health problem mostly neglected by pregnant women. The high prevalence of UI in pregnancy and its effects on the postpartum period justifies the need to determine the knowledge and attitudes of pregnant women regarding the prevention and management of UI. It is necessary to increase the awareness of pregnant women about UI, educate, consultant, and integrate pelvic floor muscle training into prenatal care services. This study aims to determine the UI awareness of pregnant women and their knowledge and attitudes in this context. This cross-sectional study was conducted with 255 pregnant women in a university hospital in Turkey between March and September 2020. Data were collected using the Incontinence Knowledge Questionnaire (PIKQ) and Urinary Incontinence Attitude Scale (UIAS). The UI prevalence was 51% during pregnancy. The mean score of PIKQ was 8.07±2.64, and only 6.3% of participants correctly answered all the questions regarding UI. The mean score of UIAS was 42.33±3.48. A positive correlation was found between UI knowledge and attitude score (r=0.35, p=0.00). The results showed that although UI is prevalent during pregnancy, pregnant women's knowledge of UI is poor. Nearly half of pregnant women need information. They tend to display positive attitudes towards UI, but not sufficient to improve their health-seeking behavior. Strategies should be developed to increase pregnant women's awareness of UI and to encourage them health-seeking behaviors for the prevention/management of UI during prenatal visits.

Applicability of kegel exercises in different urinary incontinences in women: Systematic review

Introduction: Urinary incontinence (UI) is the involuntary loss of urine. The condition also happens when there are small daily leaks. Objective: The aim of this study was to conduct a systematic review that verified the efficacy of Kegel's exercise in UI in women. Methodology: This is a systematic review, in which searches were conducted for articles related to the theme "Kegel Exercise in Urinary Incontinence in Women" in the PubMed, LILACS and SCIELO databases, the search was carried out starting on March 1, 2023 and ending on June 1 of the same year and the selection of articles was for the last 5 years. The inclusion criteria were full-text articles that talked about UI in women and the applicability of Kegel's exercise in treatment and studies with intervention, exclusion criteria were articles from the proposed period and which did not corresponded with the inclusion criteria. Altogether, 191 articles were found, after removal of articles off the subject and repeated 7 studies remained to be evaluated on the PEDro scale, among them 6 were suitable for use in the study. Results: To evaluate the articles, the PEDro scale consists of 11 questions containing yes or no answers that help validate the quality of clinical trial studies, the scores of the articles evaluated and elected in this scale of the study was 70%, in all, 6 articles were analyzed by the PEDro scale. Conclusion: Finally, it is concluded that the use of kegel exercises for the treatment of UI in women is effective, and should also be used as a method of prevention for possible incontinences, thus strengthening the pelvic floor with the exercises.

Differences in Function of the Urinary Tract Before and After Pelvic Floor Muscle Exercise (PFME) in Pregnant Women

Differences in Function of the Urinary Tract Before and After Pelvic Floor Muscle Exercise (PFME) in Pregnant Women

Analysis of the quality of information provided by "Dr. YouTube™" on premature ejaculation.

YouTube™ is an important online resource to access health-related online information by the public worldwide. However, the quality of information available on it has not been adequately characterized. To assess the quality and reliability of information available on the treatment of premature ejaculation (PME) on YouTube™ in the Hindi and English language videos. A total of 151 (Hindi: 109, English: 42) YouTube videos were selected for assessment. The quality was evaluated using structured tools: Patient Education Materials Assessment Tool (PEMAT); and a 5-point modified DISCERN questionnaire (Range: 1-serious shortcomings; 5-minimal shortcomings). PEMAT assesses the understandability and actionability of video as separate percentages. Three most common treatments suggested for PME were Kegel exercise (22.5%), start-stop technique (21.9%), and antidepressant medications (20.5%). Antidepressant medications, stop-squeeze techniques, and psychotherapy were more frequently suggested in English videos, whereas ayurvedic or herbal medicines were more frequently suggested in Hindi videos. About two-thirds of videos presented information in an easy-to-understand and actionable manner (PEMAT scores ≥70%). Only 6% of videos had a DISCERN score of ≥4, indicating good overall quality of information presented in them. People likely to encounter poor-quality information when seeking information for PME treatment on YouTube. A large number of videos suggested ineffective or unproven treatment strategies for PME. Healthcare professionals need to be mindful of this while counselling patients, and guide them regarding useful and reliable sources of health information available online.

Literature Review: Senam Kegel Terhadap Inkontinensia Urine Pada Lanjut Usia

Physiological changes include the nervous system, hearing, vision, cardiovascular, body temperature regulation, breathing, endocrine system, skin system, urinary tract system, musculoskeletal, and mental changes in the elderly, especially personality changes, and changes in memory. and intelligence, Lifestyle changes are psychosocial changes. Method using a literature study with a narrative method from research results published in 2018-2023. The search used the Kegel exercise keyword strategy at BAK frequency on Google Scholar and PubMed with the criteria used, namely articles that discuss incontinence and Kegel exercises which can be used as an alternative therapy for constipation, availability of full text, sample, year of publication in the last 5 years. From 10 articles it was described that Kegel exercises were proven to be effective as an alternative therapy for patients with constipation.

The Effectiveness of Pelvic Floor Muscle Training on Decreasing Urinary Incontinence in Pregnant or Postnatal Women: A Systematic Review

This study aims to analyze the effectiveness of pelvic floor muscle training in preventing urinary incontinence in pregnant and postpartum women. The study employed a systematic review method by searching data from journal databases such as Pubmed, Science Direct, and Web of Science. The inclusion criteria in this study were articles published in the last five years (2019-2024) that discussed pregnant and postnatal women, pelvic floor muscle training, and urinary incontinence. Those articles must come from journals that used the official languages ​​of the United Nations, such as Arabic, Chinese, English, Russian, French, and Spanish. Meanwhile, the exclusion criteria in this study were those not indexed by Scopus and Web of Science. This study then identified 2387 articles from the Pubmed, Science Direct, and Web of Science databases. Among them, eight articles met the inclusion criteria and were selected and analyzed for this systematic observation. For standard operations, the study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) assessment. The results indicated that pelvic floor muscle training or Kegel exercise can help weak pelvic muscles due to uterine growth and hormonal changes during pregnancy become stronger. This is so, especially if it is carried out regularly during pregnancy to reduce postnatal urinary incontinence. This training or exercise is recommended for six weeks during pregnancy to increase the strength of the muscle tone of the blood vessel walls and pelvic floor muscles. Additionally, it can support ligament muscles in the pelvis so that it can prevent urinary incontinence. We highly recommend further research to analyze PMFT during the postpartum period which can prevent urinary incontinence even more. Keywords: Pelvic Floor Muscle Training; Kegel Exercise; Pregnant; Postnatal; Urinary Incontinence

Defecatory dysfunction and anal incontinence symptoms among women with pelvic organ prolapse: 5-year retrospective study in a tertiary center.

To investigate the prevalence of DD and AI with POP symptoms in females attending a urogynecology clinic, and to identify factors associated with DD and AI in POP symptoms patients. Computer-based medical records of women with POP symptoms attending a urogynecology clinic in a referral tertiary center between January 2016 and December 2020 were reviewed. Demographic data were collected. Selected defecatory dysfunction (DD) and anal incontinence (AI) were recorded. The associations between patient characteristics, site and severity of prolapse, and DD and AI symptoms in POP patients were investigated for identified associated factors. The mean age of the 754 participants was 65.77 ± 9.44years. Seven hundred and fifteen (94.83%) were menopause. The prevalence of DD and AI in patients with POP symptoms was 44.03% (332/754) and 42.04% (317/754) according to the PFBQ and medical history records, respectively. Advanced posterior wall prolapse (OR 1.59, 95% CI 1.10-2.30) and wider GH (OR1.23, 95% CI 1.05-1.43) were identified as risk factors for DD by multivariate analysis. Additionally, single-compartment prolapse (OR 0.4, 95% CI 0.21-0.76) and a stronger pelvic floor muscle assessed with brink score (OR 0.94, 95% CI 0.88-0.98) are protective factors for AI. DD and AI are prevalent among women with POP symptoms who visit a urogynecology clinic. DD should be evaluated in women with POP symptoms especially in women with increased genital hiatus and point Ap beyond the hymen. To prevent AI, women with POP should be encouraged to perform pelvic floor muscle training in order to increase pelvic floor muscle strength.

(178) Climacturia: Emerging Type of Urinary Incontinence, Its Prevalence, Risk Factors, and Management: A Systematic Review and Prevalence Meta-analysis

Abstract Introduction Climacturia is an emerging type of urinary incontinence which occurs immediately following orgasm. Both men and women may suffer from climacturia in equivocal rates. This phenomenon is becoming more problematic as it impacts physiological and psychosexual aspect of well-being and quality of life. While awareness of climacturia becomes evident, studies are inadequate to support evidenced-based management in primary and urologic care settings. Objective This study aimed to conduct a systematic review and prevalence meta-analysis of climacturia and investigate its risk factors and evidenced-based management. Methods A systematic review of 24 articles were conducted following PRISMA 2020 guidelines. The PubMed, CINAHL, and Cochrane Library database were searched using the word “climacturia” and phrase “orgasm associated urinary incontinence” respectively. Search limiters applied included literature written in English from year of inception to 2022. Title and abstract reviews were conducted on 78 articles. Articles which did not discuss climacturia, duplicates, and previous systematic reviews were excluded after full article review. Results The review accounts a total of N = 7798 subjects which are composed of N = 7629 (97.83%) males and N = 169 (2.17%) females with age range of 18 to 80 years old. A total of N = 2, 039 (26%) participants are with climacturia, N = 87 or 4.26% are females and N = 1, 931 or 95.74% are males. The risk factors associated with climacturia include sexually active male, history of prostate cancer after prostatectomy within 12 months of surgery or radiation therapy, increased Body Mass Index (BMI), erectile dysfunction (ED), increased urethral width, presence of urinary incontinence, pain-associated orgasm and loss of penile length after pelvic surgery, use of aides to obtain an erection, and increased incontinence scores for men. For women, the risk factors are high scores of female sexual function index (FSFI) and detrusor overactivity. The management for females is limited to pharmacologic therapy with use of antimuscarinic agents. While, behavioral therapy, pharmacologic regimen, pelvic floor muscle training (PFMT), surgery (sling procedure) are the management options for affected men. Conclusions Climacturia affects males more than females, however, the evidence to support the efficacy of treatment options for both sexes are equally inadequate. Primary care and Advanced Practice Providers in primary and urologic care settings are at best position to query patients for the presence of and manage climacturia in timely manner. Further research is needed to increase evidence supporting effective management of climacturia for both men and women. Disclosure No.

Conservative Treatment Options to Prevent and Manage Pelvic Floor Dysfunction in Women

Background: Pelvic floor dysfunction is a widespread, multifactorial disease that progresses slowly with age and occurs in 77% of postmenopausal women.Objective: To evaluate the effectiveness of conservative treatment of pelvic floor dysfunction in women and the possibility of preventing pelvic organ prolapse.Materials and methods: We analyzed literature data (PubMed, eLibrary, Scopus) on treatment and prevention of pelvic floor dysfunction in women using various conservative treatment options.Results: The conservative approach is the only preventive measure and a first-line treatment of pelvic organ prolapse, especially at the disease onset. It involves lifestyle changes, physical therapy, and pessary insertion. Physical therapy includes pelvic floor muscle training with or without biofeedback, vaginal cones, electrical stimulation, etc.Conclusions: Despite the large number of available conservative treatment options, their effectiveness should be further studied, and preventive measures aimed at strengthening pelvic floor muscles should be actively promoted and included in the routine medical use and daily life of women to prevent pelvic organ prolapse.

Comparison of Vaginal Pessaries to Standard Care or Pelvic Floor Muscle Training for Treating Postpartum Urinary Incontinence: a Pragmatic Randomized Controlled Trial.

To compare three conservative treatment options, standard care, pelvic floor muscle training (PFMT), and vaginal pessaries, for postpartum urinary incontinence (UI) that are accessible to most patients and practitioners in a generalizable cohort. A multicenter, open-label, parallel group, pragmatic randomized controlled clinical trial comparing standard care, PFMT, and vaginal cube pessary for postpartum urinary incontinence was conducted in six outpatient clinics. Sample size was based on large treatment effects (Cramers' V>0.35) with a power of 80% and an alpha of 0.05 for a 3×3 contingency table, 44 patients needed to be included in the trial. Outcomes were analyzed according to the intention-to-treat principle. Group comparisons were made using analysis of variance (ANOVA), Kruskal-Wallis, and chi-square test as appropriate. P<0.05 was considered statistically significant. Of the 516 women screened, 111 presented with postpartum UI. Of these, 52 were randomized to one of three treatment groups: standard care (n=17), pelvic floor muscle training (n=17), or vaginal cube pessary (n=18). After 12 weeks of treatment, treatment success, as measured by patient satisfaction, was significantly higher in the vaginal pessary group (77.8%, n=14/18), compared to the standard care group (41.2%, n=7/17), and the PFMT (23.5%, n=4/17; χ 2 2,n=52 =14.55; p=0.006, Cramer-V=0.374). No adverse events were reported. SUI and MUI accounted for 88.4% of postpartum UI. Vaginal pessaries were superior to standard care or PFMT to satisfyingly reduce postpartum UI symptoms. No complications were found.

Rehabilitation combined with dietary intervention improve urinary incontinence in women with obesity: A proof-of-principle study.

This study aimed to assess the impact of add-on pelvic floor exercises on a weight management rehabilitation program. This proof of principle study was conducted between July 2019 and December 2019. Ninety-three adult female inpatients with obesity and diagnosis of urinary incontinence (UI) were assessed for inclusion, and the suitable patients were randomly assigned to the experimental group and the control group. Both groups underwent a weight management rehabilitation program, while the experimental group also performed pelvic floor exercises. The primary outcome was UI severity, assessed by the 1-h pad test. Secondary outcomes were urinary symptoms, assessed by the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Patient Global Impression of Improvement (PGI-I), and Incontinence Quality of Life Questionnaire (I-QOL). Sixty female inpatients were randomly assigned to the experimental group [n=30; median age: 64.50 (51.25 to 70.50) years] or the control group [n=30; median age: 67.50 (58.50 to 74.75) years]. The experimental group showed a statistically significant reduction in UI severity [pad test: 2.08 (1.21 to 8.85) g vs. 0.54 (0.24 to 1.13) g, p<0.01; ICIQ-SF: 14.00 (10.25 to 17.00) vs. 8.00 (6.25 to 11.75), p<0.01; I-QOL: 56.37 (42.28 to 73.64) vs. 78.64 (64.32 to 90.68), p<0.01]. Statistically significant differences were found in the between-groups analysis [pad test: 0.54 (0.24 to 1.13) g vs. 1.08 (0.83 to 3.86) g, p<0.01; ICIQ-SF: 8.00 (6.25 to 11.75) vs. 12.00 (10.00 to 16.00), p<0.01; I-QOL: 78.64 (64.32 to 90.68) vs. 68.18 (60.00 to 84.32), p<0.01]. Including pelvic floor exercises might provide additional benefits compared to standard rehabilitation in reducing UI symptoms in obese women.

Training of Pelvic Floor Muscle Training Improves the Severity and Quality of Urine Incontinence and Increases Social Participation of Older Women in Southern Iran.

Aging and gender are risk factors for urine incontinence, which can lead to psychological, physical, and social complications. This community-based study investigates the effectiveness of pelvic floor muscle training on the severity and quality of urine incontinence and social participation of older women. This quasi-experimental community-based study was performed with the participation of 60 older women referring to the Public Health Center in Kerman City, southern Iran. The experiment group was trained with pelvic floor muscle training in 7 training sessions with distance health education in the second half of 2021. Before and after the intervention, data were collected based on: demographic, severity and quality of urine incontinence, and social participation inventories. Data were analyzed using a t-test and ANOVA (P ≤ 0.05). The mean scores of severity and quality of urine incontinence and social participation in the experiment and control groups before receiving the intervention were not statistically significant (P ≥ 0.05). But after that, a statistically significant difference was observed between the groups (P <0.05), which showed an improvement in the severity and quality of urine incontinence scores as well as SP in the experiment group. Tele-training of the Kegel exercise, even during the pandemic, can play an important role in improving incontinence and social participation in older women. Therefore, this training can be used to prevent and improve urine incontinence in public health centers in the community.</p>.

Pelvic Floor Muscle Training Using the Perifit Device for the Treatment of Urinary Incontinence: A Pragmatic Trial Using Real-World Data.

There is a need for home-based alternatives for women to self-manage urinary incontinence (UI). Using a real-world data approach, the aim of this analysis was to evaluate whether training with the Perifit device was effective in reducing UI symptoms. A total of 6060 women (45 ± 10 years) with UI who purchased the Perifit device, completed a validated symptoms questionnaire before training (T1) and again at one or several predefined timepoints during training: T2, after completing 40-60 games; T3, after 90-120 games; and/or T4, after 280-300 games. UI symptom score decreased progressively from 8.4 ± 4.8 points at T1; to 6.3 ± 4.7 points, 5.5 ± 4.5 points, and 4.6 ± 4.5 points at T2, T3, and T4, respectively (all p < 0.001). The percentage of respondents reporting objective improvement in UI symptoms increased from 71%, to 79%, to 85% at T2, T3, and T4, respectively. Effect size was medium (T2) to large (T3, T4). Higher symptom score at baseline was associated with higher likelihood of improvement. There was no effect of other characteristics including respondent age, menopausal status, time since childbirth, prolapse, or baseline strength on symptom improvement. This analysis of responses from over 6000 real-world users suggests that home training with the Perifit may be an effective way to reduce UI symptoms in women of all ages. Given the quality of life, economic, and social burdens of living with UI symptoms, home-based pelvic floor muscle training with the Perifit may be a promising tool to allow women to self-manage UI.

An integrative review of home care recommendations for women after caesarean section.

To describe home-based care and practices recommended for mothers after caesarean section (CS), existing in the literature. Systematic review. This integrative literature review was conducted by using Google Scholar, PubMed and Hinari databases from its inception to June 2021. The search included research articles, protocols and guidelines that describe home care practice after CS and assessed for their quality. Synthesis of recommendations from the included literature was classified based on the type of study design, and the review was guided by methodology registered in Prospero (ID CRD42021276905). A total of 681 literatures were found, and 12 met the criteria. Recommended home care components were divided into four major categories; wound care practice (wound cleaning, drying and bandage change); nutrition (high-protein diet, vitamin C, fibre and balanced diet); exercise (pelvic floor muscle, walking and breathing exercise) and hygiene (bathing and wearing clean clothes). There was limited literature addressing the components of perineal care and home environment. Varying recommendations were found regarding wound cleaning and dressing in the studies done in low- and high-income countries.