Abstract
Objective
The study investigated the effect of a 6-week supervised pelvic floor muscle exercise
(PFME) program to prevent stress urinary incontinence (SUI) at 38 weeks’ gestation.
Study design
We conducted a randomized controlled trial into two arms design: one intervention
group and one control group, using the randomly computer-generated numbers. A research
assistant, who was not involved with care of the participants, randomly drawn up and
opened the envelope for each participant to allocate into the intervention group and
the control group. The investigators could not be blinded to allocation. Seventy primigravid
women who had continent with gestational ages of 20–30 weeks were randomly assigned
to participate in the intervention (n = 35) and control groups (n = 35). The intervention was a supervised 6-week PFME program with verbal instruction
and a handbook, three training sessions of 45 min with the main researcher (at 1st, 3rd and 5th week of the program) and self-daily
training at home for an overall period of 6 weeks. The control condition was the PFME
and the stop test had been trained by the main researcher to all of the participants
in the intervention group.
Outcomes
The primary outcome was self-reported of SUI, and the secondary outcome was the severity
of SUI in pregnant women which comprises of frequency, volume of urine leakage and
score of perceived severity of SUI in late pregnancy at 38th weeks of pregnancy. Statistical
analysis was performed using Chi-square test, Independent-sample t-test, and Mann–Whitney U-test. Significance P-value was <0.05.
Results
At the end of the intervention, 2 of 35 women in the intervention group and 5 of 35
women in the control group dropped out of the study. Therefore, the total of the study
participants consisted of 63 pregnant women (33 in the intervention group and 30 in
the control group). Fewer women in the intervention group reported SUI than the control
group: 9 of 33 (27.3%) versus 16 of 30 (53.3%) at 38 weeks’ gestational age (OR 3.05,
95% CI 1.07–8.70, P = 0.018).
Conclusions
The 6-week supervised PFME program was effective in preventing SUI and decreasing
the SUI severity in pregnant women who reported SUI at late pregnancy. The women who
performed PFME program under the training sessions once every two weeks found that
the program demands less time, incurs lower costs and possibly offers more motivation
to exercise. This 6-week supervised PFME program may be suitable in real clinical
situation.
Keywords
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Article info
Publication history
Published online: December 02, 2015
Accepted:
November 23,
2015
Received in revised form:
November 6,
2015
Received:
December 11,
2014
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.