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Randomized Controlled Trial
. 2023 Mar;34(3):717-727.
doi: 10.1007/s00192-022-05108-6. Epub 2022 May 21.

A Hybrid-Telerehabilitation Versus a Conventional Program for Urinary Incontinence: a Randomized Trial during COVID-19 Pandemic

Mariana Santiago  1 , Pedro Cardoso-Teixeira  2 , Sofia Pereira  3 , João Firmino-Machado  4   5   6   7 , Susana Moreira  3
Affiliations
Randomized Controlled Trial

A Hybrid-Telerehabilitation Versus a Conventional Program for Urinary Incontinence: a Randomized Trial during COVID-19 Pandemic

Mariana Santiago et al. Int Urogynecol J. 2023 Mar.

Abstract

Introduction and hypothesis: This study aimed to compare the effectiveness of a hybrid telerehabilitation program with a traditional face to face model in women with stress urinary incontinence (SUI) and mixed incontinence (MUI) with a predominance of SUI. The authors hypothesized that home pelvic floor muscle training (PFMT) would have a similar benefit to outpatient PFMT.

Methods: Parallel randomized controlled trial including 58 patients consecutively admitted to a tertiary academic hospital for pelvic floor rehabilitation consultation from 1 January to 30 April 2021 for conservative treatment of UI. Participants randomized to the intervention were submitted to a 12-week PFMT program: (1) a hybrid telerehabilitation program of two individual face-to-face sessions followed by 2-weekly sessions of video-telerehabilitation with a follow-up by a specialized physiotherapist, including one individual face-to-face session at 8 weeks; (2) a re-evaluation teleconsultation at 6 and 16 weeks; (3) a face-to-face consultation at 12 weeks. The control group had two initial individual sessions followed by twice-weekly group classes, and consultations were face to face. The primary outcome measure (at baseline and 12 weeks) was UI-related quality of life using the Portuguese Version of the King's Health Questionnaire.

Results: At baseline the intervention (n = 18) and control (n = 17) groups were similar. UI-related quality of life significantly improved in both the intervention and control groups betweenbaseline (T0) and the end of the 12-week PFMT program (T12) (p = 0.002, p < 0.001, respectively), although the magnitude of the improvement was not significantly different between groups (-10.0 vs. -9.5 points, p = 0.918, respectively).

Conclusion: This hybrid telerehabilitation protocol showed effectiveness comparable to the traditional model in improving UI-related quality of life. Trial registration at www.

Clinicaltrials: gov , no. NCT05114395.

Keywords: COVID-19; Female pelvic floor dysfunction; Pelvic floor muscle training; Quality of life; Telerehabilitation; Urinary incontinence.

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Conflict of interest statement

All authors declare they have no conflict of interests.

Figures

Fig. 1
Fig. 1
Patient enrollment, allocation and follow-up. ICS: International Continence Society
Fig. 2
Fig. 2
Implementation of the intervention. PFMT = pelvic floor muscle training. KHQ = King’s Health Questionnaire. ICIQ-SF = International Consultation on Incontinence Questionnaire-Short Form. FSFI = Female Sexual Function Index. HADS - Hospital Anxiety and Depression Scale. PGI-I = Patient Global Impression of Improvement
Fig. 3
Fig. 3
a and b: Spaghetti plots showing the trajectory of each patient and each study group at the two or four follow-up time points (at 0 and 12 weeks for the total KHQ and at 0, 6, 12 and 16 weeks for the total ICIQ-SF, respectively). KHQ = King’s Health Questionnaire. ICIQ-SF = International Consultation on Incontinence Questionnaire-Short Form
See this image and copyright information in PMC

References

    1. D'Ancona C, Haylen B, Oelke M, Abranches-Monteiro L, Arnold E, Goldman H, Hamid R, Homma Y, Marcelissen T, Rademakers K, Schizas A, Singla A, Soto I, Tse V, de Wachter S, Herschorn S. The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol Urodyn. 2019;38(2):433–477. doi: 10.1002/nau.23897. - DOI - PubMed
    1. Correia S, Dinis P, Rolo F, Lunet N. Prevalence, treatment and known risk factors of urinary incontinence and overactive bladder in the non-institutionalized Portuguese population. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(12):1481–1489. doi: 10.1007/s00192-009-0975-x. - DOI - PubMed
    1. Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet. 2003;82(3):327–338. doi: 10.1016/s0020-7292(03)00220-0. - DOI - PubMed
    1. Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, Coyne K, Kelleher C, Hampel C, Artibani W, Abrams P. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50(6):1306–1314. doi: 10.1016/j.eururo.2006.09.019. - DOI - PubMed
    1. Carrión Pérez F, Rodríguez Moreno MS, Carnerero Córdoba L, Romero Garrido MC, Quintana Tirado L, García Montes I. Telerehabilitation to treat stress urinary incontinence. Pilot study. Med Clin (Barc) 2015;144(10):445–448. doi: 10.1016/j.medcli.2014.05.036. - DOI - PubMed

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