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Is home-based pelvic floor muscle training effective in treatment of urinary incontinence after birth in primiparous women? A randomized controlled trial

Authors

  • Susanne Åhlund,

    1. Department of Clinical Sciences, Danderyds Hospital, Karolinska Institute, Stockholm, Sweden
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  • Birgitta Nordgren,

    1. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden
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  • Eva-Lotta Wilander,

    1. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden
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  • Ingela Wiklund,

    1. Department of Clinical Sciences, Danderyds Hospital, Karolinska Institute, Stockholm, Sweden
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  • Cecilia Fridén

    Corresponding author
    1. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden
    • Department of Clinical Sciences, Danderyds Hospital, Karolinska Institute, Stockholm, Sweden
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  • The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Correspondence

Cecilia Fridén, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Stockholm 141 86, Sweden. E-mail: cecilia.friden@ki.se

Abstract

Objective

To assess the effect of pelvic floor muscle training (PFMT) on pelvic floor muscle strength and urinary incontinence (UI) in primiparous women who underwent a home training program between three and 9 months after delivery.

Design

Randomized controlled trial.

Population

One hundred primiparous women were consecutively recruited from four different antenatal clinics in the urban area of Stockholm, Sweden. Women with UI who had undergone normal term singleton vaginal delivery, 10–16 weeks postpartum were randomly allocated to either intervention or control group.

Methods

Maximally voluntary contraction (MVC) and endurance were measured with a perionometer. The Oxford grading scale was used to manually estimate the strength of the pelvic floor muscle and self-reported symptoms of UI was registered through the Bristol Female Lower Urinary Tract Symptoms Module (ICIQ FLUTS) questionnaire.

Main outcome measures

Maximally voluntary contraction of the pelvic floor muscle measured with a perionometer.

Results

Maximally voluntary contraction increased significantly in both groups between baseline and follow up (< 0.05). The median MVC in cmHg for the intervention and control group was 16.2 and 12.1 at baseline and 26.0 and 18.2 at follow up, respectively. The median endurance, in seconds, for the intervention and control group was 9.6 and 12.0 at baseline and 26.7 and 23.4 at follow up, respectively. Pelvic floor muscle strength measured with the Oxford Scale increased significantly in both groups between baseline and follow up (p < 0.05).

Conclusion

The results indicate that home-based PFMT is effective. However, written training instructions were as efficient as home-based training with follow up visits every sixth week.

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