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The effect of an abdominopelvic exercise program alone versus in addition to postural instructions on pelvic floor muscle function in climacteric women with stress urinary incontinence. A randomized controlled trial |
Fuentes-Aparicio L, Rejano-Campo M, Lopez-Bueno L, Marie Donnelly G, Balasch-Bernat M |
Physiotherapy Theory and Practice 2023;39(4):738-749 |
clinical trial |
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
INTRODUCTION: Scarce literature exists regarding the influence of posture-based interventions for the treatment of stress urinary incontinence (SUI). OBJECTIVE: The aim of this randomized controlled trial with two parallel groups was to investigate whether the addition of postural instructions to a 12-week abdominopelvic exercise program is superior to an abdominopelvic exercise program alone, in terms of PFMs function and symptoms in climacteric women with SUI. METHODS: Climacteric women aged between 40 to 75 years old who presented with SUI were included in this parallel study (NCT03727945). Two randomized groups performing one 40-minutes session per week for 12-weeks were compared: one performing an abdominopelvic exercise program (AEP) and a second one performing the same intervention with the addition of postural instructions (AEPPI). PFMs electromyographical (EMG) activity and strength (Oxford Grading Scale) were quantified during a maximal voluntary contraction. SUI symptoms were assessed using a 3-day bladder diary. These outcomes were collected at baseline, immediately after intervention, and 3-months after the intervention. RESULTS: A total of 47 women were included in the study (AEP (n = 23), AEPPI (n = 24)). Between-group analysis showed significant differences for post-intervention EMG and strength values, showing higher values for the AEPPI compared to the AEP group. At 3-months follow-up, statistically significant differences were only obtained in strength, with higher values in the AEPPI group. No significant differences were obtained in terms of UI symptoms. CONCLUSION: A 12-session abdominopelvic exercise program supplemented with postural instructions is superior to an abdominopelvic exercise program alone in terms of PFMs function in women with SUI.
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