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Effects of individual pelvic floor muscle training vs individual training progressing to group training vs group training alone in women with stress urinary incontinence: A randomized clinical trial

2020; Wiley; Volume: 39; Issue: 5 Linguagem: Inglês

10.1002/nau.24370

1520-6777

Vilena Barros de Figueirêdo, Simony Lira do Nascimento, Renata Ferreira Lobo Martinez, Clara Taína Silva Lima, Cristine Homsi Jorge Ferreira, Patrícia Driusso,

Urinary Tract Infections Management

Abstract Aims To assess the effects of individual pelvic floor muscle (PFM) training vs individual training (IT) progressing to group training (GT) vs group‐only training in women with stress urinary incontinence (SUI). Methods Randomized controlled and pragmatic clinical trials with 90 women with SUI. Participants were randomly allocated to one of three groups: IT, GT, or four individual sessions progressing to group training (IPGT). The intervention included 12 sessions, once a week, with direct supervision by a physical therapist. Primary outcome: severity according to the King's Health Questionnaire. Secondary outcomes: PFM function by palpation and manometer, bladder and exercise diaries, PFM training adherence, and self‐efficacy. Reassessments were conducted at the end of the intervention, 3 and 6 months after the intervention. Intra‐ and intergroup analysis for all outcomes was performed using a multivariate analysis of variance. In the mixed‐effects model used, the evaluation groups and times and their interactions were considered. A significance level of 5% was adopted. Results After the intervention, the severity measure improved in all three groups ( P < .001), without difference between them ( P = .56). The benefits of the intervention were maintained 3 and 6 months after the end of the supervised training ( P < .001). The IPGT group had a significant improvement in PFM function when compared to the other groups posttreatment ( P < .001). Conclusion PFM training improved the severity of urinary incontinence in all groups after 12 sessions of training supervised by a physical therapist. IT progressing to GT improved the function of upper PFM when compared to the other groups.