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Physiotherapy for female stress urinary incontinence: individual therapy at the outpatient clinic versus home-based pelvic floor training: a 5-year follow-up study.
Neurourol Urodyn. 2004; 23(7):643-8.NU

Abstract

AIMS

To compare the long-term effects of individual physiotherapy at an outpatient clinic, including electrical stimulation (ES), active pelvic floor muscle exercises (PFMEs), and training with a vaginal ball (VB), with home-based active PFMEs and training with a VB, in cases of female stress urinary incontinence (SUI).

MATERIALS AND METHOD

Thirty-three women with SUI (outpatient clinic group [Group I, n = 16] and home group [Group II, n = 17]) participated in the 5-year follow-up study. Both groups had an active PFME program and they used a VB during daily activities for intensive pelvic floor muscle (PFM) training. Group I was also treated at the outpatient clinic with maximal interferential ES, using frequencies varying from 10 to 50 Hz, and individually instructed exercises with biofeedback were carried out at the same time, once a week, an average of nine times in the first year. After baseline examinations, both groups visited the outpatient clinic at 4 months, 12 months, and at 5 years.

RESULTS

At 12 months, there were no statistically significant differences between the study groups in any of the outcome variables, but within the groups both the subjective and objective results were significantly better in comparison with the initial values. After 12 months, two (3%) patients in Group I continued physiotherapy and seven (41%) patients in Group II needed physiotherapy because of an unsatisfactory outcome. At 5 years, according to the urinary incontinence severity score (UISS) questionnaire, subjective discomfort had decreased in both groups (P < 0.01) and 21 of the 33 women (64%) perceived a subjective cure or improvement in their condition. The mean objective urine leakage verified by the pad test decreased from 23.0 to 1.0 g in Group I and from 13.0 to 1.0 g in Group II (P < 0.001 for both groups). The strength of PFMs tested in a standing position increased by 26% in Group I and by 19% in Group II (P values 0.001 and 0.084, respectively), and in a lying position by 28% in Group I and by 32% in Group II (P values 0.001 and 0.008, respectively).

CONCLUSIONS

Home-based PFMEs and training with a VB proved to be equally effective as once-a-week supervised therapy, and the 5-year follow-up results demonstrated a successful response in the treatment of female SUI.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Kainuu Central Hospital, Kajaani, Finland. arja.parkkinen@kainuu.fiNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15382186

Citation

Parkkinen, A, et al. "Physiotherapy for Female Stress Urinary Incontinence: Individual Therapy at the Outpatient Clinic Versus Home-based Pelvic Floor Training: a 5-year Follow-up Study." Neurourology and Urodynamics, vol. 23, no. 7, 2004, pp. 643-8.
Parkkinen A, Karjalainen E, Vartiainen M, et al. Physiotherapy for female stress urinary incontinence: individual therapy at the outpatient clinic versus home-based pelvic floor training: a 5-year follow-up study. Neurourol Urodyn. 2004;23(7):643-8.
Parkkinen, A., Karjalainen, E., Vartiainen, M., & Penttinen, J. (2004). Physiotherapy for female stress urinary incontinence: individual therapy at the outpatient clinic versus home-based pelvic floor training: a 5-year follow-up study. Neurourology and Urodynamics, 23(7), 643-8.
Parkkinen A, et al. Physiotherapy for Female Stress Urinary Incontinence: Individual Therapy at the Outpatient Clinic Versus Home-based Pelvic Floor Training: a 5-year Follow-up Study. Neurourol Urodyn. 2004;23(7):643-8. PubMed PMID: 15382186.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physiotherapy for female stress urinary incontinence: individual therapy at the outpatient clinic versus home-based pelvic floor training: a 5-year follow-up study. AU - Parkkinen,A, AU - Karjalainen,E, AU - Vartiainen,M, AU - Penttinen,J, PY - 2004/9/24/pubmed PY - 2004/12/16/medline PY - 2004/9/24/entrez SP - 643 EP - 8 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 23 IS - 7 N2 - AIMS: To compare the long-term effects of individual physiotherapy at an outpatient clinic, including electrical stimulation (ES), active pelvic floor muscle exercises (PFMEs), and training with a vaginal ball (VB), with home-based active PFMEs and training with a VB, in cases of female stress urinary incontinence (SUI). MATERIALS AND METHOD: Thirty-three women with SUI (outpatient clinic group [Group I, n = 16] and home group [Group II, n = 17]) participated in the 5-year follow-up study. Both groups had an active PFME program and they used a VB during daily activities for intensive pelvic floor muscle (PFM) training. Group I was also treated at the outpatient clinic with maximal interferential ES, using frequencies varying from 10 to 50 Hz, and individually instructed exercises with biofeedback were carried out at the same time, once a week, an average of nine times in the first year. After baseline examinations, both groups visited the outpatient clinic at 4 months, 12 months, and at 5 years. RESULTS: At 12 months, there were no statistically significant differences between the study groups in any of the outcome variables, but within the groups both the subjective and objective results were significantly better in comparison with the initial values. After 12 months, two (3%) patients in Group I continued physiotherapy and seven (41%) patients in Group II needed physiotherapy because of an unsatisfactory outcome. At 5 years, according to the urinary incontinence severity score (UISS) questionnaire, subjective discomfort had decreased in both groups (P < 0.01) and 21 of the 33 women (64%) perceived a subjective cure or improvement in their condition. The mean objective urine leakage verified by the pad test decreased from 23.0 to 1.0 g in Group I and from 13.0 to 1.0 g in Group II (P < 0.001 for both groups). The strength of PFMs tested in a standing position increased by 26% in Group I and by 19% in Group II (P values 0.001 and 0.084, respectively), and in a lying position by 28% in Group I and by 32% in Group II (P values 0.001 and 0.008, respectively). CONCLUSIONS: Home-based PFMEs and training with a VB proved to be equally effective as once-a-week supervised therapy, and the 5-year follow-up results demonstrated a successful response in the treatment of female SUI. SN - 0733-2467 UR - https://www.unboundmedicine.com/medline/citation/15382186/Physiotherapy_for_female_stress_urinary_incontinence:_individual_therapy_at_the_outpatient_clinic_versus_home_based_pelvic_floor_training:_a_5_year_follow_up_study_ L2 - https://doi.org/10.1002/nau.20065 DB - PRIME DP - Unbound Medicine ER -