Effectiveness of pelvic floor muscle training and bladder training for women with urinary incontinence in primary care: a pragmatic controlled trial

• Published in: Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Vol. 23; no. 2; pp. 116 - 124
• Main Authors: Vaz, Camila Teixeira, Sampaio, Rosana Ferreira, Saltiel, Fernanda, Figueiredo, Elyonara Mello
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier Editora Ltda 01.03.2019; Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
• Subjects: Original Research; Pelvic floor; Physical therapy modalities; Primary health care; Urinary incontinence; Urinary incontinence; Pelvic floor; Primary health care; Physical therapy modalities
• ISSN: 1413-3555; 1809-9246
• DOI: 10.1016/j.bjpt.2019.01.007

•The majority of women do not have access to physical therapy for urinary incontinence in primary health centers.•Physical therapy intervention can be succssesfully implemented in primary health care centers.•The PFMT and bladder training was effective, with positive results as early as 6 weeks.•The protocols tested should be used in primary health centers. Although the efficacy of pelvic floor muscle training (PFMT) and bladder training are well established, there is a paucity of patient centered models using these interventions to treat women with UI at primary level of health assistance in Brazil. To investigate the effectiveness of a physical therapy intervention to treat women with UI in primary health centers. Pragmatic non-randomized controlled trial in which women with UI from the community participated in a supervised physical therapy program consisting of bladder training plus 12 weeks of PFMT, performed either at home or in the health center. Outcome measures were amount and frequency of urine loss measured by the 24-h pad-test and the 24-h voiding diary; secondary outcome was the impact of UI on quality of life measured by the ICIQ-SF. Outcomes were measured at baseline, at the 6th and 12th weeks of the intervention and 1 month after discharge. Interventions reduced the amount (pad-test, p=0.004; d=0.13, 95% CI=−0.23 to 0.49) and frequency of urine loss (voiding diary, p=0.003; d=0.51, 95%CI=0.14 to 0.87), and the impact of UI on quality of life (ICIQ-SF, p<0.001; d=1.26, 95%CI=0.87 to 1.66) over time, with positive effects from the 6th week up to 1 month for both intervention setting (home and health center), and no differences between them. Interventions were effective, can be implemented in primary health centers favoring the treatment of a greater number of women who do not have access to specialized physical therapy. Trial registration: RBR-8tww4y.