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Vol. 23. Issue 2.
Pages 116-124 (01 March 2019)
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Vol. 23. Issue 2.
Pages 116-124 (01 March 2019)
Original Research
DOI: 10.1016/j.bjpt.2019.01.007
Effectiveness of pelvic floor muscle training and bladder training for women with urinary incontinence in primary care: a pragmatic controlled trial
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Camila Teixeira Vaza,b, Rosana Ferreira Sampaioa, Fernanda Saltiela,c, Elyonara Mello Figueiredoa,
Corresponding author
elyonara@ufmg.br

Corresponding author at: Departamento de Fisioterapia/EEFFTO, Avenida Antonio Carlos, 6627, CEP: 31270-901 Belo Horizonte, MG, Brazil.
a Rehabilitation Sciences Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
b Physical Therapy Department, Universidade Federal de Juiz de Fora (UFJF), Governador Valadares, MG, Brazil
c Faculdade de Ciências Médicas de Minas Gerais (FCMMG) Belo Horizonte, MG, Brazil
Highlights

  • 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.

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Figures (1)
Tables (4)
Table 1. Socio-demographic and clinical characteristics of the participants by settings (N=60).
Table 2. Changes in the outcomes over time for the total sample (within groups comparison) (N=60).
Table 3. Multiple comparisons over time for each outcome for the total sample, collapsed by setting (N=60).
Table 4. Changes in the outcomes over time according to settings (within and between settings comparisons) (N=60).
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Abstract
Background

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.

Objective

To investigate the effectiveness of a physical therapy intervention to treat women with UI in primary health centers.

Methods

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.

Results

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.

Conclusion

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.

Keywords:
Urinary incontinence
Pelvic floor
Physical therapy modalities
Primary health care.

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