Physiotherapy in Stress Urinary Incontinence
Condition: Urinary Incontinence,Stress
MeSH terms: Urinary Incontinence; Enuresis; Urinary Incontinence, Stress
Study type: Interventional

Summary: 
      The goal of this randomized controlled trial is to evaluate and compare the effects of
      functional magnetic stimulation and pelvic floor muscle training on pelvic floor muscle
      function, urinary incontinence symptoms and quality of life in women with stress urinary
      incontinence. The main questions it aims to answer are:

        -  What is the effect of functional magnetic stimulation on pelvic floor muscle function,
           symptoms of urinary incontinence and quality of life in women with stress urinary
           incontinence?

        -  What is the effect of pelvic floor muscle training program on pelvic floor muscle
           function, symptoms of urinary incontinence and quality of life in women with stress
           urinary incontinence?

        -  Which intervention is more effective - functional magnetic stimulation or pelvic floor
           muscle training program?

      Participants will be evaluated before and after the intervention with the following methods:

        -  International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF);

        -  Incontinence Impact Questionnaire-Short Form (IIQ-7);

        -  Pelvic floor muscle strength and endurance will be assessed with a "Pelvexiser"
           perineometer.
    

Detailed description: 
      The study was performed in the period of 07/21/2021-30/10/2021. The study included 48 women
      29-49 years old who have complained of stress urinary incontinence for at least 4 weeks, who
      gave birth and signed the consent form. Women complaining of vaginismus, suffering from
      urinary tract infection, cancer, epilepsy or skin conditions with implanted pacemakers, metal
      implants and pregnant women were excluded from the study. Study participants were randomly
      divided into two groups: the I group (n=24), in which participants underwent functional
      magnetic stimulation (FMS) and the II group (n=24) in which subjects received pelvic floor
      muscle training (PFMT) program. Participants were evaluated before the intervention and
      repeated after 6 weeks. Subjects responded to a general questionnaire before the
      intervention, before and after the intervention, the International Consultation on
      Incontinence Questionnaire-Short Form (ICIQ-SF) and Incontinence Impact Questionnaire-Short
      Form (IIQ-7) were used to assess the symptoms of urinary incontinence and their impact on
      quality of life. Pelvic floor muscle strength and endurance were assessed with a "Pelvexiser"
      perineometer. Statistical analysis was performed by IBM SPSS Statistics 26.0 and Microsoft
      Excel software 365.
    

Intervention name(s): functional magnetic stimulation; pelvic floor muscle training program
Intervention type(s): Other; Other
Intervention description(s): When applying functional magnetic stimulation, the stress urinary incontinence program "P2 stress" was chosen. The first 20 min. current frequency was 35 Hz, modulation - rising amplitude (from 0 to maximum per second), total wave duration 12 s. active time 6 s., pause time 6 s. After 20 min. current frequency changed to 5 Hz, modulation and wave remained the same. After 2 min. current frequency changed to 35 Hz, modulation - amplitude, one-sided sinusoidal, wave remained the same. The total duration of the procedure was 30 min. A magnetic spring is installed at the bottom of the chair. During the treatment, each subject was instructed to sit on a chair so that the perineum was centered on the spring and that the subjects felt the contraction of the muscles. The intensity of the magnetic field was adjusted so as to feel comfortable during the study procedure (Vadalà et al., 2017).; The program consisted of two parts. From procedures 1 to 6, 6 exercises were performed, after 6 times the exercises were adjusted, and from procedures 7 to 12, another 5 exercises were performed. The program consists of breathing, pelvic floor muscle strength, endurance, speed training exercises and exercises to strengthen the thighs, buttocks, deep back and deep abdominal muscles. Exercises were performed in 2 sets of 10 repetitions at an intensity from various positions: lying on the back, side, sitting, quadruped (Oliveira et al., 2017; Walton et al., 2019).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: stress incontinence; pelvic floor; functional magnetic stimulation; muscle training