Clinical trial NCT05443074: Efficacy of a Face to Face Versus a Remote Physiotherapy Instruction Session About Pelvic Floor in Women With Urinary Incontinence
Official title: Efficacy of a Face-to-face Versus a Remote Physiotherapy Instruction Session About Pelvic Floor in the Pelvic Floor Muscle Capacity of Incontinent Women: a Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Urinary Incontinence
Lead sponsor: University of Sao Paulo
Sponsor class: OTHER
First posted: 2022-07-05
Enrollment: 90
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to assess and to compare the efficacy of a face to face versus a remote physiotherapy instruction session about pelvic floor muscle (PFM) function, including teaching women how to contract their PFM and how to perceive a correct PFM contraction. Study participants will be randomly assigned to participate in one of the three study groups: Group 1 will receive face to face instructions, Group 2 will receive real time remote instructions and Group 3 will not receive any instruction. The primary outcome measure is PFM function assessed using the modified Oxford Scale.


Eligibility criteria: Inclusion Criteria:

* Women who are not able to contract their PFM (≤ 2 of Modified Oxford Scale);
* Cognitive ability, hearing and visual acuity preserved (through 10-point cognitive screener and Snellen test, respectively);
* Non-neurogenic UI;
* No history of neurological disorders;
* No symptoms of a vaginal or urinary tract infection;
* Pelvic organ prolapse ≤2 (according to the Baden and Walker scale);
* Who have not already been instructed on how to perform PFM contraction or who is not already performing PFM training;
* No suspected or confirmed pregnancy.

Exclusion Criteria:

* Who have intolerance to physical examination, or latex allergy;
* Who withdraws from participating in the study.

Primary outcomes:
measure: Change in contraction capacity
timeFrame: At baseline, immediately after intervention and 20 days after the intervention.
measure: Change in self-perception of the PFM
timeFrame: At baseline, immediately after intervention and 20 days after the intervention.
Secondary outcomes:
measure: Self-report of UI symptoms
timeFrame: At baseline and 20 days after the intervention.
measure: Assessment of the usefulness of teaching resources
timeFrame: Immediately after intervention
measure: Satisfaction with the orientations
timeFrame: Immediately after intervention
measure: System usability assessment
timeFrame: Immediately after intervention
Other outcomes:
Locations:
city: Ribeirão Preto
country: Brazil
facility: University of São Paulo
state: São Paulo
Study officials:
affiliation: University of Sao Paulo
name: Cristine H Jorge
role: STUDY_DIRECTOR
References:
citation: Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers. 2017 Jul 6;3:17042. doi: 10.1038/nrdp.2017.42.
citation: Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, Bortolini M, Dumoulin C, Gomes M, McClurg D, Meijlink J, Shelly E, Trabuco E, Walker C, Wells A. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Neurourol Urodyn. 2017 Feb;36(2):221-244. doi: 10.1002/nau.23107. Epub 2016 Dec 5.
citation: Cacciari LP, Dumoulin C, Hay-Smith EJ. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a cochrane systematic review abridged republication. Braz J Phys Ther. 2019 Mar-Apr;23(2):93-107. doi: 10.1016/j.bjpt.2019.01.002. Epub 2019 Jan 22.
citation: Dantas LO, Barreto RPG, Ferreira CHJ. Digital physical therapy in the COVID-19 pandemic. Braz J Phys Ther. 2020 Sep-Oct;24(5):381-383. doi: 10.1016/j.bjpt.2020.04.006. Epub 2020 May 1. No abstract available.
citation: de Andrade RL, Bo K, Antonio FI, Driusso P, Mateus-Vasconcelos ECL, Ramos S, Julio MP, Ferreira CHJ. An education program about pelvic floor muscles improved women's knowledge but not pelvic floor muscle function, urinary incontinence or sexual function: a randomised trial. J Physiother. 2018 Apr;64(2):91-96. doi: 10.1016/j.jphys.2018.02.010. Epub 2018 Mar 21.
citation: de Freitas LM, Bo K, Fernandes ACNL, Uechi N, Duarte TB, Ferreira CHJ. Pelvic floor muscle knowledge and relationship with muscle strength in Brazilian women: a cross-sectional study. Int Urogynecol J. 2019 Nov;30(11):1903-1909. doi: 10.1007/s00192-018-3824-y. Epub 2018 Nov 22.
citation: Ferreira CHJ, Driusso P, Haddad JM, Pereira SB, Fernandes ACNL, Porto D, Reis BM, Mascarenhas LR, Brito LGO, Ferreira EAG. A guide to physiotherapy in urogynecology for patient care during the COVID-19 pandemic. Int Urogynecol J. 2021 Jan;32(1):203-210. doi: 10.1007/s00192-020-04542-8. Epub 2020 Sep 28.
citation: Fernandes ACNL, Palacios-Cena D, Hay-Smith J, Pena CC, Sidou MF, de Alencar AL, Ferreira CHJ. Women report sustained benefits from attending group-based education about pelvic floor muscles: a longitudinal qualitative study. J Physiother. 2021 Jul;67(3):210-216. doi: 10.1016/j.jphys.2021.06.010. Epub 2021 Jun 17.
citation: Frawley HC, Galea MP, Phillips BA, Sherburn M, Bo K. Reliability of pelvic floor muscle strength assessment using different test positions and tools. Neurourol Urodyn. 2006;25(3):236-242. doi: 10.1002/nau.20201.
citation: Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010 Jan;21(1):5-26. doi: 10.1007/s00192-009-0976-9. Epub 2009 Nov 25.
citation: Hay-Smith J, Herderschee R, Dumoulin C, Herbison P. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women: an abridged Cochrane systematic review. Eur J Phys Rehabil Med. 2012 Dec;48(4):689-705.
citation: Hui E, Lee PS, Woo J. Management of urinary incontinence in older women using videoconferencing versus conventional management: a randomized controlled trial. J Telemed Telecare. 2006;12(7):343-7. doi: 10.1258/135763306778682413.
citation: Laycock J. Pelvic muscle exercises: physiotherapy for the pelvic floor. Urol Nurs. 1994 Sep;14(3):136-40. No abstract available.
citation: Liao YM, Dougherty MC, Liou YS, Tseng IJ. Pelvic floor muscle training effect on urinary incontinence knowledge, attitudes, and severity: an experimental study. Int J Nurs Stud. 2006 Jan;43(1):29-37. doi: 10.1016/j.ijnurstu.2005.01.004.
citation: Mateus-Vasconcelos ECL, Brito LGO, Driusso P, Silva TD, Antonio FI, Ferreira CHJ. Effects of three interventions in facilitating voluntary pelvic floor muscle contraction in women: a randomized controlled trial. Braz J Phys Ther. 2018 Sep-Oct;22(5):391-399. doi: 10.1016/j.bjpt.2017.12.006. Epub 2018 Feb 3.
citation: Miller JM, Ashton-Miller JA, DeLancey JO. A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc. 1998 Jul;46(7):870-4. doi: 10.1111/j.1532-5415.1998.tb02721.x.
citation: Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007 Aug;39(8):1435-45. doi: 10.1249/mss.0b013e3180616aa2.
citation: Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare. 2018 Jan;24(1):4-12. doi: 10.1177/1357633X16674087. Epub 2016 Oct 16.
citation: Smith AL, Nissim HA, Le TX, Khan A, Maliski SL, Litwin MS, Sarkisian CA, Raz S, Rodriguez LV, Anger JT. Misconceptions and miscommunication among aging women with overactive bladder symptoms. Urology. 2011 Jan;77(1):55-9. doi: 10.1016/j.urology.2010.07.460. Epub 2010 Oct 23.
citation: Talasz H, Himmer-Perschak G, Marth E, Fischer-Colbrie J, Hoefner E, Lechleitner M. Evaluation of pelvic floor muscle function in a random group of adult women in Austria. Int Urogynecol J Pelvic Floor Dysfunct. 2008 Jan;19(1):131-5. doi: 10.1007/s00192-007-0404-y. Epub 2007 Sep 18.
citation: Tibaek S, Dehlendorff C. Pelvic floor muscle function in women with pelvic floor dysfunction: a retrospective chart review, 1992-2008. Int Urogynecol J. 2014 May;25(5):663-9. doi: 10.1007/s00192-013-2277-6. Epub 2013 Dec 12.
citation: Uechi N, Fernandes ACNL, Bo K, de Freitas LM, de la Ossa AMP, Bueno SM, Ferreira CHJ. Do women have an accurate perception of their pelvic floor muscle contraction? A cross-sectional study. Neurourol Urodyn. 2020 Jan;39(1):361-366. doi: 10.1002/nau.24214. Epub 2019 Nov 18.