Can postpartum pelvic floor muscle training reduce urinary and anal incontinence?: An assessor-blinded randomized controlled trial.

• Published in: American Journal of Obstetrics and Gynecology
• Main Authors: Sigurdardottir, Thorgerdur, Steingrimsdottir, Thora, Geirsson, Reynir T, Halldorsson, Thorhallur I, Aspelund, Thor, Bø, Kari
• Other Authors: 1Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland. Electronic address: [e-mail]. 2Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland. 3Faculty of Food Sciences and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 4Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 5Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway; Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier 2020
• Subjects: anal incontinence; anal sphincter muscles; pelvic floor muscle training; pelvic floor muscles; postpartum; primiparity; quality of life; short-term; urinary incontinence; Grindarbotnsæfingar; Fæðing; Pelvic Floor; Exercise; Postpartum Period; Fecal Incontinence; Iceland
• Online Access: http://hdl.handle.net/2336/621355; https://doi.org/10.1016/j.ajog.2019.09.011

To access publisher's full text version of this article click on the hyperlink below Background: Pelvic floor dysfunction, including urinary and anal incontinence, is a common postpartum complaint and likely to reduce quality of life. Objective: To study the effects of individualized physical therapist-guided pelvic floor muscle training in the early postpartum period on urinary and anal incontinence and related bother, as well as pelvic floor muscle strength and endurance. Materials and methods: This was an assessor-blinded, parallel-group, randomized controlled trial evaluating effects of pelvic floor muscle training by a physical therapist on the rate of urinary and/or anal leakage (primary outcomes); related bother and muscle strength and endurance in the pelvic floor were secondary outcomes. Between 2016 and 2017, primiparous women giving birth at Landspitali University Hospital in Reykjavik, Iceland, were screened for eligibilty 6-10 weeks after childbirth. Of those identified as urinary incontinent, 95 were invited to participate, of whom 84 agreed. The intervention, starting at ∼9 weeks postpartum consisted of 12 weekly sessions with a physical therapist, after which the main outcomes were assessed (endpoint, ∼6 months postpartum). Additional follow-up was conducted at ∼12 months postpartum. The control group received no instructions after the initial assessment. The Fisher exact test was used to test differences in the proportion of women with urinary and anal incontinence between the intervention and control groups, and independent-sample t tests were used for mean differences in muscle strength and endurance. Significance levels were set as α = 0.05. Results: A total of 41 and 43 women were randomized to the intervention and control groups, respectively. Three participants and 1 participant withdrew from these respective groups. Measurement variables and main delivery outcomes were not different at recruitment. At the endpoint, urinary incontinence was less frequent in the intervention group, with ...