Cinara Sacomori1, Bary Berghmans2, Ilse Mesters3, Rob de Bie3, Fernando Luiz Cardoso4. 1. CAPES Foundation, Ministry of Education of Brazil, Brasília. 2. Pelvic Care Center Maastricht, Maastricht University Medical Center. 3. Department of Epidemiology, Maastricht University, Maastricht, Netherlands. 4. Department of Health Sciences, Centre of Health and Sports Sciences, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.
Abstract
QUESTION: Do strategies to enhance self-efficacy and exercise mastery affect adherence to home-based pelvic floor muscle exercises in women with urinary incontinence? DESIGN: Two-arm, parallel, randomised, controlled trial with intention-to-treat analysis. Randomisation was performed using computer-generated random numbers in five blocks of 20 women. PARTICIPANTS: Eighty-six women with stress, urgency or mixed urinary incontinence. INTERVENTION: All participants underwent three individual physiotherapy clinic visits at Day 0, 15 and 30, and 2 further months of home-based pelvic floor muscle exercises. The experimental group also received self-efficacy enhancing interventions, including a structured discussion on accomplishments and goals, a 9-minute video with testimonials, and a reminder. OUTCOME MEASURES: The primary outcome - adherence to at least 20 fast and 20 slow contractions every day - was evaluated with a structured questionnaire at 15, 30 and 90 days after enrolment and completion of a daily diary. A validated questionnaire was used to assess urinary incontinence. Self-efficacy and pelvic floor muscle function were also measured. RESULTS: Seven women withdrew from each group before the Day-30 assessment. There was no difference in adherence to pelvic floor muscle exercises at 90 days between the groups (MD 0.5 points, 95% CI -1.1 to 2.1) on the questionnaire, which was scored from 2 to 21. At Day 90, 56% of the experimental group and 44% of the control group were performing the exercises every day. Adherence scores of both groups decreased during the 2-month follow-up period without any supervised physiotherapy session (p<0.05). The groups did not differ on the remaining secondary outcomes. CONCLUSION: Discussion of accomplishments and goals, a testimonial video and a reminder did not increase exercise adherence more than exercise mastery. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials UTN:U1111-1128-8684.
RCT Entities:
QUESTION: Do strategies to enhance self-efficacy and exercise mastery affect adherence to home-based pelvic floor muscle exercises in women with urinary incontinence? DESIGN: Two-arm, parallel, randomised, controlled trial with intention-to-treat analysis. Randomisation was performed using computer-generated random numbers in five blocks of 20 women. PARTICIPANTS: Eighty-six women with stress, urgency or mixed urinary incontinence. INTERVENTION: All participants underwent three individual physiotherapy clinic visits at Day 0, 15 and 30, and 2 further months of home-based pelvic floor muscle exercises. The experimental group also received self-efficacy enhancing interventions, including a structured discussion on accomplishments and goals, a 9-minute video with testimonials, and a reminder. OUTCOME MEASURES: The primary outcome - adherence to at least 20 fast and 20 slow contractions every day - was evaluated with a structured questionnaire at 15, 30 and 90 days after enrolment and completion of a daily diary. A validated questionnaire was used to assess urinary incontinence. Self-efficacy and pelvic floor muscle function were also measured. RESULTS: Seven women withdrew from each group before the Day-30 assessment. There was no difference in adherence to pelvic floor muscle exercises at 90 days between the groups (MD 0.5 points, 95% CI -1.1 to 2.1) on the questionnaire, which was scored from 2 to 21. At Day 90, 56% of the experimental group and 44% of the control group were performing the exercises every day. Adherence scores of both groups decreased during the 2-month follow-up period without any supervised physiotherapy session (p<0.05). The groups did not differ on the remaining secondary outcomes. CONCLUSION: Discussion of accomplishments and goals, a testimonial video and a reminder did not increase exercise adherence more than exercise mastery. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials UTN:U1111-1128-8684.
Authors: Neil V Shah; Maximilian Solow; John J Kelly; Alexandr Aylyarov; James P Doran; Lee R Bloom; Samuel Akil; Bilal Siddiqui; Jared M Newman; Dipal Chatterjee; Neel Pancholi; Anant Dixit; Borna Kavousi; Scott E Barbash; William P Urban; David T Neuman Journal: J Orthop Date: 2018-05-07
Authors: María Torres-Lacomba; Beatriz Navarro-Brazález; María José Yuste-Sánchez; Beatriz Sánchez-Sánchez; Virginia Prieto-Gómez; Fernando Vergara-Pérez Journal: J Pers Med Date: 2022-03-19