Effects Of Telerehabilitation-Based Pelvıc Floor Muscle Exercises On Urinary Incontinance, Pelvic Floor Functions and Childbirth In Pregnant Women

Artvin Coruh University1 个研究点分布在 1 个国家目标入组 45 人开始时间: 2024年9月16日最近更新: 2026年8月7日

适应症

干预措施

试验速览

阶段: 不适用
状态: 已完成
发起方
入组人数: 45
试验地点: 1
主要终点: Percentage of Maximum Voluntary Contraction (%MVC) of Pelvic Floor Muscles

研究概览研究设计入排标准研究组 & 干预措施结局指标研究者研究点记录与标识符相似试验

研究概览

简要总结

The aim of this study is to examine the effect of pelvic floor exercises performed via prenatal tele-rehabilitation on the following issues:

Perceived symptom severity and frequency associated with the development of urinary incontinence and quality of life
Pelvic floor muscle function and
Birth and delivery parameters in pregnant women. Research Questions

1. Does prenatal tele-pelvic floor exercise reduce the frequency or symptom severity of urinary incontinence in the late stages of pregnancy and the early postpartum period? 2. Does prenatal tele-pelvic floor exercise improve pelvic floor muscle function and contraction performance? 3. Does prenatal tele-pelvic floor exercise affect delivery parameters such as labor duration, mode of delivery, episiotomy, and perineal trauma? The current literature indicates that prenatal tele-pelvic floor exercise can reduce the risk of urinary incontinence during pregnancy and the postpartum period by preserving pelvic floor muscle function in pregnant women, and recommends the application of pelvic floor muscle exercises and pelvic floor training during pregnancy due to their protective effect. However, more data are needed to draw meaningful conclusions about the participation (continuity) of PTKE in treatment, how and by whom it is administered, and its effects on postnatal UI. In addition to preventing UI, studies are needed that more clearly express the effects of antenatal PTKE, such as improved quality of life specific to UI with a reduction in the severity, frequency, and amount of leakage, and the determination of changes in pelvic floor muscle strength and function in the long term. There are studies that mention various content regarding education and exercise practices. With the Covid-19 conditions, the way healthcare institutions operate has been visibly affected. Based on this, potential situations such as individuals not being able to benefit sufficiently from healthcare facilities may occur. Investigators believe that tele-rehabilitation methods will provide us with positive support in this regard, in terms of reaching individuals and providing healthcare services to individuals during the thesis study. Furthermore, more studies are needed on the effects of PTKE programs conducted through tele-health applications on treatment participation, patient adherence to treatment, and prenatal/postnatal urinary tract infection.

Evidence from research on application/tele-rehabilitation-based pelvic floor muscle exercises in women during pregnancy and the postnatal period shows potential benefits in terms of adherence and symptom management, but the literature is less mature than the literature on general pelvic floor muscle exercises. The aim of this study is to investigate the effectiveness of a tele-rehabilitation-supervised pelvic floor muscle exercise program (PFME) in preventing urinary incontinence during pregnancy and postpartum, and its effects on pelvic floor function, strength, and delivery parameters.

Hypotheses H0 (primary): In pregnant women, a structured tele-rehabilitation-based pelvic floor muscle exercise (PFME) program does not differ from a home exercise program in terms of its effect on urinary incontinence symptoms in the late pregnancy and early postpartum period.

H1 (primary): In pregnant women, a structured tele-rehabilitation-based PFME program reduces urinary incontinence symptoms in the late pregnancy and early postpartum period compared to a home exercise program.

H0 (primary): In pregnant women, a structured tele-rehabilitation-based pelvic floor muscle exercise (PFME) program does not differ from a home exercise program in terms of its effect on pelvic floor muscle function in the late pregnancy and early postpartum period.

H 2 (primary): In pregnant women, a structured tele-rehabilitation-based PFME program improves pelvic floor muscle function in late pregnancy and early postpartum compared to a PFME program given as a home exercise program.

详细描述

Pregnancy and childbirth are significant risk factors for urinary incontinence (UI); mechanical and hormonal changes, increased intra-abdominal pressure, and pregnancy-related changes in pelvic floor tissues and nerves, vaginal delivery, and obstetric anal sphincter injury increase the risk of developing UI, while cesarean delivery reduces the short-term postpartum UI risk. Stress incontinence may also be linked to hormones such as relaxin and progesterone during pregnancy.

The prevalence of UI reported personally during the prenatal period is being widely investigated. Figures indicating UI prevalence vary greatly in published reports depending on the case definitions applied, the population recruited, and the study methodology (9-63%).

Urinary incontinence is a common problem among adults living in the community. It is more frequent in women, and pregnancy or the postpartum period may be the first time many women experience UI. Stress urinary incontinence (involuntary urine leakage with physical exertion) and urge incontinence (involuntary urine leakage associated with or immediately following a sudden need to urinate) are the two most common types of urinary incontinence in women. Many women experience symptoms of both stress and urge incontinence; this is called mixed type UI. Of these types, stress urinary incontinence is most commonly associated with pregnancy and the postpartum period.

The degree of discomfort experienced by pregnant women regarding UI varies. Since the degree of discomfort or severity of UI, or the prevalence of urge incontinence, can overestimate the actual prevalence, (high) prevalence rates should be interpreted cautiously when case definitions do not include a measure of symptom discomfort. Therefore, the International Incontinence Consultation (ICI) recommends adding a measure of discomfort to prevalence figures.

研究设计

研究类型: Interventional
分配方式: Randomized
干预模型: Parallel
主要目的: Prevention
盲法: Single (Participant)

入排标准

年龄范围: 18 Years 至 35 Years（Adult）
性别: Female
接受健康志愿者: 是

入选标准

•Single pregnancy
•BMI < 30 kg/m^2
•Being between 18-35 years old

排除标准

•Women with risk of abortion
•Women with serious lung diseases (COPD, asthma, etc.)
•Women with gestational diabetes
•Women with high-risk pregnancies (gestational diabetes, preeclampsia, bleeding, severe anemia, cervical insufficiency, trauma, etc.)
•Women with multiple pregnancies
•Women with a BMI above 30 kg/m^2 and below 20 kg/m^2 during pregnancy
•Women undergoing infertility treatment
•Women whose height is less than 150 cm
•Women who regularly exercise during pregnancy
•Women who do not continue exercise for more than 4 weeks

研究组 & 干预措施

Intervention (tele-PFME)

Experimental

In the Tele-PFME group, exercises were performed 3 days a week under video call supervision (correct use of the diaphragm and breathing and positions were checked during the exercises). Participation and continuity of the exercise program, which was implemented via teleconference with a physiotherapist in individual programs based on the PFME group training program, were recorded by the physiotherapist.

Pelvic Floor Muscle Exercises program:

It is specially planned according to the individual's muscle strength. (Sample progress below.) Week 1: 5x(10 taps +10 lifts) Week 2: 10x(10 taps +10 lifts) Week 3: 15x(10 taps +10 lifts) Week 4: 20x(10 taps +10 lifts) Week 5: 25x(10 taps +10 lifts) Week 6: 30x(10 taps +10 lifts) Week 7: 10x (10 taps + 5 lifts) + 10x (10 taps + 10 lifts)

干预措施: Tele-rehabilitation (Other)

Control(Home based, none supervised)

Other

Control (home exercise) group. In the control (home exercise) group, since PFME is routinely used in many pelvic floor studies and in the clinic, the patient was taught the exercise routine and the weekly program given in writing was followed up by calling every two weeks. In both groups, patients who did not continue the exercise program at least two days a week for more than four weeks were excluded from the study. Otherwise, the study would have remained as an educational study only, with the control group against the tele-PFME group.

干预措施: Home based-Non supervised PFME (Other)