An Innovative, Non-invasive, Biofeedback Device for the Treatment of Stress Urinary Incontinence in Women: Evaluation and Mechanism Testing
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 132
- 试验地点
- 2
- 主要终点
- Severity of urine loss
研究概览
简要总结
Background and purpose: The research team developed the PelviSense, a non-invasive biofeedback device paired with wearable EMG sensors for use as a PFMT adjunct. The proposed study aims to (1) investigate the efficacy of PelviSense-assisted PFMT compared with unassisted PFMT on SUI in women, and (2) identify the mechanisms underlying the beneficial effects of PFMT for the treatment of SUI. Methods: A two-arm, parallel-group RCT will be conducted using 132 non-pregnant women with SUI, aged 18-60 years. The study participants will be randomised into two study groups: PelviSense-assisted PFMT or unassisted PFMT. Women will be supervised in the performance of PelviSense-assisted and unassisted PFMT on a 1:1 basis for 4 weeks and instructed to perform unsupervised home exercises for 24 weeks after the completion of supervised training. The primary outcome will be the severity of urine loss, as measured using the one-hour pad test. Secondary outcomes will include quality of life, SUI symptoms severity, and PFM strength, as measured using the incontinence impact questionnaire, short-form, international consultation on incontinence questionnaire, short-form, and modified Oxford scale, respectively. Mediator variables will include the following: bladder neck elevation and levator hiatus area. Outcomes and mediator variables will be assessed at baseline, 4, and 28 weeks. Statistical analysis: Treatment and mediation effects will be evaluated using analysis of covariance and the Hayes' PROCESS macro, respectively.
详细描述
Background and purpose: Stress urinary incontinence (SUI) is a common condition among women, resulting in urine leakage during physical exertion, sneezing, or coughing. Due to the risks associated with surgical and pharmacological treatments, women with SUI often prefer conservative treatments, such as pelvic floor muscle (PFM) training (PFMT). PFMT has been shown to provide increased beneficial effects when combined with electromyography (EMG) biofeedback (referred to as conventional biofeedback [CB]) via intravaginal probe than when performed alone. However, the CB device applied in clinical practice is not preferred by women because it is invasive, and involves the insertion of a probe into the vagina, causing pain/ discomfort. Therefore, we developed the PelviSense, a non-invasive biofeedback device paired with wearable EMG sensors for use as a PFMT adjunct.
The proposed study aims to (1) investigate the efficacy of PelviSense-assisted PFMT compared with unassisted PFMT on SUI in women, and (2) identify the mechanisms underlying the beneficial effects of PFMT for the treatment of SUI.
Hypotheses: (1) women assigned to the PelviSense-assisted PFMT group will report a greater reduction in the severity of urine loss compared with women assigned to the unassisted PFMT group; and (2) improvements in the severity of urine loss will be mediated by increased PFM strength, causing an increase in bladder neck elevation and a reduction in levator hiatus (LH) area during the Valsalva manoeuvre.
Methods: A two-arm, parallel-group RCT will be conducted using 132 non-pregnant women with SUI, aged 18-60 years. The study participants will be randomised into two study groups: PelviSense-assisted PFMT or unassisted PFMT. Women will be supervised in the performance of PelviSense-assisted and unassisted PFMT on a 1:1 basis for 4 weeks and instructed to perform unsupervised home exercises for 24 weeks after the completion of supervised training.
Recruitment. Potential participants will be recruited using a non-probability convenience sampling technique through public and university campus advertising.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •non-pregnant women with SUI and
- •aged 18-60 years; and (2) women who experience mild-to-moderate SUI, as indicated by a pad weight gain of 1-50 g during the 1-h pad test and stress test (referred to as the 1-h pad test)
排除标准
- •non-pregnant women with SUI and
- •aged 18-60 years; and (2) women who experience mild-to-moderate SUI, as indicated by a pad weight gain of 1-50 g during the 1-h pad test and stress test (referred to as the 1-h pad test)
- •women with severe pelvic organ prolapse (stages 3 and 4 according to the Baden-Walker Halfway Scoring System)
- •women with complicated urinary incontinence due to pelvic radiation; (3) women with severe psychological problems that would impair study participation; and
- •women with urge-predominant mixed urinary incontinence or urge incontinence.
结局指标
主要结局
Severity of urine loss
时间窗: Baseline (0 month), 4 and 24 weeks
The one-hour pad test will be used to quantify the severity of urine loss. For the one-hour pad test, all participants will be instructed to empty their bladders before wearing the pre-weighed pads, after which they will be made to drink 500 ml water. The women will then perform a set of activities for 30 minutes: walking, climbing up and down one flight of stairs, standing up from sitting (10 times), coughing vigorously (10 times), bending to pick up an object from the floor (5 times), and washing their hands for one minute under running water. The weight of the pad will then be measured after 1 hour to quantify urine loss in grams.
次要结局
- Quality of life of women with stress urinary incontinence(Baseline (0 month), 4 and 24 weeks)
- Levator Hiatus (LH) area(Baseline (0 month), 4 and 24 weeks)
- Bladder neck elevation(Baseline (0 month), 4 and 24 weeks)
- Stress urinary incontinence symptoms severity(Baseline (0 month), 4 and 24 weeks)
- Pelvic Floor Muscle Strength(Baseline (0 month), 4 and 24 weeks)
研究者
Dr. Priya Kannan
Associate Professor
The Hong Kong Polytechnic University