This study aimed to evaluate the effects of a telehealth-delivered PFMT program on postmenopausal women with urinary incontinence and to compare its effectiveness with that of face-to-face PFMT in this cohort.
This was a non-inferiority pilot randomized controlled trial. Twenty-two participants were recruited from the community through snowball sampling and randomly assigned to either a telehealth group, which received eight sessions of individualized PFMT administered by a physical therapist via telehealth along with weekly telephone coaching, or a face-to-face group, which received PFMT supervised by a physiotherapist twice weekly for 12 weeks. Home exercises (pelvic floor safe exercises) were also provided to both groups. Outcomes measured included symptom severity (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI SF]), pelvic floor muscle function (assessed via digital palpation, manometry, and transperineal ultrasound), muscle strength (hand grip dynamometer), and exercise capacity (six-minute walk test), assessed at baseline and post-intervention. Data were analyzed using intention-to-treat with last observation carried forward imputation. Paired t-tests were utilized to compare pre- and post-intervention changes, while 2x2 repeated-measures analysis of variance tests were employed to compare intergroup changes post-intervention. Statistical significance was set at p 0.05.
In the telehealth group (n=11), paired t-tests indicated significant improvements in symptom severity (ICIQ-UI SF, p = 0.007), grip strength (p = 0.030), maximum voluntary contraction of pelvic floor muscles (digital palpation, p = 0.023), pelvic floor muscle endurance (p = 0.034), and fast contraction (p = 0.035) post-intervention. Similarly, the face-to-face group (n=11) demonstrated significant improvements in symptom severity, maximum voluntary contraction and fast contraction of pelvic floor muscles (digital palpation), bladder symphyseal distance displacement, and urogenital hiatus diameter. Notable group-by-time interactions were observed for maximum voluntary contraction (p = 0.045) and endurance (p = 0.030) of pelvic floor muscles as measured by manometry.
Both telehealth and face-to-face PFMT significantly reduced symptom severity and enhanced pelvic floor muscle function in postmenopausal women with urinary incontinence.
The findings of this study highlight the significant potential of telehealth in delivering PFMT to postmenopausal women with urinary incontinence. Both telehealth and face-to-face interventions resulted in substantial improvements in symptom severity and pelvic floor muscle function, indicating the efficacy of PFMT irrespective of the delivery mode. These results suggest that healthcare providers can effectively integrate telehealth solutions into treatment protocols, thereby enhancing accessibility and convenience for patients. By establishing the equivalency of telehealth and traditional face-to-face methods, this study supports the broader implementation of telehealth-delivered PFMT, which could lead to improved patient outcomes and more efficient care pathways for postmenopausal women with urinary incontinence.
Pelvic floor muscle training
Telehealth
