The primary objective of this study is to investigate the effects of PFMT and respiratory training (RT) on women with urinary incontinence (UI) through telerehabilitation (TeleR). Specifically, we aim to evaluate the impact on UI symptoms, severity, quality of life, and body awareness.
A total of 48 women with UI were included in this study and randomly divided into four groups: PFMT group (PFMT only), RT group (Respiratory training only), Combined group (PFMT and RT) and Control group (No intervention, verbal advice only). Assessments included the Sandvik Severity Scale for UI severity, Stop Test for pelvic floor muscle strength, Visual Analog Scale (VAS) for leakage severity, Bristol Female Lower Urinary Tract Symptoms Questionnaire for UI symptoms, Incontinence Quality of Life Scale (IQLS) for quality of life impact, and Body Awareness Questionnaire (BQQ) for body awareness. Evaluations were conducted before treatment and after 6 weeks. The intervention groups received 12 TeleR sessions (2 sessions per week for 6 weeks). Respiratory exercises were taught progressively according to neurodevelopmental motor learning principles, starting from lying in the hook position to more dynamic postures such as sitting, crawling, lunging, and standing. PFMT targeted both fast- and slow-contracting muscles in various positions such as supine, side-lying, sitting, and standing.
No significant differences were found between groups in baseline clinical data or total questionnaire scores (p>0.05). Post-treatment, significant improvements were observed in the PFMT and RT groups in VAS, Bristol questionnaire scores, and IQLS social subscores (p0.05). VAS improvements were also noted in the PFMT and combined groups compared to the control (p0.05).
The results indicate that all three treatment approaches delivered through TeleR effectively improved UI severity, symptoms and quality of life. The effectiveness of telerehabilitation and face-to-face application can be investigated in future studies.
Based on the patient's individual needs, motivation, and the physiotherapist's clinical judgement, respiratory training, PFMT, or a combination of these approaches can be integrated into the physiotherapy and rehabilitation program. We hypothesize that expanding the variety of exercises within these programs will enhance patient adherence, allowing them to maintain engagement with the rehabilitation process. Such variety aligns with the principles of motor learning, promoting effective repetition while minimizing monotony. Furthermore, respiratory training may be a valuable alternative approach for patients unable to perform PFMT, offering a non-invasive treatment option before resorting to pharmacological or surgical interventions.
respiratory training
pelvic floor muscle training
