Background

Although the efficacy of pelvic floor muscle training (PFMT) and bladder training are well established, there is a paucity of patient centered models using these interventions to treat women with UI at primary level of health assistance in Brazil.

Objective

To investigate the effectiveness of a physical therapy intervention to treat women with UI in primary health centers.

Methods

Pragmatic non-randomized controlled trial in which women with UI from the community participated in a supervised physical therapy program consisting of bladder training plus 12 weeks of PFMT, performed either at home or in the health center. Outcome measures were amount and frequency of urine loss measured by the 24-h pad-test and the 24-h voiding diary; secondary outcome was the impact of UI on quality of life measured by the ICIQ-SF. Outcomes were measured at baseline, at the 6th and 12th weeks of the intervention and 1 month after discharge.

Results

Interventions reduced the amount (pad-test, p = 0.004; d = 0.13, 95% CI = −0.23 to 0.49) and frequency of urine loss (voiding diary, p = 0.003; d = 0.51, 95%CI = 0.14 to 0.87), and the impact of UI on quality of life (ICIQ-SF, p < 0.001; d = 1.26, 95%CI = 0.87 to 1.66) over time, with positive effects from the 6th week up to 1 month for both intervention setting (home and health center), and no differences between them.

Conclusion

Interventions were effective, can be implemented in primary health centers favoring the treatment of a greater number of women who do not have access to specialized physical therapy.

Trial registration: RBR-8tww4y.

中文翻译：

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骨盆底肌肉训练和膀胱训练对初级保健中尿失禁妇女的有效性：一项实用对照试验。

背景

尽管骨盆底肌肉训练（PFMT）和膀胱训练的功效已得到公认，但在巴西，以这些干预措施以UI为主治疗妇女的UI缺乏患者为中心的模型。

目的

调查物理治疗干预措施在初级保健中心治疗UI的妇女的有效性。

方法

实用性非随机对照试验，其中社区UI的妇女参加了在家里或在医疗中心进行的有监督的物理治疗计划，包括膀胱训练加12周的PFMT。结果测量是通过24小时便笺本测试和24小时排尿日记测量的尿液流失的数量和频率；次要结果是UI对ICIQ-SF衡量的生活质量的影响。在基线，干预的第6周和第12周以及出院后1个月测量结局。

结果

干预减少了 尿量（便笺纸试验，p  = 0.004; d = 0.13，95％CI = -0.23至0.49）和尿频（尿日记，p  = 0.003; d  = 0.51，95％CI = 0.14至0.87） ），以及UI对生活质量的影响（ICIQ-SF，p  <0.001；d  = 1.26，95 ％CI = 0.87至1.66），两种干预设置从第6周到1个月都具有积极作用（家庭和健康中心），两者之间没有区别。

结论

干预是有效的，可以在初级保健中心实施，以治疗更多无法获得专门物理疗法的妇女。

试用注册：RBR-8tww4y。