Journal article
Adherence to behavioral interventions for stress incontinence: rates, barriers, and predictors
Physical therapy, Vol.93(6), pp.757-770
06/2013
DOI: 10.2522/ptj.20120072
PMCID: PMC3664038
PMID: 23431210
Abstract
First-line conservative treatment for stress urinary incontinence (SUI) in women is behavioral intervention, including pelvic-floor muscle (PFM) exercise and bladder control strategies. The purposes of this study were: (1) to describe adherence and barriers to exercise and bladder control strategy adherence and (2) to identify predictors of exercise adherence. This study was a planned secondary analysis of data from a multisite, randomized trial comparing intravaginal continence pessary, multicomponent behavioral therapy, and combined therapy in women with stress-predominant urinary incontinence (UI). Data were analyzed from the groups who received behavioral intervention alone (n=146) or combined with continence pessary therapy (n=150). Adherence was measured during supervised treatment and at 3, 6, and 12 months post-randomization. Barriers to adherence were surveyed during treatment and at the 3-month time point. Regression analyses were performed to identify predictors of exercise adherence during supervised treatment and at the 3- and 12-month time points. During supervised treatment, ≥86% of the women exercised ≥5 days a week, and ≥80% performed at least 30 contractions on days they exercised. At 3, 6, and 12 months post-randomization, 95%, 88%, and 80% of women, respectively, indicated they were still performing PFM exercises. During supervised treatment and at 3 months post-randomization, ≥87% of the women reported using learned bladder control strategies to prevent SUI. In addition, the majority endorsed at least one barrier to PFM exercise, most commonly "trouble remembering to do exercises." Predictors of exercise adherence changed over time. During supervised intervention, less frequent baseline UI and higher baseline 36-Item Short-Form Health Survey (SF-36) mental scores predicted exercise adherence. At 3 months post-randomization, women who dropped out of the study had weaker PFMs at baseline. At 12 months post-randomization, only "trouble remembering" was associated with exercise adherence. Adherence and barrier questionnaires were not validated. Adherence to PFM exercises and bladder control strategies for SUI can be high and sustained over time. However, behavioral interventions to help women link exercise to environmental and behavioral cues may only be beneficial over the short term.
Details
- Title: Subtitle
- Adherence to behavioral interventions for stress incontinence: rates, barriers, and predictors
- Creators
- Diane Borello-France - Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA 15282, USA. borellofrance@duq.eduKathryn L BurgioPatricia S GoodeWen YeAlison C WeidnerEmily S LukaczJohn-Eric JelovsekCatherine S BradleyJoseph SchafferYvonne HsuKimberly KentonCathie SpinoPelvic Floor Disorders Network
- Resource Type
- Journal article
- Publication Details
- Physical therapy, Vol.93(6), pp.757-770
- DOI
- 10.2522/ptj.20120072
- PMID
- 23431210
- PMCID
- PMC3664038
- NLM abbreviation
- Phys Ther
- ISSN
- 0031-9023
- eISSN
- 1538-6724
- Publisher
- United States
- Grant note
- U10 HD054136 / NICHD NIH HHS U10 HD054215 / NICHD NIH HHS UG1 HD054214 / NICHD NIH HHS U10 HD041267 / NICHD NIH HHS U10 HD041261 / NICHD NIH HHS UG1 HD041267 / NICHD NIH HHS U10 HD054214 / NICHD NIH HHS U10 HD041263 / NICHD NIH HHS
- Language
- English
- Date published
- 06/2013
- Academic Unit
- Epidemiology; Obstetrics and Gynecology; Urology
- Record Identifier
- 9983930405102771
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