Effects of a home-based pelvic floor muscle training with and without action and cue observation on urinary incontinence after prostatectomy: A randomized controlled trial

Objective To investigate the effects of a home-based pelvic floor muscle training with and without action and cue observation on urinary incontinence after prostatectomy.Design Two-armed single-blind randomized controlled trial.Setting Humanitas Research Hospital, Milan, Italy.Participants Ninety-two participants with age between 40 and 80 years and urinary incontinence after robot-assisted laparoscopic prostatectomy.Intervention Participants were randomized into an action and cue observation (n = 46) or control (n = 46) group undergoing an 8-week home-based pelvic floor muscle training. Action and cue observation group observed video clips showing exercises synchronized with a visual cue indicating the correct pelvic floor muscle activation timing and imitated the observed tasks. Control group observed landscape video clips and performed the same exercises of experimental group.Main measures A blinded physiotherapist assessed participants for urinary leakages (24-h pad test), symptom severity (International Prostate Symptoms Score and International Prostate Symptoms Score - Quality of Life), quality of life (International Consultation on Incontinence Questionnaire - Short Form), and erectile dysfunction (International Index of Erectile Function) before and after the training.Results All participants improved urinary leakages, symptom severity, and quality of life after training. Action and cue observation group revealed significantly larger improvements in 24-h pad test (mean difference: 106.1 g, 95% CI: 13.4 g, 199.1 g, p = .037) than control group.Conclusions Home-based pelvic floor muscle training with action and cue observation led to larger improvements in urinary continence compared to the same training without action and cue observation after prostatectomy.