Effectiveness of supervised Kegel exercises using bio-feedback versus unsupervised Kegel exercises on stress urinary incontinence: a quasi-experimental study

Introduction and hypothesis The objective was to investigate and compare the efficacy of supervised Kegel exercises with bio-feedback on stress urinary incontinence (SUI) and pelvic floor muscle strength (PFMS) compared with unsupervised Kegel exercises. Method Matched-group quasi-experimental study of 29 female participants divided into two groups (supervised and non-supervised) was conducted over 12 weeks. Baseline measurements of PFMS were undertaken by a women's health physiotherapist and a Kegel exercise regime bespoke designed for each participant. The supervised group visited the physiotherapist monthly for bio-feedback training (BT); the unsupervised group continued at home with their individualised Kegel exercises. Data were collected via a perineometer (Peritron (TM)) and self-reporting responses to questionnaires. All participants received a final PFMS measurement on completion of the study. Results Overall Incontinence Severity index (ISI) score was significantly lower in the supervised group post-intervention. Wilcoxon signed-rank tests indicated that supervised Kegel exercises significantly reduced frequency (p= 0.002) and severity (p= 0.020) of overall ISI. Analysis of PFMS were not significantly different, despite an increase in maximum voluntary contraction or pelvic floor muscle strength (PFMS) (p= 0.032) in the supervised group. Of the questionnaires, results of Wilcoxon signed-rank tests indicated that "total bother" was significantly reduced (p= 0.005) in the supervised group. The correlation analysis between PFMS and ISI did not reveal any significant results. Conclusions The study confirmed that supervised BT is more effective in reducing SUI than unsupervised Kegel exercises, and that this reduction in ISI score did not correlate with the improvement in PFMS.