Continence and Quality-of-Life Outcomes 6 Months Following an Intensive Pelvic-Floor Muscle Exercise Program for Female Stress Urinary Incontinence: A Randomized Trial Comparing Low- and High-Frequency Maintenance Exercise

Background and Objectives. Few studies have examined the effectiveness of pelvic-floor muscle (PFM) exercises to reduce female stress urinary incontinence (SUI) over the long term. This study: (1) evaluated continence and quality-of-life outcomes of women 6 months following formalized therapy and (2) determined whether low- and high-frequency maintenance exercise programs were equivalent in sustaining outcomes. Subjects and Methods. Thirty-six women with SUI who completed an intensive PFM exercise intervention trial were randomly assigned to perform a maintenance exercise program either I or 4 times per week. Urine leaks per week, volume of urine loss, quality of life (Incontinence Impact Questionnaire [IIQ] score), PFM strength (Brink score), and prevalence Of Urodynamic stress incontinence (USI) were measured at a 6-month follow-up for comparison with postintervention status. Parametric and nonparametric statistics were used to determine differences in outcome status over time and between exercise frequency groups. Results. Twenty-eight women provided follow-up data. Postintervention status was sustained at 6 months for all outcomes (mean [SD] urine leaks per week=1.2 +/- 2.1 versus 1.4 +/- 3.1; mean [SD] urine loss=0.2 +/- 0.5 g versus 0.2 +/- 0.8 g; mean [SD] IIQ score=17 +/- 20 versus 22 +/- 30; mean [SD] Brink score = 11 +/- 1 versus 11 +/- 1; and prevalence of USI =48% versus 35%). Women assigned to perform exercises once or 4 times per week similarly Sustained their postintervention status. Discussion and Conclusions. Benefits of an initial intensive intervention program for SUI were sustained over 6 months. However, only 15 of the 28 women provided documentation of their exercise adherence, limiting conclusions regarding the need for continued PFM exercise during follow-up intervals of :56 months.