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Do women with pelvic floor dysfunction referred by gynaecologists and urologists at hospitals complete a pelvic floor muscle training programme? A retrospective study, 1992–2008

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Abstract

Introduction and hypothesis

For decades women with pelvic floor dysfunction (PFD) have been referred to pelvic floor muscle training (PFMT), but there is only little information on whether the women complete the programmes and why. The objectives of this study were to investigate to which extent women completed a PFMT programme to which they were referred by gynaecologists and urologists and to identify associated factors for completion.

Methods

In a hospital-based, retrospective clinical design women with PFD referred to a free PFMT programme as outpatients were included. The PFMT programme consisted of: (a) vaginal digital palpation test of PFM, (b) individual instructions, (c) introduction (theory), (d) weekly supervised PFMT in groups for 3 months (12 sessions) and (e) progressive home exercises (10 sets).

Results

Data were analysed in 1,544 women, mean age 54 (SD 13) years, with PFD (urinary incontinence, n = 1,214; anal incontinence, n = 41; pelvic organ prolapse, n = 162; other PFD, n = 127). In total 747 (48 %) subjects completed (attended ≥8 sessions) the PFMT programme, 466 (30 %) dropped out and 331 (22 %) cancelled or stayed away. Age, year of referral and nationality were significantly different (p < 0.01) between completers and non-completers. Likewise, year of referral, distance from home to hospital, waiting list times and diagnosis were significantly different (p < 0.01) between dropouts and subjects who cancelled or stayed away.

Conclusions

The results showed that less than half of the women with PFD completed a PFMT programme to which they were referred by gynaecologists and urologists. The most important associated factors for completion were age, year of referral and nationality.

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References

  1. Abrams P, Blaivas JG, Stanton SL, Andersen JT (1990) The standardization of terminology of lower urinary tract function recommended by the International Continence Society. Int Urogynecol J 1:45–58

    Article  Google Scholar 

  2. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29(1):4–20

    PubMed  Google Scholar 

  3. Bump RC, Norton PA (1998) Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am 25(4):723–746

    Article  PubMed  CAS  Google Scholar 

  4. Dumoulin C, Hay-Smith J (2010) Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev (1):CD005654

  5. Hagen S, Stark D, Cattermole D (2004) A United Kingdom-wide survey of physiotherapy practice in the treatment of pelvic organ prolapse. Physiotherapy 90:19–26

    Article  Google Scholar 

  6. Hay-Smith EJ, Herderschee R, Dumoulin C, Herbison GP (2011) Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev (12):CD009508

  7. Bø K (2012) Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World J Urol 30(4):437–443

    Article  PubMed  Google Scholar 

  8. Imamura M, Abrams P, Bain C, Buckley B, Cardozo L, Cody J et al (2010) Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence. Health Technol Assess 14(40):1–188, iii–iv

    PubMed  CAS  Google Scholar 

  9. Welsh A (2006) CG40: Urinary incontinence: the management of urinary incontinence in women. RCOG Press, London

    Google Scholar 

  10. Hay-Smith EJC, Bø K, Berghmans LCM, Hendriks HJ, de Bie RA, van Waalwijk van Doorn ES (2001) Pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev (1):CD001407. doi:10.1002/14651858.CD001407

  11. Wijewickrama AK, Tanakuwa S (2006) Simulation analysis of an outpatient department of internal medicine in a university hospital. In: 2006 Winter Simulation Conference

  12. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA et al (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39(8):1423–1434

    Article  PubMed  Google Scholar 

  13. Bø K, Mørkved S (2007) Motor learning. In: Bø K BB, Mørkved S, Van Kampen M (eds) Evidence-based physical therapy for the pelvic floor: bridging science and clinical practice. Churchill Livingstone Elsevier, Edinburgh, pp 113–119

  14. Hruda KV, Hicks AL, McCartney N (2003) Training for muscle power in older adults: effects on functional abilities. Can J Appl Physiol 28(2):178–189

    Article  PubMed  Google Scholar 

  15. de Groot GC, Fagerström L (2011) Older adults’ motivating factors and barriers to exercise to prevent falls. Scand J Occup Ther 18(2):153–160

    Article  PubMed  Google Scholar 

  16. Miller JM, Sampselle C, Ashton-Miller J, Hong GR, DeLancey JO (2008) Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19(6):773–782

    Article  PubMed  Google Scholar 

  17. Bø K (1990) Pelvic floor muscle exercise for treatment of female stress urinary incontinence. Methodological studies and clinical results. Doctoral thesis. The Norwegian University of Sport and Physical Education, Oslo

    Google Scholar 

  18. R Development Core Team (2011) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna

  19. Harrell Jr FE (2011) Modeling strategies. R package version 3.3–2

  20. Dacey ML, Renne A (2005) A client-centered counseling approach for motivating older adults toward physical activity. Top Geriatr Rehabil 21(3):194–205

    Google Scholar 

  21. James DV, Johnston LH, Crone D, Sidford AH, Gidlow C, Morris C et al (2008) Factors associated with physical activity referral uptake and participation. J Sports Sci 26(2):217–224

    Article  PubMed  Google Scholar 

  22. Marzolini S, Brooks D, Oh PI (2008) Sex differences in completion of a 12-month cardiac rehabilitation programme: an analysis of 5922 women and men. Eur J Cardiovasc Prev Rehabil 15(6):698–703

    Article  PubMed  Google Scholar 

  23. Gidlow C, Johnston LH, Crone D, Morris C, Smith A, Forster C et al (2007) Socio-demographic pattering of referral, uptake and attendance in Physical Activity Referral Schemes. J Public Health (Oxf) 29(2):107–113

    Article  Google Scholar 

  24. Margetts BM, Rogers E, Widhal K, de Remaut de Winter AM, Zunft HJ (1999) Relationship between attitudes to health, body weight and physical activity and level of physical activity in a nationally representative sample in the European Union. Public Health Nutr 2(1A):97–103

    Article  PubMed  CAS  Google Scholar 

  25. Gidlow C, Johnston LH, Crone D, James D (2005) Attendance of exercise referral schemes in the UK: a systematic review. Health Educ J 64(2):168–186

    Article  Google Scholar 

  26. Romé A, Persson U, Ekdahl C, Gard G (2009) Physical activity on prescription (PAP): costs and consequences of a randomized, controlled trial in primary healthcare. Scand J Prim Health Care 27(4):216–222

    Article  PubMed  Google Scholar 

  27. Sanderson BK, Phillips MM, Gerald L, DiLillo V, Bittner V (2003) Factors associated with the failure of patients to complete cardiac rehabilitation for medical and nonmedical reasons. J Cardiopulm Rehabil 23(4):281–289

    Article  PubMed  Google Scholar 

  28. McGrady A, McGinnis R, Badenhop D, Bentle M, Rajput M (2009) Effects of depression and anxiety on adherence to cardiac rehabilitation. J Cardiopulm Rehabil Prev 29(6):358–364

    PubMed  Google Scholar 

  29. Alewijnse D, Mesters I, Metsemakers J, van den Borne B (2007) Strategies to enhance adherence and reduce drop out in conservative treatment. In: Bø K, Berghmans B, Mørkved S, van Kampen M (eds) Evidence-based physical therapy for the pelvic floor: bridging science and clinical practice. Churchill Livingstone Elsevier, Edinburgh, pp 133–146

    Chapter  Google Scholar 

  30. Dumoulin C, Glazener C, Jenkinson D (2011) Determining the optimal pelvic floor muscle training regimen for women with stress urinary incontinence. Neurourol Urodyn 30(5):746–753

    Article  PubMed  Google Scholar 

  31. Hansen D, Astrup A, Toubro S, Finer N, Kopelman P, Hilsted J et al (2001) Predictors of weight loss and maintenance during 2 years of treatment by sibutramine in obesity. Results from the European multi-centre STORM trial. Sibutramine Trial of Obesity Reduction and Maintenance. Int J Obes Relat Metab Disord 25(4):496–501

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The study was funded by the Department of Physiotherapy and Occupational Therapy, Copenhagen University, Glostrup, Denmark. The authors wish to thank Anne Kure and Susi Jeppesen, Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Glostrup for their secretarial assistance.

Conflicts of interest

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Authors and Affiliations

  1. Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital Glostrup, Glostrup, Denmark

    Sigrid Tibaek

  2. Danish Cancer Society Research Center, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Christian Dehlendorff

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  1. Sigrid Tibaek
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  2. Christian Dehlendorff
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Correspondence to Sigrid Tibaek.

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Tibaek, S., Dehlendorff, C. Do women with pelvic floor dysfunction referred by gynaecologists and urologists at hospitals complete a pelvic floor muscle training programme? A retrospective study, 1992–2008. Int Urogynecol J 24, 1361–1369 (2013). https://doi.org/10.1007/s00192-012-2018-2

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  • DOI: https://doi.org/10.1007/s00192-012-2018-2

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