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The Comparison of Individual and Group Hybrid Telerehabilitation Methods in Women with Urinary Incontinence

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Introduction and Hypothesis

The aim is to compare the effects of the progressive training program (PTP), a new protocol, with two different hybrid telerehabilitation methods, on the parameters related to urinary incontinence in women with urinary incontinence.


A total of 50 participants with stress or mixed urinary incontinence participated in this two-arm, parallel-group, randomized, non-inferiority trial. Individual hybrid training (IHT) or group hybrid training (GHT) was given to women for 8 weeks. The Power, Endurance, Repetitions, Fast contractions, and Every Contraction Timed (PERFECT) scheme and surface electromyography were used to assess pelvic floor muscle function, whereas quality of life, exercise adherence, and symptoms were assessed by questionnaires and a 3-day bladder diary. An intention-to-treat analysis was performed. Linear mixed model analysis with the factors “time” and “group” was used to determine the effects of IHT and GHT.


The primary outcome was changes in pelvic floor muscle function as evaluated using the PERFECT scheme and surface electromyography at the 4th and 8th weeks relative to baseline. No statistical difference was found between the groups except for “power” of the PERFECT scheme and “nocturnal urination frequency” (p > 0.05). The GHT showed significant improvement in P and nocturnal urination frequency at the end of the 8th week (p < 0.05). From baseline to week 8, the effect size for the P value was found to be small (Cohen’s d = 0.33).


Eight weeks of PTP did not lead to different results in incontinence-related parameters in either of the training methods. It may be better to conduct GHT in terms of implementing PTP in incontinence and training programs in terms of time, staff workload, and applicability.

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We thank Emel METE and all participants who contributed to the study. Berivan Beril Kiliç is supported by “Turkey’s Council of Higher Education—YÖK 100/2000 Doctoral Scholarship Program” and “The Scientific and Technological Research Council of Turkey—TUBİTAK BİDEB 2211-A General National PhD Scholarship Program” within the scope of doctoral education.



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Authors and Affiliations



B.B.K.: project development, data collection, manuscript writing; A.Y.O.: project development, statistical analysis, manuscript writing; C.O.: manuscript writing/editing; M.G.P.: manuscript writing/editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Berivan Beril Kilic.

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Ethical Approval

Ethical approval was obtained from the Scientific Research Ethical Committee of the Faculty of Medicine of Marmara University (approval date and number: 30.11.2020/09.2021.1195). This study was conducted in compliance with the Declaration of Helsinki (Clinical trial registry number: NCT05154760).

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

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Table 4 The progressive training program

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Kilic, B.B., Yildiz Ozer, A., Ozarpaci, C. et al. The Comparison of Individual and Group Hybrid Telerehabilitation Methods in Women with Urinary Incontinence. Int Urogynecol J 35, 1299–1315 (2024).

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