Hip Muscle Strengthening and Electrical Stimulation as Adjuncts to Pelvic Floor Training on Urinary Incontinence

Area of Science:

• Urology
• Physical Therapy
• Women's Health

Background:

• Stress and mixed urinary incontinence (SUI and MUI) significantly impact women's quality of life.
• Pelvic floor muscle training (PFMT) is a primary conservative treatment, but adherence and effectiveness can be challenging.
• Adjunctive therapies like hip strengthening or electrical stimulation (ES) may enhance PFMT outcomes.

Purpose of the Study:

• To compare the effectiveness of biofeedback-assisted PFMT (BF-PFMT) alone versus BF-PFMT combined with hip rotator exercises or intravaginal ES.
• To evaluate the impact of these combined interventions on pelvic floor muscle (PFM) strength, function, and quality of life in women with SUI/MUI.

Main Methods:

• A randomized controlled trial involving 60 women (aged 30-65) with SUI or MUI.
• Participants were allocated to three groups: BF-PFMT, BF-PFMT + hip rotator strengthening, or BF-PFMT + intravaginal ES.
• A 6-week supervised intervention with primary outcomes including PFM strength, Oxford Grading Scale (OGS), myoelectric activity (EMG), and quality of life (I-QoL).

Main Results:

• All groups showed significant within-group improvements in PFM strength, OGS, EMG, and I-QoL (p < 0.05).
• A significant difference in PFM strength was observed between groups (p = 0.001).
• The BF-PFMT plus hip strengthening group demonstrated the most substantial improvement in PFM strength compared to BF-PFMT alone and BF-PFMT plus ES.

Conclusions:

• Biofeedback-assisted PFMT is effective in improving pelvic floor function and quality of life for women with SUI/MUI.
• Incorporating hip rotator exercises or intravaginal ES as adjuncts to BF-PFMT offers additional benefits.
• Hip strengthening exercises, when combined with BF-PFMT, yielded the greatest enhancement in PFM strength.