Pelvic Floor Muscle Exercises Utilizing Trunk Stabilization for Treating Postpartum Urinary Incontinence: Randomized Controlled Pilot Trial of Supervised Versus Unsupervised Training

Objective: To investigate the effect of supervised and unsupervised pelvic floor muscle exercises utilizing trunk stabilization for treating postpartum urinary incontinence and to compare the outcomes.

Design: Randomized, single-blind controlled study.

Setting: Outpatient rehabilitation hospital.

Subjects: Eighteen subjects with postpartum urinary incontinence.

Interventions: Subjects were randomized to either a supervised training group with verbal instruction from a physiotherapist, or an unsupervised training group after undergoing a supervised demonstration session.

Main Measures: Bristol Female Lower Urinary Tract Symptom questionnaire (urinary symptoms and quality of life) and vaginal function test (maximal vaginal squeeze pressure and holding time) using a perineometer.

Results: The change values for urinary symptoms (-27.22 ± 6.20 versus -18.22 ± 5.49), quality of life (-5.33 ± 2.96 versus -1.78 ± 3.93), total score (-32.56 ± 8.17 versus -20.00 ± 6.67), maximal vaginal squeeze pressure (18.96 ± 9.08 versus 2.67 ± 3.64 mmHg), and holding time (11.32 ± 3.17 versus 5.72 ± 2.29 seconds) were more improved in the supervised group than in the unsupervised group (P < 0.05). In the supervised group, significant differences were found for all variables between pre- and post-test values (P < 0.01), whereas the unsupervised group showed significant differences for urinary symptom score, total score and holding time between the pre- and post-test results (P < 0.05).

Conclusions: These findings suggest that exercising the pelvic floor muscles by utilizing trunk stabilization under physiotherapist supervision may be beneficial for the management of postpartum urinary incontinence.