Comprehensive reporting of pelvic floor muscle training for urinary incontinence: CERT-PFMT

Pelvic floor muscle training delivered via telehealth to treat urinary and/or faecal incontinence after gynaecological cancer surgery: a single cohort feasibility study

PURPOSE

To assess the feasibility and clinical outcomes of telehealth-delivered pelvic floor muscle training (PFMT) for urinary incontinence (UI) and/or faecal incontinence (FI) after gynaecological cancer surgery.

METHODS

In this pre-post cohort clinical trial, patients with incontinence after gynaecological cancer surgery underwent a 12-week physiotherapist-supervised telehealth-delivered PFMT program. The intervention involved seven videoconference sessions with real-time feedback from an intra-vaginal biofeedback device and a daily home PFMT program. Feasibility outcomes included recruitment, retention, engagement and adherence rates. Clinical outcomes were assessed at baseline, immediately post-intervention and a 3-month post-intervention using International Consultation on Incontinence questionnaires for UI (ICIQ-UI-SF) and Bowel function (ICIQ-B) and the intra-vaginal biofeedback device. Means and 95%CIs for all time points were analysed using bootstrapping methods.

RESULTS

Of the 63 eligible patients, 39 (62%) consented to the study. Three participants did not complete baseline assessment and were not enrolled in the trial. Of the 36 participants who were enrolled, 32 (89%) received the intervention. Retention was 89% (n=32/36). The majority of participants (n=30, 94%) demonstrated high engagement, attending at least six videoconference sessions. Adherence to the daily PFMT program was moderate, with 24 participants (75%) completing five-to-seven PFMT sessions per week during the intervention. All clinical outcomes improved immediately post-intervention; however, the magnitude of these improvements was small.

CONCLUSION

Telehealth-delivered PFMT may be feasible to treat incontinence after gynaecological cancer surgery.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: ACTRN12621000880842).

The feasibility of pelvic floor training to treat urinary incontinence in women with breast cancer: a telehealth intervention trial

PURPOSE

To investigate the feasibility of recruiting into a pelvic floor muscle training (PFMT) program delivered via telehealth to treat urinary incontinence (UI) in women with breast cancer on aromatase inhibitors.

METHODS

We conducted a pre-post single cohort clinical trial with 54 women with breast cancer. Participants underwent a 12-week PFMT program using an intra-vaginal pressure biofeedback device: femfit^®. The intervention included eight supervised individual PFMT sessions over Zoom^™ and a 12-week home exercise program. The primary outcome of this study was feasibility, specifically consent rate. Secondary outcomes which included prevalence and burden of UI measured using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and pelvic floor muscle (PFM) strength measured as intravaginal squeeze pressure were compared using McNemar's and paired t tests.

RESULTS

The mean age of participants was 50 years (SD ± 7.3). All women who were eligible to participate in this study consented (n = 55/55, 100%). All participants reported that the program was beneficial and tailored to their needs. The results showed a statistically significant decline in the prevalence (percentage difference 42%, 95% CI 28, 57%) and burden (ICIQ-UI SF score mean change 9.4, 95% CI 8.5, 10.4) of UI post intervention. A significant increase in PFM strength was observed post-intervention (mean change 4.8 mmHg, 95% CI 3.9, 5.5).

CONCLUSION

This study indicated that PFMT delivered via telehealth may be feasible and potentially beneficial in treating stress UI in women with breast cancer. Further studies such as randomized controlled trials are required to confirm these results.

If exercise is medicine, why don't we know the dose? An overview of systematic reviews assessing reporting quality of exercise interventions in health and disease

OBJECTIVE

To determine how well exercise interventions are reported in trials in health and disease.

DESIGN

Overview of systematic reviews.

DATA SOURCES

PubMed, EMBASE, CINAHL, SPORTDiscus and PsycINFO from inception until June 2021.

ELIGIBILITY CRITERIA

Reviews of any health condition were included if they primarily assessed quality of exercise intervention reporting using the Consensus on Exercise Reporting Template (CERT) or the Template for Intervention Description and Replication (TIDieR). We assessed review quality using a modified version of A MeaSurement Tool to Assess systematic Reviews.

RESULTS

We identified 7804 studies and included 28 systematic reviews. The median (IQR) percentage of CERT and TIDieR items appropriately reported was 24% (19%) and 49% (33%), respectively. TIDieR items 1, Brief name (median=100%, IQR 4) and 2, Why (median=98%, IQR 6), as well as CERT item 4, Supervision and delivery (median=68%, IQR 89), were the best reported. For replication of exercise interventions, TIDieR item 8, When and how much, was moderately well reported (median=62%, IQR 68) although CERT item 8, Description of each exercise to enable replication (median=23%, IQR 44) and item 13, Detailed description of the exercise intervention (median=24%, IQR 66) were poorly reported. Quality of systematic reviews ranged from moderate to critically low quality.

CONCLUSION

Exercise interventions are poorly reported across a range of health conditions. If exercise is medicine, then how it is prescribed and delivered is unclear, potentially limiting its translation from research to practice.

PROSPERO REGISTRATION NUMBER

CRD42021261285; Open Science Framework: osf.io/my3ec/.