School of Kinesiology, Universidad Bernardo O'Higgins, Santiago de Chile, Chile.
Pelvic care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
Physiother Theory Pract. 2020 Jan;36(1):186-195. doi: 10.1080/09593985.2018.1482583. Epub 2018 Jun 4.
: To assess predictors for adherence to a home-based pelvic floor muscle exercise (PFME) program supplemented with three physical therapy sessions in women with urinary incontinence (UI). : Secondary analysis of a randomized controlled trial of interventions to enhance self-efficacy with respect to PFME. : Patients were referred from public primary or secondary care providers in Florianópolis, Brazil. : Adult women with UI. : Three supervised physiotherapy sessions for the treatment of UI combined with home-based PFME program. Treatment groups were combined for predictive modelling because there was no difference after intervention between groups regarding UI and adherence rates. : Adherence to PFME at 3-month follow-up (structured questionnaire). Baseline Predictors: self-efficacy and outcome expectation scales; severity of UI (ICIQ-SF), pelvic floor muscle strength, age, body mass index (BMI), and educational level. : 86 women with UI of whom 72 completed the study. An intention-to-treat analysis was performed. Forty-three women reported carrying out PFME every day. Adherence was correlated to: baseline self-efficacy ( = 0.299); age ( = 0.242); and educational level ( = -0.273). Hierarchical regression analyses incorporating treatment group, age, education, disease-related factors (severity of UI; pelvic floor muscle strength; BMI), and outcome expectations and self-efficacy showed that only baseline self-efficacy predicted adherence ( = 0.217). : Adherence to home-based PFME is a complex phenomenon. Assessing self-efficacy may help physiotherapists to detect patients' confidence in performing home-based exercises and, when necessary, give patients additional incentives.
: 评估伴有 3 次物理治疗的家庭盆底肌锻炼(PFME)方案对尿失禁(UI)女性依从性的预测因素。 : 针对增强 PFME 自我效能干预的随机对照试验的二次分析。 : 患者来自巴西弗洛里亚诺波利斯的公共初级或二级保健提供者。 : 患有 UI 的成年女性。 : 3 次监督物理治疗用于治疗 UI 合并家庭 PFME 方案。由于干预后两组之间在 UI 和依从率方面没有差异,因此将治疗组合并进行预测建模。 : 在 3 个月随访时对 PFME 的依从性(结构化问卷)。基线预测因素:自我效能和结果预期量表;UI 严重程度(ICIQ-SF),盆底肌力量,年龄,体重指数(BMI)和教育水平。 : 86 名患有 UI 的女性,其中 72 名完成了研究。进行了意向治疗分析。43 名女性报告每天进行 PFME。依从性与:基线自我效能(= 0.299);年龄(= 0.242);和教育水平(= -0.273)。纳入治疗组,年龄,教育程度,疾病相关因素(UI 严重程度;盆底肌力量;BMI)以及结果期望和自我效能的层次回归分析表明,仅基线自我效能可预测依从性(= 0.217)。 : 家庭 PFME 的依从性是一个复杂的现象。评估自我效能可以帮助物理治疗师检测患者对进行家庭锻炼的信心,并在必要时为患者提供额外的激励。