Kijmanawat Athasit, Saraluck Apisith, Manonai Jittima, Wattanayingcharoenchai Rujira, Aimjirakul Komkrit, Chinthakanan Orawee
Department of Obstetrics & Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
J Clin Med. 2023 Nov 9;12(22):7003. doi: 10.3390/jcm12227003.
A first-line treatment for stress urinary incontinence (SUI) is pelvic floor muscle training (PFMT) for at least three months. The key problem is that patients do not understand the importance of these exercises and their effectiveness. Mobile health apps offer new possibilities to increase treatment adherence. This study compared a reduction in SUI, exercise adherence, and quality of life in PFMT with animation vs. standard instruction. A prospective, single-blind, randomized control trial was collected. SUI patients were randomized into the application or control groups confirmed using a one-hour pad test. In the intervention group, the PFMT application was applied via mobile phone (PFMT with animations, recording system, and reminder system). The standard exercise protocol was similar in both groups. Additional follow-up was conducted at 4, 8, and 12 weeks. A total of 51 participants were randomized to the application (n = 26) and control groups (n = 25), respectively. At the 12-week follow-up, there was no significant difference between the two groups in terms of SUI cure rate, SUI severity by pad test, and daily SUI episodes from the bladder diary (-value of 0.695, 0.472, and 0.338, respectively). The mean PFME adherence in the application group was higher than the control group at 8 weeks (66.3 ± 13.6 vs. 52.7 ± 16.6, = 0.002) and 12 weeks (59.1 ± 13.9 vs. 37.8 ± 11.0, = 0.001). The application group reported no difference from the conventional PFMT group in terms of improvements in SUI cure rate, symptom severity, and quality of life effects at 12-week follow-up. However, the improvement evaluated by the mean difference in SUI episodes and quality of life effects (ICIQ-UI SF) reported a better outcome in the mobile app group. The PFMT application has been proven to be an effective tool that improves PFMT adherence.
压力性尿失禁(SUI)的一线治疗方法是进行至少三个月的盆底肌肉训练(PFMT)。关键问题在于患者不理解这些锻炼的重要性及其有效性。移动健康应用程序为提高治疗依从性提供了新的可能性。本研究比较了采用动画指导与标准指导进行PFMT时,SUI的减轻情况、锻炼依从性和生活质量。收集了一项前瞻性、单盲、随机对照试验。通过一小时的尿垫试验确认,SUI患者被随机分为应用组或对照组。在干预组中,通过手机应用PFMT(带有动画、记录系统和提醒系统的PFMT)。两组的标准锻炼方案相似。在第4、8和12周进行了额外的随访。共有51名参与者分别被随机分为应用组(n = 26)和对照组(n = 25)。在12周的随访中,两组在SUI治愈率、尿垫试验评估的SUI严重程度以及膀胱日记记录的每日SUI发作次数方面无显著差异(P值分别为0.695、0.472和0.338)。应用组在第8周(66.3±13.6 vs. 52.7±16.6,P = 0.002)和第12周(59.1±13.9 vs. 37.8±11.0,P = 0.001)时的平均PFME依从性高于对照组。在12周随访时,应用组在SUI治愈率、症状严重程度和生活质量改善方面与传统PFMT组无差异。然而,通过SUI发作次数和生活质量影响(ICIQ-UI SF)的平均差异评估,移动应用程序组的改善效果更好。PFMT应用程序已被证明是提高PFMT依从性的有效工具。