Lin Kuan-Yin, Chen Chao-Yin, Wu Pei-Chi, Huang Min-Hsuan, Ou Yin-Chien, Kao Yao-Lin, Lin Kuan-Han
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist., Taipei City 100, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, No. 7, Chung Shan S. Rd. (Zhongshan S. Rd.), Zhongzheng Dist., Taipei City 100, Taiwan.
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 3F., No. 17, Xuzhou Rd., Zhongzheng Dist., Taipei City 100, Taiwan; Physical Therapy Center, National Taiwan University Hospital, No. 7, Chung Shan S. Rd. (Zhongshan S. Rd.), Zhongzheng Dist., Taipei City 100, Taiwan.
Maturitas. 2025 Jun;197:108376. doi: 10.1016/j.maturitas.2025.108376. Epub 2025 Apr 23.
This study investigated the feasibility and effectiveness of a telehealth-delivered pelvic floor muscle training program for postmenopausal women with urinary incontinence, in comparison with face-to-face pelvic floor muscle training.
This was a pilot mixed-methods study that included a non-inferiority randomized controlled trial with a nested qualitative study. Community-dwelling postmenopausal women (>40 years) with urinary incontinence were recruited and randomly allocated to 12 weeks of telehealth or face-to-face pelvic floor muscle training. The face-to-face group received supervised training twice weekly, while the telehealth group had eight virtual sessions plus weekly telephone coaching.
Assessments at baseline, post-intervention, and three-month follow-up included feasibility, anthropometry, body composition, hand grip strength, functional exercise capacity, physical activity levels, the severity of urinary incontinence, and pelvic floor muscle function (assessed through vaginal manometry, transperineal ultrasound, and digital palpation).
Among 55 potential participants, 22 enrolled (40 % consent rate). Attendance was 100 %, with 63.3 % adherence to the home program. Satisfaction was high (very satisfied: 71 % face-to-face, 89 % telehealth). Both groups reported increased confidence in pelvic floor muscle training. Urinary symptoms and pelvic floor function improved in both groups, with benefits sustained at three months. Telehealth pelvic floor muscle training also enhanced grip strength. No significant differences were found between groups.
Telehealth pelvic floor muscle training appears to be a feasible and potentially effective alternative to face-to-face therapy for postmenopausal women with urinary incontinence. Larger studies are needed to confirm these preliminary findings and guide future interventions.
ClinicalTrials.gov (NCT05970796); date of registration: 29/07/2023.
本研究调查了通过远程医疗提供的盆底肌肉训练计划对绝经后尿失禁女性的可行性和有效性，并与面对面盆底肌肉训练进行比较。
这是一项试点混合方法研究，包括一项非劣效性随机对照试验和一项嵌套的定性研究。招募了社区居住的绝经后尿失禁女性（年龄>40岁），并将她们随机分配到接受12周远程医疗或面对面盆底肌肉训练组。面对面组每周接受两次监督训练，而远程医疗组有八次虚拟课程以及每周的电话指导。
在基线、干预后和三个月随访时的评估包括可行性、人体测量学、身体成分、握力、功能运动能力、身体活动水平、尿失禁严重程度以及盆底肌肉功能（通过阴道测压、经会阴超声和指诊评估）。
在55名潜在参与者中，22名登记入组（同意率40%）。出勤率为100%，家庭训练计划的依从率为63.3%。满意度很高（非常满意：面对面组71%，远程医疗组89%）。两组均报告对盆底肌肉训练的信心增强。两组的泌尿症状和盆底功能均有所改善，且三个月时仍保持有益效果。远程医疗盆底肌肉训练还增强了握力。两组之间未发现显著差异。
对于绝经后尿失禁女性，远程医疗盆底肌肉训练似乎是一种可行且可能有效的面对面治疗替代方案。需要更大规模的研究来证实这些初步发现并指导未来的干预措施。
ClinicalTrials.gov（NCT05970796）；注册日期：2023年7月29日。
