Telerehabilitation in the treatment of urinary incontinence: An Alternative in Pandemic Times?
DOI:
https://doi.org/10.25759/spmfr.452Keywords:
Exercise Therapy, Internet, Mobile Applications, Pandemics, Pelvic Floor, Physical Therapy Modalities, Urinary Incontinence/rehabilitation, Urinary Incontinence/ therapy, Telemedicine, VideoconferencingAbstract
Introduction: Urinary incontinence (UI) is a common problem, particularly in women. The first line approach for UI is conservative, which includes lifestyle changes, bladder training strategies and pelvic floor muscle training (PFMT). PFMT can be held in different formats: individual supervised sessions, group classes or home exercises according to an individualized plan.
The SARS-CoV-2 pandemic caused the loss or delay of rehabilitation care in many patients, and telerehabilitation has gained importance. The aim of this review is to analyse the effect of different telerehabilitation methods used for UI.
Methods: We performed a research on PubMed database, using the terms “telerehabilitation”, “telemedicine”, “app”, “smartphone”, “mobile health” or “videoconference”, combined with “pelvic floor” or “urinary incontinence”.
Results: Nine articles have been reviewed. The analysed methods were mobile applications (6 articles), with or without biofeedback device, group classes via videoconference (1 article), website-based instructions for PFMT programme (1 article) and a smartphone-based reminder system (1 article).
Group classes via videoconference showed similar results to supervised individual PFMT sessions. An app-guided programme showed superiority to the absence of treatment (delayed treatment in control group). Website-based or app- guided PFMT programmes seem to obtain similar results to written instructions for home exercises. There is no additional benefit to adding a biofeedback device to an app. In men after prostatectomy, an app-guided PFMT programme appears to accelerate the improvement of UI. Using technologies seems to increase adhesion and satisfaction with the programmes.
Conclusion: Telerehabilitation in UI seems to be a useful alternative in the absence of supervised hospital-based programmes, showing similar results to home-based exercises and increasing patient adhesion and satisfaction. More studies are needed regarding its applicability in elder populations and their long-term results.
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