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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References
Abrams P, Cardozo L, Wagg A, Wein A. (Editors). Incontinence 6th Edition. Bristol UK: ICI-ICS International Continence Society; 2017
Website Associação Portuguesa de Urologia [Internet]. Prevalência e tratamento de Incontinência Urinária na População Portuguesa Não Institucionalizada. Disponível em: https://www.apurologia.pt/pdfs/estud-epidem-incont-08.pdf
Dumoulin C, Glazener C, Jenkinson D, Determining the Optimal Pelvic Floor Muscle Training Regimen for Women with Stress Urinary Incontinence, Neurourology and Urodynamics. 2011;30:746–753
Website World Health Organization. [Internet]. Telemedicine – Opportunities and developments in Member States. Disponível em https://www.who.int/goe/ publications/ goe_telemedicine_2010.pdf
Hui E, Lee PS, Woo J. Management of urinary incontinence in older women using videoconferencing versus conventional management: a randomized controlled trial. J Telemed Telecare. 2006;12(7):343-7
Sjöström M, Umefjord G, Stenlund H, Carlbring P, Andersson G, Samuelsson E. Internet-based treatment of stress urinary incontinence: a randomised controlled study with focus on pelvic floor muscle training. BJU Int. 2013;112(3):362-72
Kinouchi K, Ohashi K. Smartphone-based reminder system to promote pelvic floor muscle training for the management of postnatal urinary incontinence: historical control study with propensity score-matched analysis. PeerJ. 2018;6:e4372
Asklund I, Nyström E, Sjöström M, Umefjord G, Stenlund H, Samuelsson E. Mobile app for treatment of stress urinary incontinence: A randomized controlled trial. Neurourol Urodyn. 2017;36(5):1369-1376
Araujo CC, Marques AA, Juliato CRT. The Adherence of Home Pelvic Floor Muscles Training Using a Mobile Device Application for Women With Urinary Incontinence: A Randomized Controlled Trial. Female Pelvic Med Reconstr Surg. 2020;26(11):697-703
Wang X, Xu X, Luo J, Chen Z, Feng S. Effect of app-based audio guidance pelvic floor muscle training on treatment of stress urinary incontinence in primiparas: A randomized controlled trial. Int J Nurs Stud. 2020;104:103527
Junwen S, Rongjiang W. The Efficacy of the WeChat App Combined with Pelvic Floor Muscle Exercise for the Urinary Incontinence after Radical Prostatectomy. Biomed Res Int;2020:6947839
Carrión Pérez F, Rodríguez Moreno MS, Carnerero Córdoba L, Romero Garrido MC, Quintana Tirado L, García Montes I. Tratamiento de la incontinencia urinaria de esfuerzo mediante telerrehabilitación. Estudio piloto [Telerehabilitation to treat stress urinary incontinence. Pilot study]. Med Clin (Barc). 2015;144(10):445-8
Dufour S, Fedorkow D, Kun J, Deng SX, Fang Q. Exploring the Impact of a Mobile Health Solution for Postpartum Pelvic Floor Muscle Training: Pilot Randomized Controlled Feasibility Study. JMIR Mhealth Uhealth. 2019;7(7):e12587
Dumoulin, C., Alewijnse, D., Bo, K., Hagen, S., Stark, D., Van Kampen, M., Dean, S. Pelvic-Floor-Muscle Training Adherence: Tools, Measurements and Strategies-2011 ICS State-of-the-Science Seminar Research Paper II of IV. Neurourol Urodyn, 2015; 34(7), 615-621
Alewijnse D, Mesters I, Metsemakers J, et al. Predictors of intention to adhere to physiotherapy among women with urinary incontinence. Health Educ Res 2001;16:173–186
Borello-France D, Burgio KL, Goode PS, et al. Adherence to behavioral interventions for stress incontinence: rates, barriers, and predictors. Phys Ther 2013;93:757–773
Hoffman V, Söderström L, Samuelsson E. Self-management of stress urinary incontinence via a mobile app: two-year follow-up of a randomized controlled trial. Acta Obstet Gynecol Scand. 2017;96(10):1180-1187
Cifu D. Braddom’s Physical Medicine and Rehabilitation. 5th edition. Philadelphia, US: Elsevier; 2015
Dufour SP, Graham S, Friesen J, Rosenblat M, Rous C, Richardson J. Physiotherapists supporting self-management through health coaching: a mixed methods program evaluation. Physiother Theory Pract 2015;31(1):29-38
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