Group vs Individual Pelvic Floor Muscle Training for Urinary Incontinence

Group-based pelvic floor muscle training (PFMT) was found to be just as effective as individual PFMT for treating urinary incontinence in older women, according to the results of a recent study.

“Urinary incontinence is one of the most prevalent health concerns experienced by older women (aged ≥60 years). Individual pelvic floor muscle training (PFMT) is the recommended first-line treatment for stress or mixed urinary incontinence in women, but human and financial resources limit its delivery,” the researchers wrote.

The Group Rehabilitation or Individual Physiotherapy (GROUP) study included a total of 362 women, aged 60 years or older, who all reported symptoms of stress or mixed urinary incontinence.  This single-blind, randomized, noninferiority trial was conducted from July 2012 to June 2018.

All participants attended an individual session in which they were taught how to contract pelvic floor muscles. Participants then completed either 12 weeks of individual PFMT (n=184) or group PFMT in sessions of 8 women (n=178).  

The researchers utilized data from participants’ 7-day bladder diary and pretreatment baselines to measure the percentage reduction in urinary incontinence episodes at 1 year. The researchers also assessed lower urinary tract-related signs, symptoms, and quality of life following 1 year as secondary outcomes.

Of the 362 participants, 319 completed the 1-year follow-up. The researchers found that the median percentage reduction in urinary incontinence episodes for participants in the individual PFMT arm was 70% (95% CI, 44-89%), compared with 74% (95% CI, 46-48%) in patients from the group-based PFMT arm. The difference in percentage reduction between the arms was small enough to confirm noninferiority. Secondary outcomes were found to be similar between the groups.

“To our knowledge, this is the first and only adequately powered trial to assess noninferiority of group-based PFMT compared with individual PFMT for urinary incontinence,” the researchers wrote.

“Widespread use in clinical practice may help increase continence-care affordability and treatment availability,” they concluded.”

—Leigh Precopio

Reference:

Dumoulin C, Morin M, Danieli C. Group-based vs individual pelvic floor muscle training to treat urinary incontinence in older women: a randomized clinical trial. JAMA Intern Med. 2020;180(10):1284-1293. Doi: 10.1001/jamainternmed.2020.2993