The effect of pelvic floor muscle training and intravaginal electrical stimulation on urinary incontinence in women with incomplete spinal cord injury: an investigator-blinded parallel randomized clinical trial

Marlene Elmelund; Fin Biering-Sørensen; Ulla Due; Niels Klarskov

doi:10.1007/s00192-018-3630-6

The effect of pelvic floor muscle training and intravaginal electrical stimulation on urinary incontinence in women with incomplete spinal cord injury: an investigator-blinded parallel randomized clinical trial

Marlene Elmelund^*, Fin Biering-Sørensen, Ulla Due, Niels Klarskov

^*Corresponding author for this work

Department of Clinical Medicine

11 Citations (Scopus)

Abstract

Introduction and hypothesis: Urinary incontinence is a prevalent problem in women with spinal cord injury. The aim of this study was to examine the effect of pelvic floor muscle training (PFMT) alone and combined with intravaginal electrical stimulation (IVES) on urinary incontinence in women with incomplete spinal cord injury. Methods: In this investigator-blinded randomized clinical trial, we recruited women aged 18–75 with incomplete spinal cord injury and urinary incontinence from a single spinal cord injury clinic in Denmark. Women were randomly assigned to either PFMT or PFMT combined with IVES daily at home for 12 weeks. All women were trained by a physiotherapist using vaginal palpation and electromyography biofeedback. Outcome measures were recorded at baseline (week 0), post-intervention (week 12) and follow-up (week 24) and included change in the total score on the International Consultation on Incontinence Questionnaire urinary incontinence short form (ICIQ-UI-SF) and daily episodes of urinary incontinence. Results: From 27 April 2015−9 September 2016, we randomly assigned 36 women (17 in the PFMT group and 19 in the PFMT+IVES group); 27 completed the interventions (13 in the PFMT group and 14 in the PFMT+IVES group). The results showed no difference between the groups on ICIQ-UI-SF or episodes of urinary incontinence at 12 and 24 weeks. Only the PFMT group had a significant change from baseline on ICIQ-UI-SF [−2.4 (95% CI -4.3−−0.5), p = 0.018] and daily episodes of urinary incontinence [−0.4 (95% CI -0.8−−0.1), p = 0.026] at 12 weeks. Conclusions: PFMT+IVES is not superior to PFMT alone in reducing urinary incontinence in women with incomplete spinal cord injury.

Original language	English
Journal	International Urogynecology Journal
Volume	29
Issue number	11
Pages (from-to)	1597-1606
Number of pages	10
ISSN	0937-3462
DOIs	https://doi.org/10.1007/s00192-018-3630-6
Publication status	Published - 2018

Keywords

Electrical stimulation
Neurogenic bladder
Pelvic floor muscle training
Spinal cord injury
Urinary incontinence

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10.1007/s00192-018-3630-6

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Elmelund, M., Biering-Sørensen, F., Due, U., & Klarskov, N. (2018). The effect of pelvic floor muscle training and intravaginal electrical stimulation on urinary incontinence in women with incomplete spinal cord injury: an investigator-blinded parallel randomized clinical trial. International Urogynecology Journal, 29(11), 1597-1606. https://doi.org/10.1007/s00192-018-3630-6

The effect of pelvic floor muscle training and intravaginal electrical stimulation on urinary incontinence in women with incomplete spinal cord injury: an investigator-blinded parallel randomized clinical trial. / Elmelund, Marlene; Biering-Sørensen, Fin; Due, Ulla et al.
In: International Urogynecology Journal, Vol. 29, No. 11, 2018, p. 1597-1606.

Research output: Contribution to journal › Journal article › Research › peer-review

Elmelund, M, Biering-Sørensen, F, Due, U & Klarskov, N 2018, 'The effect of pelvic floor muscle training and intravaginal electrical stimulation on urinary incontinence in women with incomplete spinal cord injury: an investigator-blinded parallel randomized clinical trial', International Urogynecology Journal, vol. 29, no. 11, pp. 1597-1606. https://doi.org/10.1007/s00192-018-3630-6

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title = "The effect of pelvic floor muscle training and intravaginal electrical stimulation on urinary incontinence in women with incomplete spinal cord injury: an investigator-blinded parallel randomized clinical trial",

abstract = "Introduction and hypothesis: Urinary incontinence is a prevalent problem in women with spinal cord injury. The aim of this study was to examine the effect of pelvic floor muscle training (PFMT) alone and combined with intravaginal electrical stimulation (IVES) on urinary incontinence in women with incomplete spinal cord injury. Methods: In this investigator-blinded randomized clinical trial, we recruited women aged 18–75 with incomplete spinal cord injury and urinary incontinence from a single spinal cord injury clinic in Denmark. Women were randomly assigned to either PFMT or PFMT combined with IVES daily at home for 12 weeks. All women were trained by a physiotherapist using vaginal palpation and electromyography biofeedback. Outcome measures were recorded at baseline (week 0), post-intervention (week 12) and follow-up (week 24) and included change in the total score on the International Consultation on Incontinence Questionnaire urinary incontinence short form (ICIQ-UI-SF) and daily episodes of urinary incontinence. Results: From 27 April 2015−9 September 2016, we randomly assigned 36 women (17 in the PFMT group and 19 in the PFMT+IVES group); 27 completed the interventions (13 in the PFMT group and 14 in the PFMT+IVES group). The results showed no difference between the groups on ICIQ-UI-SF or episodes of urinary incontinence at 12 and 24 weeks. Only the PFMT group had a significant change from baseline on ICIQ-UI-SF [−2.4 (95% CI -4.3−−0.5), p = 0.018] and daily episodes of urinary incontinence [−0.4 (95% CI -0.8−−0.1), p = 0.026] at 12 weeks. Conclusions: PFMT+IVES is not superior to PFMT alone in reducing urinary incontinence in women with incomplete spinal cord injury.",

keywords = "Electrical stimulation, Neurogenic bladder, Pelvic floor muscle training, Spinal cord injury, Urinary incontinence",

author = "Marlene Elmelund and Fin Biering-S{\o}rensen and Ulla Due and Niels Klarskov",

year = "2018",

doi = "10.1007/s00192-018-3630-6",

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T1 - The effect of pelvic floor muscle training and intravaginal electrical stimulation on urinary incontinence in women with incomplete spinal cord injury

T2 - an investigator-blinded parallel randomized clinical trial

AU - Elmelund, Marlene

AU - Biering-Sørensen, Fin

AU - Due, Ulla

AU - Klarskov, Niels

PY - 2018

Y1 - 2018

N2 - Introduction and hypothesis: Urinary incontinence is a prevalent problem in women with spinal cord injury. The aim of this study was to examine the effect of pelvic floor muscle training (PFMT) alone and combined with intravaginal electrical stimulation (IVES) on urinary incontinence in women with incomplete spinal cord injury. Methods: In this investigator-blinded randomized clinical trial, we recruited women aged 18–75 with incomplete spinal cord injury and urinary incontinence from a single spinal cord injury clinic in Denmark. Women were randomly assigned to either PFMT or PFMT combined with IVES daily at home for 12 weeks. All women were trained by a physiotherapist using vaginal palpation and electromyography biofeedback. Outcome measures were recorded at baseline (week 0), post-intervention (week 12) and follow-up (week 24) and included change in the total score on the International Consultation on Incontinence Questionnaire urinary incontinence short form (ICIQ-UI-SF) and daily episodes of urinary incontinence. Results: From 27 April 2015−9 September 2016, we randomly assigned 36 women (17 in the PFMT group and 19 in the PFMT+IVES group); 27 completed the interventions (13 in the PFMT group and 14 in the PFMT+IVES group). The results showed no difference between the groups on ICIQ-UI-SF or episodes of urinary incontinence at 12 and 24 weeks. Only the PFMT group had a significant change from baseline on ICIQ-UI-SF [−2.4 (95% CI -4.3−−0.5), p = 0.018] and daily episodes of urinary incontinence [−0.4 (95% CI -0.8−−0.1), p = 0.026] at 12 weeks. Conclusions: PFMT+IVES is not superior to PFMT alone in reducing urinary incontinence in women with incomplete spinal cord injury.

AB - Introduction and hypothesis: Urinary incontinence is a prevalent problem in women with spinal cord injury. The aim of this study was to examine the effect of pelvic floor muscle training (PFMT) alone and combined with intravaginal electrical stimulation (IVES) on urinary incontinence in women with incomplete spinal cord injury. Methods: In this investigator-blinded randomized clinical trial, we recruited women aged 18–75 with incomplete spinal cord injury and urinary incontinence from a single spinal cord injury clinic in Denmark. Women were randomly assigned to either PFMT or PFMT combined with IVES daily at home for 12 weeks. All women were trained by a physiotherapist using vaginal palpation and electromyography biofeedback. Outcome measures were recorded at baseline (week 0), post-intervention (week 12) and follow-up (week 24) and included change in the total score on the International Consultation on Incontinence Questionnaire urinary incontinence short form (ICIQ-UI-SF) and daily episodes of urinary incontinence. Results: From 27 April 2015−9 September 2016, we randomly assigned 36 women (17 in the PFMT group and 19 in the PFMT+IVES group); 27 completed the interventions (13 in the PFMT group and 14 in the PFMT+IVES group). The results showed no difference between the groups on ICIQ-UI-SF or episodes of urinary incontinence at 12 and 24 weeks. Only the PFMT group had a significant change from baseline on ICIQ-UI-SF [−2.4 (95% CI -4.3−−0.5), p = 0.018] and daily episodes of urinary incontinence [−0.4 (95% CI -0.8−−0.1), p = 0.026] at 12 weeks. Conclusions: PFMT+IVES is not superior to PFMT alone in reducing urinary incontinence in women with incomplete spinal cord injury.

KW - Electrical stimulation

KW - Neurogenic bladder

KW - Pelvic floor muscle training

KW - Spinal cord injury

KW - Urinary incontinence

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DO - 10.1007/s00192-018-3630-6

M3 - Journal article

C2 - 29574482

AN - SCOPUS:85044372840

SN - 0937-3462

VL - 29

SP - 1597

EP - 1606

JO - International Urogynecology Journal

JF - International Urogynecology Journal

IS - 11

ER -