Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review

Sheng, Ying; Carpenter, Janet S.; Ashton-Miller, James A.; Miller, Janis M.

doi:10.1186/s12905-022-01742-w

BMC Women's Health

Table 2 Description of pelvic floor muscle strength and urinary incontinence measures used

From: Mechanisms of pelvic floor muscle training for managing urinary incontinence in women: a scoping review

Author and year	PFM strength			UI
Author and year	Subjective	Objective	Direction of change over time	Subjective	Objective	Direction of change over time
Mechanism 1. Enhanced PFM strength
Bø (2003)		Vaginal balloon catheter	↑	Leakage index	Pad test	Not reported
Burns et al. (1993)		EMG	↑^a	24-h urinary diary		↓
Dinc et al. (2009)		Perineometer	↑	3-day urinary diary	1-h pad test	↓
Dougherty et al. (1993)		Intravaginal balloon device	↑	24-h urinary diary	24-h pad test	↓
Hahn et al. (1993)	Vaginal palpation		↑		Pad test	↓
Hung et al. (2012)	Modified Oxford scale		↑	Severity Index score		↓
Kim et al. (2007)		Dynamometer	↑	Modified ICIQ questions		↓
Nystrom et al. (2018)	A self-rated PFM strength question		↑	PGI-I		↓
Segal et al. (2016)		Vaginal EMG	↑	Self-reported UI improvement		↓
Sun et al. (2018)		Vaginal manometer	↑		1-h pad test	↓
Theofrastous et al. (2002)		Balloon devices	↑	Urinary diary	48-h pad test	↓
Mechanism 2. Maximized awareness of timing
Cammu et al. (2000)^b	Vaginal palpation^c		↑ Timely precontraction skill	Self-assessment		↓
Junginger et al. (2014)	Vaginal palpation^d	Perineal ultrasound^e	↑ Timely precontraction skill	Posttreatment improvement scales, analog scales for satisfaction, frequency of precontraction		↓

Blank cells = Information was not appliable or not available. Articles retained from search results (n = 13 including 11 for enhanced PFM strength mechanism and 2 for maximized awareness of timing mechanism). This table focuses on tabulation in readiness of integration of information for critical analysis of the general quality of studies on PFMT to treat UI, while also testing for theorized mechanism/s of effect. All pad tests for UI were performed under provocative maneuver to ask participants to, such as cough, pick, set up and down, run or walk, jump, step, bounce, rise, lay down sit-ups, or stand
PFM, pelvic floor muscle; UI, urinary incontinence; PFMT, pelvic floor muscle training; EMG, electromyography; ICIQ, International Consultation on Incontinence Questionnaire; PGI-I, Patient Global Impression of Improvement Questionnaire
^aPelvic muscle electromyography scores measured as quick and sustained contractions only increased in PFMT + biofeedback group, not in the PFMT only group
^bA 10-year PFMT follow up article was also found in the main PFMT strengthening theory literature search, but it was not included in the analysis of results for the main PFMT strengthening theory since it did not report PFM strength and had no statistical analysis of correlation between changes in PFM strength and incontinence
^cVaginal palpation to correct PFM contraction
^dVaginal palpation to evaluate pelvic floor dysfunction
^ePerineal ultrasound to evaluate pelvic floor dysfunction and for bladder-neck effective PFM contraction

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ISSN: 1472-6874

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