Pelvic floor muscle exercises utilizing trunk stabilization for treating postpartum urinary incontinence: randomized controlled pilot trial of supervised versus unsupervised training

Objective: To investigate the effect of supervised and unsupervised pelvic floor muscle exercises utilizing trunk stabilization for treating postpartum urinary incontinence and to compare the outcomes. Design: Randomized, single-blind controlled study. Setting: Outpatient rehabilitation hospital. Subjects: Eighteen subjects with postpartum urinary incontinence. Interventions: Subjects were randomized to either a supervised training group with verbal instruction from a physiotherapist, or an unsupervised training group after undergoing a supervised demonstration session. Main measures: Bristol Female Lower Urinary Tract Symptom questionnaire (urinary symptoms and quality of life) and vaginal function test (maximal vaginal squeeze pressure and holding time) using a perineometer. Results: The change values for urinary symptoms (−27.22 ± 6.20 versus −18.22 ± 5.49), quality of life (−5.33 ± 2.96 versus −1.78 ± 3.93), total score (−32.56 ± 8.17 versus −20.00 ± 6.67), maximal vaginal squeeze pressure (18.96 ± 9.08 versus 2.67 ± 3.64 mmHg), and holding time (11.32 ± 3.17 versus 5.72 ± 2.29 seconds) were more improved in the supervised group than in the unsupervised group ( P < 0.05). In the supervised group, significant differences were found for all variables between pre- and post-test values ( P < 0.01), whereas the unsupervised group showed significant differences for urinary symptom score, total score and holding time between the pre- and post-test results ( P < 0.05). Conclusions: These findings suggest that exercising the pelvic floor muscles by utilizing trunk stabilization under physiotherapist supervision may be beneficial for the management of postpartum urinary incontinence.