Effectiveness of behaviour change strategies for pelvic floor muscle training in urinary incontinence: a meta-analysis

Abstract

Background: It is known that pelvic floor muscle training (PFMT) is effective in reducing mild to moderate urinary incontinence (UI) in women. However, there are factors hampering effectiveness of PFMT such as low discipline to exercise, interference with routines, low self-efficacy, all of which make elements of delivery important in treatment effectiveness. Aim: We investigated whether and which theory-grounded strategies used in interventions increase effectiveness of PFMT. Method: A meta-analysis was conducted with 55 interventions reporting effects of PFMT. A literature search was performed on ISI WOS, PubMed, PsychInfo, Cochrane, and included experimental and cvasiexperimental (pre-post) reports of interventions comprising PFMT for women with mild and moderate UI, regardless of age. Intervention strategies were coded by using the behavior change techniques taxonomy. Results: Overall, there was a significant effect, of medium size of PFMT on behavioral indices of UI, , g = .52, CI95 = [.48, .64], p < .001. There was a little effect of specific behavior change techniques, with only 1 (prompting practice) being associated with effectiveness, g= 0.44, CI95 = [.37, .50), p< .009. The results should be cautiously interpreted, as it is hard to estimate the degree to which the interventions corresponded to the reported strategies or the approaches of different persons implementing the PFMT protocols.