Predictors for adherence to a home-based pelvic floor muscle exercise program for treating female urinary incontinence in Brazil

• Published in: Physiotherapy theory and practice Vol. 36; no. 1; pp. 186 - 195
• Main Authors: Sacomori, PT, PhD, Cinara, Berghmans, PT, MSc, PhD, Bary, de Bie, PT, PhD, Rob, Mesters, PhD, Ilse, Cardoso, PhD, Fernando Luiz
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Ltd 02-01-2020
• Subjects: Academic achievement; Adherence; Age; Body mass index; Clinical trials; Home based; Incentives; Intervention; Medical personnel; Patient compliance; Pelvic floor exercise; Pelvis; Physical therapists; Physiotherapy; Prediction models; Questionnaires; Self-efficacy; Urinary incontinence; Women; Brazil; exercise; pelvic floor; Patient adherence; urinary incontinence
• ISSN: 0959-3985; 1532-5040
• DOI: 10.1080/09593985.2018.1482583

: To assess predictors for adherence to a home-based pelvic floor muscle exercise (PFME) program supplemented with three physical therapy sessions in women with urinary incontinence (UI).
: Secondary analysis of a randomized controlled trial of interventions to enhance self-efficacy with respect to PFME.
: Patients were referred from public primary or secondary care providers in Florianópolis, Brazil.
: Adult women with UI.
: Three supervised physiotherapy sessions for the treatment of UI combined with home-based PFME program. Treatment groups were combined for predictive modelling because there was no difference after intervention between groups regarding UI and adherence rates.
: Adherence to PFME at 3-month follow-up (structured questionnaire). Baseline Predictors: self-efficacy and outcome expectation scales; severity of UI (ICIQ-SF), pelvic floor muscle strength, age, body mass index (BMI), and educational level.
: 86 women with UI of whom 72 completed the study. An intention-to-treat analysis was performed. Forty-three women reported carrying out PFME every day. Adherence was correlated to: baseline self-efficacy (
 = 0.299); age (
 = 0.242); and educational level (
 = -0.273). Hierarchical regression analyses incorporating treatment group, age, education, disease-related factors (severity of UI; pelvic floor muscle strength; BMI), and outcome expectations and self-efficacy showed that only baseline self-efficacy predicted adherence (
 = 0.217).
: Adherence to home-based PFME is a complex phenomenon. Assessing self-efficacy may help physiotherapists to detect patients' confidence in performing home-based exercises and, when necessary, give patients additional incentives.