Article

Behavioral intervention outcomes for urinary incontinence (UI) depend
on active patient participation. The purpose of this study was to
describe adherence to behavioral interventions (pelvic-floor muscle [PFM]
exercises, UI prevention strategies, and delayed voiding), patient-perceived
exercise barriers, and predictors of exercise adherence in women with
urge-predominant UI. DESIGN: This was a prospectively planned secondary data
analysis from a 2-stage, multicenter, randomized clinical trial.
INTERVENTION: Three hundred seven women with urge-predominant UI were randomly
assigned to receive either 10 weeks of drug therapy only or 10 weeks of drug
therapy combined with a behavioral intervention for UI. One hundred fifty-four
participants who received the combined intervention were included in this
analysis. MEASUREMENTS: Pelvic-floor muscle exercise adherence and exercise
barriers were assessed during the intervention phase and 1 year afterward.
Adherence to UI prevention strategies and delayed voiding were assessed during
the intervention only. RESULTS: During intervention, 81% of women exercised at
least 5 to 6 days per week, and 87% performed at least 30 PFM contractions per
day. Ninety-two percent of the women used the urge suppression strategy
successfully. At the 12-month follow-up, only 32% of the women exercised at least
5 to 6 days per week, and 56% performed 15 or more PFM contractions on the days
they exercised. The most persistent PFM exercise barriers were difficulty
remembering to exercise and finding time to exercise. Similarly, difficulty
finding time to exercise persisted as a predictor of PFM exercise adherence over
time. LIMITATIONS: Co-administration of medication for UI may have influenced
adherence. CONCLUSIONS: Most women adhered to exercise during supervised
intervention; however, adherence declined over the long term. Interventions to
help women remember to exercise and to integrate PFM exercises and UI prevention
strategies into daily life may be useful to promote long-term adherence.

Langue : ANGLAIS