title: Physiotherapy for persistent postnatal stress urinary incontinence: a randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to compare the effectiveness of multimodal supervised physiotherapy programs with the absence of treatment among women with persistent postnatal stress urinary incontinence.
  
  
  METHODS
  This was a single-blind randomized controlled trial. Sixty-four women with stress urinary incontinence were randomly assigned to 8 weeks of either multimodal pelvic floor rehabilitation (n = 21), multimodal pelvic floor rehabilitation with abdominal muscle training (n = 23), or control non-pelvic floor rehabilitation (n = 20). The primary outcome measure consisted of a modified 20-minute pad test. The secondary outcome measures included a Visual Analog Scale describing the perceived burden of incontinence, the Urogenital Distress Inventory, the Incontinence Impact Questionnaire, and pelvic floor muscle function measurements.
  
  
  RESULTS
  Two patients dropped out, leaving 62 for analysis. At follow-up, more than 70% of the women in the treatment groups (14/20 in the pelvic floor and 17/23 in the pelvic floor plus abdominal group) were continent on pad testing compared with 0% of women in the control group. Scores on the pad test, Visual Analog Scale, Urogenital Distress Inventory, and Incontinence Impact Questionnaire improved significantly in both treatment groups (all P <.002), whereas no changes were observed in the control group. Pelvic floor muscle function, however, did not improve significantly in either active group.
  
  
  CONCLUSIONS
  Multimodal supervised pelvic floor physiotherapy is an effective treatment for persistent postnatal stress urinary incontinence.
authors.affiliation: School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Canada. dumoulin@sympatico.ca
authors.forename: Chantale
authors.initials: C
authors.lastname: Dumoulin
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Lemieux
authors.forename: Daniel
authors.initials: D
authors.lastname: Bourbonnais
authors.forename: Denis
authors.initials: D
authors.lastname: Gravel
authors.forename: Gina
authors.initials: G
authors.lastname: Bravo
authors.forename: Mélanie
authors.initials: M
authors.lastname: Morin
mesh_terms: D000009:Abdominal Muscles; D000328:Adult; D005260:Female; D006801:Humans; D017773:Pelvic Floor; D026741:Physical Therapy Modalities; D011644:Puerperal Disorders / Q000628:therapy; D016037:Single-Blind Method; D014550:Urinary Incontinence, Stress / Q000628:therapy*