Predictors of success for physiotherapy treatment in women with persistent postpartum stress urinary incontinence.
OBJECTIVE
To identify predictors of success for physiotherapy treatment in women with persistent postpartum stress urinary incontinence (SUI).


METHODS
Secondary analysis of data from a single-blind randomized controlled trial comparing 2 physiotherapy intervention programs for persistent SUI in postpartum women.


METHODS
Obstetric clinic of a mother and children's university hospital.


METHODS
Women, ages 23 to 39 (N=57), were randomized to 1 of 2 pelvic floor muscle (PFM) training programs, 1 with and 1 without abdominal muscle training.


METHODS
Over 8 weeks, participants in each group followed a specific home exercise program once a day, 5 days a week. In addition, participants attended individual weekly physiotherapy sessions throughout the 8-week program.


METHODS
Treatment success was defined as a pad weight gain of less than 2 g on a 20-minute pad test with standardized bladder volume after 8 weeks' treatment. The relationship between potential predictive PFM function variables as measured by a PFM dynamometer and success of physiotherapy was studied using forward stepwise multivariate logistic regression analyses.


RESULTS
Forty-two women (74%) were classified as treatment successes, and 15 (26%) were not. Treatment success was associated with lower pretreatment PFM passive force and greater PFM endurance pretreatment, but the latter association was barely statistically significant. This model explained between 23% (Cox and Snell R(2)) and 34% (Nagelkerke R(2)) of the outcome variability.


CONCLUSIONS
The results contribute new information on predictors of success for physiotherapy treatment in women with persistent postpartum SUI.
School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada. chantal.dumoulin@umontreal.ca
Chantale
C
Dumoulin
Daniel
D
Bourbonnais
Mélanie
M
Morin
Denis
D
Gravel
Marie-Claude
MC
Lemieux
D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006785:Hospitals, University; D006801:Humans; D017773:Pelvic Floor; D049590:Postpartum Period; D011379:Prognosis; D011644:Puerperal Disorders / Q000175:diagnosis / Q000534:rehabilitation*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000534:rehabilitation*; D055815:Young Adult