title: Long-term efficacy of Paula method as compared with pelvic floor muscle training for stress urinary incontinence in women: a 6-month follow-up.
abstract: OBJECTIVE
  The purpose of this study was to examine the long-term efficacy of an exercise regimen based on circular muscle strengthening (Paula method) as opposed to pelvic floor muscle training (PFMT) on stress urinary incontinence symptoms at 6 months postintervention.
  
  
  METHODS
  Of 240 women who had initially participated in a randomized clinical trial, 143 women suffering from stress urinary incontinence participated in this follow-up study.
  
  
  METHODS
  Subjects participated in a randomized controlled clinical trial comparing 2 exercise programs (12 private Paula lessons vs 6 group PFMT lessons) over a 12-week period. Of these, 143 women took part in the follow-up study: 64 from the Paula group and 79 from the PFMT group. Six-month follow-up data were gathered via telephone interviews.
  
  
  RESULTS
  No significant deterioration in stress urinary incontinence symptoms occurred 6 months after completion of the interventions in either group. We found a statistically significant difference between the groups with regard to reported frequency of urinary leakage; 25 of subjects (39.7%) allocated to the Paula method reported a low frequency rate of incontinence episodes upon completion of the study as compared to 18 (22.8%) in the PFMT group (P = .03). Forty-nine of the 64 women in the Paula group (76.6%) and 62 of the 79 women in the PFMT group (78.5%) reported that they continued exercising 6 months after completion of the trial (P = .8).
  
  
  CONCLUSIONS
  Both intervention methods reduced frequency of urinary incontinence over a 6-month period. Long-term adherence was similar in both groups. Pelvic floor muscle training was associated with fewer sessions and decreased cost and fewer lessons needed as compared with the Paula method. Nevertheless, results also suggest that the Paula method achieves a lower frequency of urinary leakage than PFMT.
authors.affiliation: Henrietta Szold Hadassah-Hebrew University School of Nursing, Jerusalem, Israel. michall2@hadassah.org.il
authors.forename: M
authors.initials: M
authors.lastname: Liebergall-Wischnitzer
authors.forename: O
authors.initials: O
authors.lastname: Paltiel
authors.forename: Y
authors.initials: Y
authors.lastname: Lavy
authors.forename: D
authors.initials: D
authors.lastname: Shveiky
authors.forename: O
authors.initials: O
authors.lastname: Manor
authors.forename: D
authors.initials: D
authors.lastname: Hochner-Celnikier
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053580:Muscle Strength; D009130:Muscle, Smooth / Q000503:physiopathology; D017773:Pelvic Floor; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000628:therapy*