title: Randomized controlled trial of physiotherapy for postpartum stress incontinence: 7-year follow-up.
abstract: OBJECTIVE
  To estimate the long-term effect of intensive, 6-week physiotherapy programs, with and without deep abdominal muscle (TrA) training, on persistent postpartum stress urinary incontinence (SUI).
  
  
  METHODS
  The study was a single-blind randomized controlled trial. Fifty-seven postnatal women with clinically demonstrated persistent SUI 3 months after delivery participated in 8 weeks of either pelvic floor muscle training (PFMT) (28) or PFMT with deep abdominal muscle training (PFMT + TrA) (29). Seven years post-treatment, 35 (61.4%) participants agreed to the follow-up; they were asked to complete a 20-min pad test and three incontinence-specific questionnaires with an assessor blinded to each participant's group assignment.
  
  
  RESULTS
  Of the 35 (61.4%) who agreed to the follow-up: 26 (45.6%) took the 20-min pad test (12 PFMT and 14 PFMT + TrA) and 35 (61.4%) completed the questionnaires (18 PFMT and 17 PFMT + TrA). The baseline clinical characteristics of the follow-up and non-follow-up participants were not significantly different; nor did they differ between PFMT and PFMT + TrA participants enrolled in the follow-up study. At 7 years, the pad test scores for the PFMT group did not differ statistically from those of the PFMT + TrA group. When combining both treatment groups, a total of 14/26 (53%) follow-up participants were still continent according to the pad test.
  
  
  CONCLUSIONS
  The addition of deep abdominal training does not appear to further improve the outcome of PFM training in the long term. However, benefits of physiotherapy for postpartum SUI, although not as pronounced as immediately after the initial intervention, is still present 7 years post-treatment.
authors.affiliation: Faculty of Medicine, School of Rehabilitation, University of Montreal, Montreal, Québec, Canada. chantal.dumoulin@umontreal.ca
authors.forename: Chantale
authors.initials: C
authors.lastname: Dumoulin
authors.forename: Claudine
authors.initials: C
authors.lastname: Martin
authors.forename: Valérie
authors.initials: V
authors.lastname: Elliott
authors.forename: Daniel
authors.initials: D
authors.lastname: Bourbonnais
authors.forename: Mélanie
authors.initials: M
authors.lastname: Morin
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Lemieux
authors.forename: Robert
authors.initials: R
authors.lastname: Gauthier
mesh_terms: D000009:Abdominal Muscles / Q000503:physiopathology*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D049590:Postpartum Period; D011247:Pregnancy; D011792:Quebec; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*