title: Does self-motivation improve success rates of pelvic floor muscle training in women with urinary incontinence in a secondary care setting?
abstract: OBJECTIVE
  Pelvic floor muscle training (PFMT) is the recommended first-line treatment for women with urinary incontinence (UI). Success rates are variable and dependent on a number of factors. The development of an incontinence treatment motivation questionnaire (ITMQ) provides us with a tool to assess patient self-motivation with respect to PFMT and UI. The aim of this study was to determine the effect of women's self-motivation to perform PFMT on outcome.
  
  
  METHODS
  Women with stress predominant UI completed an ITMQ and a 24-h pad test and then underwent a 12-week course of supervised PFMT. At the end of their treatment they completed a patient global impression of improvement questionnaire (PGI-I) and a second 24-h pad test. The PGI-I scores and the difference in pad test weight correlated with the ITMQ according to Spearman's correlation coefficient.
  
  
  RESULTS
  Sixty-five women were recruited. Thirty-two (49%) patients perceived themselves as having improved, 28 women (43%) did not experience any change in symptoms and 5 women (8%) felt that their symptoms deteriorated following treatment. When correlating the PGI-I with the ITMQ, 3 of the 5 domains: MQS1 (positive attitude for treatment; p = 0.003), MQS3 (frustration of living with incontinence; p = 0.002) and MQS4 (desire for treatment; p = 0.002) correlated significantly with outcome. Desire for treatment was the only domain to correlate with change in pad weight (p = 0.001).
  
  
  CONCLUSIONS
  Self-motivation is essential in order to determine improved success rates with PFMT.
authors.affiliation: Department of Urogynaecology, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9 RS, UK, mvella@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Vella
authors.forename: E
authors.initials: E
authors.lastname: Nellist
authors.forename: L
authors.initials: L
authors.lastname: Cardozo
authors.forename: H
authors.initials: H
authors.lastname: Mastoroudes
authors.forename: I
authors.initials: I
authors.lastname: Giarenis
authors.forename: J
authors.initials: J
authors.lastname: Duckett
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D059952:Pelvic Floor Disorders / Q000628:therapy*; D063127:Secondary Health Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000628:therapy*; D055815:Young Adult