title: 2014 consensus statement on improving pelvic floor muscle training adherence: International Continence Society 2011 State-of-the-Science Seminar.
abstract: OBJECTIVE
  To summarize the findings and "expert-panel" consensus of the State-of-the-Science Seminar on pelvic floor muscle training (PFMT) adherence held prior to the 41st International Continence Society scientific meeting, Glasgow, 2011.
  
  
  METHODS
  Summaries of research and theory about PFMT adherence (based on a comprehensive literature search) were presented by subject experts at the 2011 Seminar to generate discussion and guidance for clinical practice and future research. Supplemental research, post-seminar, resulted in, three review papers summarizing: (1) relevant behavioral theories, (2) adherence measurement, determinants and effectiveness of PFMT adherence interventions, and (3) patients' PFMT experiences. A fourth, reported findings from an online survey of health professionals and the public.
  
  
  RESULTS
  Few high-quality studies were found. Paper I summarizes 12 behavioral frameworks relevant to theoretical development of PFMT adherence interventions and strategies. Findings in Paper II suggest both PFMT self-efficacy and intention-to-adhere predict PFMT adherence. Paper III identified six potential adherence modifiers worthy of further investigation. Paper IV found patient-related factors were the biggest adherence barrier to PFMT adherence.
  
  
  CONCLUSIONS
  Given the lack of high-quality studies, the conclusions were informed by expert opinion. Adherence is central to short- and longer-term PFMT effect. More attention and explicit reporting is needed regarding: (1) applying health behavior theory in PFMT program planning; (2) identifying adherence determinants; (3) developing and implementing interventions targeting known adherence determinants; (4) using patient-centred approaches to evaluating adherence barriers and facilitators; (5) measuring adherence, including refining and testing instruments; and (6) testing the association between adherence and PFMT outcome.
authors.affiliation: School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Canada.|Urogynecological Health and Aging Research Chair, Research Centre of the Institut Universitaire de Geriatrie de Montreal, Montreal, Canada.
authors.forename: Chantale
authors.initials: C
authors.lastname: Dumoulin
authors.affiliation: Rehabilitation Teaching and Research Unit, University of Otago, Wellington, New Zealand.|Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, New Zealand.
authors.forename: Jean
authors.initials: J
authors.lastname: Hay-Smith
authors.affiliation: School of Allied Health, La Trobe University, Melbourne, Australia.|Allied Health Research, Cabrini Health, Melbourne, Australia.
authors.forename: Helena
authors.initials: H
authors.lastname: Frawley
authors.affiliation: Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, Scotland.
authors.forename: Doreen
authors.initials: D
authors.lastname: McClurg
authors.affiliation: PR and Marketing, Gelre Hospitals, Apeldoorn and Zutphen, The Netherlands.
authors.forename: Dianne
authors.initials: D
authors.lastname: Alewijnse
authors.affiliation: Departement of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Bo
authors.affiliation: Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham.|Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Department of Veterans Affairs, Birmingham.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Burgio
authors.affiliation: Department of Nursing, Hungkuang University, Taiwan.
authors.forename: Shu-Yueh
authors.initials: SY
authors.lastname: Chen
authors.affiliation: School of Health Sciences, University of Newcastle, Australia.
authors.forename: Pauline
authors.initials: P
authors.lastname: Chiarelli
authors.affiliation: Psychology Applied to Health, University of Exeter Medical School, Exeter, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Dean
authors.affiliation: Nursing Midwifery & Allied Health Professions (NMAHP) Research Unit.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hagen
authors.affiliation: Bradford University, Bradford, United Kingdom.
authors.forename: Julia
authors.initials: J
authors.lastname: Herbert
authors.affiliation: Indira Gandhi Memorial Hospital, Male', Maldives.
authors.forename: Aishath
authors.initials: A
authors.lastname: Mahfooza
authors.affiliation: General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Scotland.
authors.forename: Frances
authors.initials: F
authors.lastname: Mair
authors.affiliation: Functional Bowel Service, Clinic 2 Balmoral Building, Leicester Royal infirmary, Leicester, United Kingdom.
authors.forename: Diane
authors.initials: D
authors.lastname: Stark
authors.affiliation: Faculty of Kinesiology and Rehabilitation Sciences, K.U.Leuven, Leuven, Belgium.
authors.forename: Marijke
authors.initials: M
authors.lastname: Van Kampen
mesh_terms: D032921:Consensus; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010349:Patient Compliance; D017773:Pelvic Floor / Q000503:physiopathology*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*
keywords: consensus statement; exercise; pelvic floor muscle training; treatment adherence