title: Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse: a randomized controlled trial.
abstract: OBJECTIVE
  We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program.
  
  
  METHODS
  This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized to a structured lifestyle advice program with or without PFMT. Both groups received similar lifestyle advice in six separate group sessions. The combined group performed group PFMT after an individual assessment. Primary outcome was a global improvement scale at six-month follow-up. Secondary outcomes were the global scale and objective POP at three-month follow-up, symptoms and quality of life including sexuality, at three and six-month follow-up. A clinically relevant change of symptoms was defined as ≥ 15 %.
  
  
  RESULTS
  We included 109 women. Eighty-nine women (82 %) completed three months follow-up; 85 (78 %) completed six-month follow-up. At both follow-ups, significantly more women in the combined group reported improvement in the global scale. At the three-month follow-up, the combined group only had significant improvement of POP symptoms while only the lifestyle advice group had significant improvement of quality of life. Change in objective POP and sexuality was nonsignificant. The symptom score improved 17 % in the combined group and 14 % in the lifestyle advice group (P = 0.57). Significantly more women in the lifestyle advice group had sought further treatment at the six-month follow-up.
  
  
  CONCLUSIONS
  Adding PFMT to a structured lifestyle advice program gave superior results in a global scale and for POP symptoms. Overall effect of either intervention barely reached clinical relevance.
authors.affiliation: Department of Obstetrics and Gynecology, Herlev Hospital, Herlev Ringvej 75, 2730, Herlev, Copenhagen, Denmark. ulla.due@regionh.dk.|Department of Occupational and Physical therapy, Herlev Hospital, Herlev, Denmark. ulla.due@regionh.dk.
authors.forename: Ulla
authors.initials: U
authors.lastname: Due
authors.affiliation: Danish Health and Medicines Authority, Division of Hospital Services and Emergency Management, Copenhagen, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Brostrøm
authors.affiliation: Department of Obstetrics and Gynecology, Herlev Hospital, Herlev Ringvej 75, 2730, Herlev, Copenhagen, Denmark.|Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Lose
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D037001:Directive Counseling; D005081:Exercise Therapy; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D017773:Pelvic Floor / Q000502:physiology*; D056887:Pelvic Organ Prolapse / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D012720:Severity of Illness Index; D019529:Sexuality; D016037:Single-Blind Method; D063189:Symptom Assessment
keywords: Conservative treatment; Lifestyle advice; Pelvic floor muscle training; Pelvic organ prolapse