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Assessing Physical Therapy Outcomes for Women With Urinary Incontinence

Dusi, Jodi PhD, MPT1; France, Diane Borello PhD, PT2; George, Susan PT, DPT, MS, OCS, WCS3; Phelps, Amy PhD4; Somers, David PhD, PT2

Journal of Women’s Health Physical Therapy: May/August 2012 - Volume 36 - Issue 2 - p 78–89
doi: 10.1097/JWH.0b013e3182615d3a
Research Report

Background: Women with urinary incontinence (UI) often have coexisting pelvic symptoms, including bowel and/or pelvic organ prolapse. There are too few published data to conclude whether or not physical therapy (PT) interventions can effectively manage women with UI and coexisting pelvic symptoms.

Objective: The objectives of this study were to (1) determine the efficacy of PT interventions to reduce pelvic symptoms and improve health-related quality of life in women with UI and (2) determine the relationship between selected patient-related characteristics and treatment success.

Design: A pragmatic study design was used.

Methods and Measures: A total of 100 female patients with UI provided data for this study. Women's postintervention impression of symptom improvement was recorded using the Patient Global Index of Improvement (PGI-I). Improvements in pelvic symptoms and health-related quality of life were measured using the Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7, respectively. The relationships between patient-related characteristics and PGI-I defined treatment success were explored using logistic regression.

Results: The sample median PGI-I score was “2” indicating symptoms were “much better” after intervention. Mean pre- to postintervention Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire-7 scores were significantly reduced. Only the variables barriers to intervention recommendations (odds ratio, 12.82; 95% confidence interval, 4.05–40.55) and number of PT visits (odds ratio, 1.26; 95% confidence interval, 1.07–1.50) were influential in predicting PGI-I outcome.

Limitations: Limitations of the study were the small sample size and that data were obtained from 1 outpatient PT company.

Conclusions: In our sample of convenience, 66% of women achieved the study criteria for PGI-I treatment success. Patients without barriers to intervention recommendations and patients who attended more PT visits were more likely to attain PGI-I defined success.

1Department of Health Science, California University of Pennsylvania.

2Department of Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania.

3WomensReahb, UPMC Centers for Rehab Services, Pittsburgh, Pennsylvania.

4Department of Quantitative Sciences, Duquesne University, Pittsburgh, Pennsylvania.

The authors declare no confilcts of interest.

Copyright © 2012 Section on Women's Health, American Physical Therapy Association