Comparative Effectiveness of Supervised versus Home-Based Pelvic Floor Muscle Training in Women with Postpartum Urinary Incontinence: An OPD-Based Study

Abstract

Objective: To compare the improvement in urinary incontinence symptoms between supervised pelvic floor muscle training (PFMT) and home-based PFMT in postpartum women.
Methodology: This prospective comparative interventional study was conducted on 70 postpartum
women with urinary incontinence, equally divided into two groups of 35 each, at Gynae and Obs department of QAMC Bahawalpur. The group A received supervised PFMT sessions conducted by a trained physiotherapist, while group B performed a standardized home-based PFMT program following written and verbal instructions. Both groups were followed for duration of 8–12 weeks. Outcome measures included incontinence severity assessed by the International Consultation on Incontinence Questionnaire (ICIQ-UI SF), pelvic floor muscle strength, and health-related quality of life scores, measured at baseline and post-intervention.

Results: Overall 50 postpartum women were enrolled particularly 25 women in each group. Both groups were almost matched at baseline across most demographic and clinical variables. However following intervention, the supervised PFMT group showed significantly higher overall improvement compared tothe home-based group (56.19 ± 19.85% vs. 29.58 ± 11.80%) p = 0.000. Strength of PFM was significantly greater in the supervised group, with 32% achieving good muscle contraction versus 12% in the home-based group (p = 0.039). Additionally the clinical cure rate 32% in supervised PFMT group compared to 16.0% in the home-based group (p = 0.002). 
Conclusion: Both supervised and home-based PFM training interventions observed to be effective and safe for postpartum UI, with supervised PFMT consistently some superior outcomes across all the clinical measures, with home-based PFMT remains as a feasible and accessible alternative specifically where supervised care is inaccessible.