Is pelvic floor muscle training effective for symptoms of overactive bladder in women? A systematic review.

Overactive bladder (OAB) syndrome can be very bothersome and is associated with impaired quality of life and work productivity.

To evaluate the effect of pelvic floor muscle training (PFMT) on OAB symptoms in women. Furthermore, to assess the influence of PFMT on pelvic floor muscle (PFM) function, satisfaction with treatment, side effects, adherence and the quality of exercise reporting.

Systematic review of randomized controlled trials (RCTs). Electronic search was conducted on MEDLINE/PubMed, Embase, CINAHL, SciELO, SCOPUS, Web of Science and Physiotherapy Evidence Database (PEDro). The risk of bias was assessed using the PEDro scale. The Consensus on Exercise Reporting Template (CERT) was used to assess the quality of exercise reporting.

Full text RCTs including non-pregnant female participants, investigating PFMT vs inactive control or usual care, other life style modifications or other interventions.

Descriptive analysis.

Eleven RCTs were included. There was considerable heterogeneity of PFMT protocols, outcome measures and follow-up periods. Hence, a qualitative analysis was undertaken. PFMT provided a significant reduction of OAB symptoms in five studies with a reduction in urinary frequency (n=1), and urgency urinary incontinence (n=4). PFM function was assessed in three studies, and two studies found improvement in favor of PFMT.

A meta-analysis was not possible due to huge heterogeneity of included studies.

PFMT might reduce OAB symptoms, however, due to many limitations of the published studies it is not possible to clearly determine the effect of PFMT on OAB symptoms and PFM function. Systematic Review Registration Number PROSPERO CRD42018085640.

Physiotherapy. 2019 Aug 24 [Epub ahead of print]

K Bo, A C N L Fernandes, T B Duarte, L G O Brito, C H J Ferreira

The Norwegian School of Sport Sciences, Department of Sports Medicine and Akershus University Hospital, Department of Obstetrics and Gynecology, PO Box 4014, Ullevål stadion, 0806 Oslo, Norway. Electronic address: ., University of São Paulo, Ribeirão Preto Medical School, Av. Bandeirantes, Monte Alegre CEP: 14049-900, 3900 Ribeirão Preto, SP, Brazil. Electronic address: ., University of São Paulo, Ribeirão Preto Medical School, Av. Bandeirantes, Monte Alegre CEP: 14049-900, 3900 Ribeirão Preto, SP, Brazil. Electronic address: ., University of Campinas, School of Medical Sciences, Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas 13083-970, SP, Brazil. Electronic address: ., University of Sao Paulo, Ribeirão Preto Medical School, Av. Bandeirantes, Monte Alegre CEP: 14049-900, 3900 Ribeirao Preto, SP, Brazil. Electronic address: .