Livestream

Efficacy of an Animated Pelvic Floor Physical Therapy Video for Stress Urinary Incontinence; A Randomized Controlled Trial

Friday, October 6, 2023

8:14 AM – 8:18 AM US PST

Location: A105-106

Presenting Author(s)

Atieh Novin, MD MHS

Fellow Urogynecology
University of Southern California
los Angeles, California, United States

PDF

Co-Author(s)

AZ

Aldene Zeno, MD

Urogynecologist
Adventist Health
Los Angeles, California, United States
SB

Swathi Balaji, BS (she/her/hers)

Medical Student (MD/MPH)
Keck School of Medicine of USC
Loma Linda , California, United States
MB

Madeleine Bingham, DPT (she/her/hers)

Physical Therapist
USC
La Mesa, California, United States
SB

Sarah Bloss, BA

Undergraduate
USC
Los Angeles, California, United States
CD

Christina Dancz, MD

OBGYN Residency Program Director/Urogynecologist
USC
Los Angeles, California, United States
Tanaz Ferzandi, MD, MBA, MA

Director, Division of Urogynecology; Service Line Chief of Ob.Gyn at Keck Hospital
University of Southern California
Los Angeles, California, United States
OL

Oscar Li, BS

Medical Student
Johns Hopkins University
Baltimore, Maryland, United States
ER

Enanyeli Rangel, MD

Resident Physician
LAC-USC
Los Angeles, California, United States
EJ

Eileen Johnson, DPT (she/her/hers)

Doctor of Physical Therapy
USC
Altadena, California, United States

Disclosure(s):

Atieh Novin, MD MHS: No financial relationships to disclose

Aldene Zeno, MD: No financial relationships to disclose

Swathi Balaji, BS: No financial relationships to disclose

Madeleine Bingham, DPT: No financial relationships to disclose

Sarah Bloss, BA: No financial relationships to disclose

Christina Dancz, MD: No financial relationships to disclose

Tanaz Ferzandi, MD, MBA, MA: Med Mal: Expert Witness (Ongoing)

Oscar Li, BS: No financial relationships to disclose

Enanyeli Rangel, MD: No financial relationships to disclose

Eileen Johnson, DPT: No financial relationships to disclose

Importance: Pelvic floor physical therapy (PFPT) can be a first-line conservative management for incontinence. Barriers to therapy include cost, access, and adherence.

Objectives- Our objective was to quantify the effect of an animated video of PFPT exercises on patients with a diagnosis of female stress urinary incontinence.

Methods- This was a single-blind randomized controlled trial of adult women with stress urinary incontinence or stress-predominant mixed urinary incontinence, who presented to the Urogynecology clinic at LAC+USC Medical Center between August 2021 to April 2023. After informed consent was obtained, participants were randomized to an animated video of guided PFPT (experimental) or an educational video on incontinence (control). Outcomes were assessed with the primary outcome as Patient Global Impression of Improvement (PGII), at baseline, 6 and 12 weeks after intervention. Other standardized questionnaires such as the Incontinence Severity Index (ISI), Urinary Distress Inventory- short version (UDI6), as well as physical exam measures such as an empty cough stress test, a Modified Oxford Scale of pelvic strength, 3-day bladder diary were included to measure the subjective and objective changes in symptoms.

Results: 56 women agreed to participate in the study. The average age was 50 years and was not different between groups (p>0.05). The majority (96%) of participants self-identified as Hispanic/Latino. Adherence to the video websites demonstrated a total of 41% compliance with watching the videos. Overall, 52% reported improvement in their symptoms at 12 weeks (PFPT video group 50%, educational video group 54%) when this was measured by the primary outcome. UDI6 scores improved overall in both groups, with a 16.7 point improvement in the control group (p < 0.05) and a 6.7 point improvement in the experimental group (p < 0.05), though there was no difference in improvement between the groups (p>0.05). Incontinence severity scores improved in both groups, but there was no difference in the degree of improvement between groups. In terms of physical exam findings, the groups did not differ on the 12-week empty cough stress test (p=0.70) or on the 12-week Modified Oxford Scale (p=0.41). Internet accessibility was the only significant difference between the groups.

Conclusion: Adherence rates to watching the videos were low (41%). Significant symptom improvement was seen in both the experimental and control groups. Video PFPT did not significantly improve symptoms compared to an educational video,