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Can Pelvic Floor Muscle Training Reduce my Prolapse

2. februar 2016 oppdatert av: Copenhagen University Hospital at Herlev

Can Pelvic Floor Muscle Training Reduce my Prolapse? A Randomised Controlled Trial Comparing the Effect of Pelvic Floor Muscle Training and Lifestyle Advice on Pelvic Organ Prolapse

Purpose The aim of this study is to examine if a structured pelvic floor muscle training combined with lifestyle advice with can improve pelvic organ prolapse (POP) symptoms more than structured lifestyle advice programme alone.

Background Pelvic organ prolapse (POP) is a common condition among adult women and almost one in ten women experience symptoms caused by POP. The key symptom of POP is seeing or feeling a bulge in the vaginal opening but POP often gives other symptoms, such as pain, difficulty emptying the bladder or the bowel, incontinence and sexual problems such as dyspareunia.

A majority of women with POP will be offered reconstructive surgery but the risk of reoperations is substantial and surgery may cause new symptoms. In one out of four women surgery does not relieve symptoms and the women have been exposed to unnecessary risk of complications.

It is therefore important to evaluate the effect of conservative treatments for POP. New studies have shown that pelvic floor muscle training offered in combination with lifestyle advice has a significant on POP symptoms and objective measures of POP compared to a lifestyle advice leaflet alone.

No studies have compared the effect of a combined pelvic floor muscle training and lifestyle advice programme with a structured programme of lifestyle advice and hypothetically the structured lifestyle advice programme could have a substantial effect on its own. Our hypothesis is that the pelvic floor muscle training is a vital component of a conservative treatment for POP.

Methods In this single-blind randomised controlled study women with POP will randomised to either a programme of structured pelvic floor muscle training combined with lifestyle advice or a structured lifestyle advice programme alone. Both groups will receive the same lifestyle advices through six (separate) lectures within 12 weeks. The training group will be examined and individually instructed in pelvic floor muscle training before the intervention starts and they will, in continuation with their lifestyle lectures, perform pelvic floor muscle training as group training

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Faktiske)

108

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Danmark
      • Copenhagen, Danmark, DK - 2730
        • Copenhagen University Hospital at Herlev

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Hunn

Beskrivelse

Inclusion Criteria:

  • ≥18 years of age female reporting bothersome symptoms of any type of POP
  • Newly referred to the hospital clinic
  • Prolapse ≥II POP-Q
  • Understand and write Danish

Exclusion Criteria:

  • Instruction in pelvic floor muscle training within the last two years
  • Dementia
  • Pregnancy or less than one year postnatal
  • Disorders that can affect ability to participate in the intervention such as neurological or psychiatric disorders

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Group 1
Group 1 will be individually examined and instructed in pelvic floor muscle training before the intervention starts by specialized physiotherapists. The examination includes a vaginal or an anal examination. The women attend six group sessions within 12 weeks containing structured information about POP and the possible affection of POP on quality of life, exercising and sexual relationship. The lifestyle advice contains information about life style changes that could improve POP symptoms, such as bladder and bowel habits, coughing, heavy lifting, eating habits and weight loss. The women will perform pelvic floor muscle training in the group and they will perform pelvic floor muscle training at home. The training will be individually planned according to the findings of the pelvic floor physiotherapist. The women in the intervention group fill in an exercise diary and also describe on a Visual Analog Scale if the training causes any bother.
Atferdsmessig: Pelvic floor muscle training and lifestyle advice
Group 1 will be individually examined and instructed in pelvic floor muscle training before the intervention starts by specialized physiotherapists. The examination includes a vaginal or an anal examination. The women attend six group sessions within 12 weeks containing structured information about POP and the possible affection of POP on quality of life, exercising and sexual relationship and information that could improve POP symptoms, such as bladder and bowel habits, coughing, heavy lifting, eating habits and weight loss. The women will perform pelvic floor muscle training in the group and perform pelvic floor muscle training at home. The training will be individually planned according to the findings of the pelvic floor physiotherapist. The women in the intervention group fill in an exercise diary and also describe on a Visual Analog Scale if the training causes any bother.
Aktiv komparator: Group 2
Group 2 attend six group sessions within 12 weeks containing structured information about POP and the possible affection of POP on quality of life, exercising and sexual relationship. The lifestyle advice contains information about life style changes that could improve POP symptoms, such as bladder and bowel habits, coughing, heavy lifting, eating habits and weight loss
Atferdsmessig: Lifestyle advice
Group 2 attend six group sessions within 12 weeks containing structured information about POP and the possible affection of POP on quality of life, exercising and sexual relationship. The lifestyle advice contains information about life style changes that could improve POP symptoms, such as bladder and bowel habits, coughing, heavy lifting, eating habits and weight loss

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Patient Global Index of Improvement scale (PGI-I)
Tidsramme: three months after ended intervention
three months after ended intervention

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Objective pelvic organ prolapse measured with the pelvic organ prolapse Quantification system (POP-Q)
Tidsramme: before, right after, three and 12 months after the intervention has ended
before, right after, three and 12 months after the intervention has ended
Pelvic Floor Distress Inventory - short form 20 (PFDI-20)
Tidsramme: right after, three months and 12 months after ended intervention
Validated condition-specific questionnaire
right after, three months and 12 months after ended intervention
Pelvic Floor Impact Questionnaire - short form 7 (PFIQ-7)
Tidsramme: right after, three months and 12 months after ended intervention
Validated condition-specific questionnaire
right after, three months and 12 months after ended intervention
Background variables
Tidsramme: At time of inclusion
age, parity, BMI, working status as predictors of effect of the intervention
At time of inclusion
Size of levator hiatus and presence of levator ani avulsions examined through transperineal ultrasound
Tidsramme: At time of inclusion
as predictors of effect of the intervention
At time of inclusion
Cost-effectiveness
Tidsramme: 12 months after ended intervention
Need for further treatment and calculation of economic costs for both interventions compared to number of surgeries avoided will be evaluated
12 months after ended intervention
Patient Global Index of Improvement scale (PGI-I)
Tidsramme: Right after ended intervention and 12 months after ended intervention
Right after ended intervention and 12 months after ended intervention

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Copenhagen University Hospital at Herlev

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. august 2012

Primær fullføring (Faktiske)

1. april 2015

Studiet fullført (Faktiske)

1. april 2015

Datoer for studieregistrering

Først innsendt

4. juni 2012

Først innsendt som oppfylte QC-kriteriene

5. juni 2012

Først lagt ut (Anslag)

6. juni 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

3. februar 2016

Siste oppdatering sendt inn som oppfylte QC-kriteriene

2. februar 2016

Sist bekreftet

1. juli 2014

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • H-4-2011-072

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