Pelvic floor muscle training included in a pregnancy exercise program is effective in primary prevention of urinary incontinence: a randomized controlled trial

Neurourol Urodyn. 2014 Jan;33(1):67-71. doi: 10.1002/nau.22381. Epub 2013 Feb 6.


Aims: To investigate the effect of pelvic floor muscle training (PFMT) taught in a general exercise class during pregnancy on the prevention of urinary incontinence (UI) in nulliparous continent pregnant women.

Methods: This was a unicenter two armed randomized controlled trial. One hundred sixty-nine women were randomized by a central computer system to an exercise group (EG) (exercise class including PFMT) (n = 73) or a control group (CG) (n = 96). 10.1% loss to follow-up: 10 from EG and 7 from CG. The intervention consisted of 70-75 sessions (22 weeks, three times per week, 55-60 min/session including 10 min of PFMT). The CG received usual care (which included follow up by midwifes including information about PFMT). Questions on prevalence and degree of UI were posed before (week 10-14) and after intervention (week 36-39) using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF).

Results: At the end of the intervention, there was a statistically significant difference in favor of the EG. Reported frequency of UI [Never: CG: 54/60.7%, EG: 60/95.2% (P < 0.001)]. Amount of leakage [None: CG: 45/60.7%, EG: 60/95.2% (P < 0.001)]. There was also a statistically significant difference in ICIQ-UI SF Score between groups after the intervention period [CG: 2.7 (SD 4.1), EG: 0.2 (SD 1.2) (P < 0.001)]. The estimated effect size was 0.8.

Conclusion: PFMT taught in a general exercise class three times per week for at least 22 weeks, without former assessment of ability to perform a correct contraction was effective in primary prevention of UI in primiparous pregnant women.

Trial registration: NCT01578369.

Keywords: gestation; nulliparous; physical exercise; physical therapy; prevention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Exercise Therapy*
  • Female
  • Humans
  • Parity
  • Patient Compliance
  • Pelvic Floor / physiopathology*
  • Pelvic Floor Disorders / diagnosis
  • Pelvic Floor Disorders / physiopathology
  • Pelvic Floor Disorders / prevention & control*
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / physiopathology
  • Pregnancy Complications / prevention & control*
  • Primary Prevention / methods*
  • Severity of Illness Index
  • Spain
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Urinary Incontinence / diagnosis
  • Urinary Incontinence / physiopathology
  • Urinary Incontinence / prevention & control*

Associated data