Effect of pelvic floor muscle training on pelvic floor muscle function and lower urinary tract symptoms in stroke patients: a systematic review

Zhang, Xuan; Mai, Yiying; Hu, Xiquan

Abstract

Background
Pelvic floor muscle (PFM) dysfunction and lower urinary tract symptoms (LUTS) are common in stroke patients. Although pelvic floor muscle training (PFMT) is a promising intervention, its effects on stroke patients have not been fully studied.

Objective
The goal of this study was to conduct a systematic review of the effect of PFMT on PFM and urinary function of stroke patients.

Methods
The databases AMED, MEDLINE, CINAHL, Cochrane Library, and PEDro were searched for title/abstract on PFMT and stroke. RCTs and quasi-experimental trials that compared the effects of PFMT to a control intervention in stroke patients were included. The RoB 2.0 and ROBINS-I were used to assess the methodological quality of the included studies. The Standardized mean difference (SMD) and its 95% confidence interval (CI) were calculated.

Results
The current review included three RCTs and one quasi-experimental study, all of which were moderate to high quality. The analysis revealed that PFMT significantly improved PFM contraction (SMD: 0.92; 95% CI, 0.47 to 1.38; p < .0001), dynamic endurance (SMD: 0.61; 95% CI, 0.06 to 1.16; p = .030), daytime frequency (SMD: −0.81; 95% CI, −1.37 to −0.25; p = .004), ICIQ-SF (SMD: −1.64; 95% CI, −2.39 to −0.89; p < .0001), and LUTS (SMD: −1.82; 95% CI, −2.67 to −0.96; p < .0001). Differences in PFM strength, static endurance, nocturia, UI frequency, and 24-hour pad weight were insignificant or non-existent between the two groups.

Conclusion
This review demonstrates that PFMT improves PFM contraction, PFM dynamic endurance, daytime frequency, and overall LUTS in stroke patients. To validate these findings, well-designed RCTs with large sample sizes and reliable outcome measures should be conducted.

Citation

Zhang, X., Mai, Y., & Hu, X. (2023). Effect of pelvic floor muscle training on pelvic floor muscle function and lower urinary tract symptoms in stroke patients: a systematic review. Physiotherapy Theory and Practice, 39(7), 1342-1354. https://doi.org/10.1080/09593985.2022.2040668

• Journal Article Type: Review
• Acceptance Date: Jan 8, 2022
• Online Publication Date: Mar 1, 2022
• Publication Date: Jul 3, 2023
• Deposit Date: Jul 11, 2023
• Journal: Physiotherapy Theory and Practice
• Print ISSN: 0959-3985
• Electronic ISSN: 1532-5040
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Volume: 39
• Issue: 7
• Pages: 1342-1354
• DOI: https://doi.org/10.1080/09593985.2022.2040668
• Keywords: Physical Therapy; Sports Therapy and Rehabilitation; Pelvic floor; stroke; muscle contraction; muscle strength; lower urinary tract symptoms