The feasibility and effects of a telehealth-delivered physical therapy program for postmenopausal women with urinary incontinence: A pilot mixed-methods study

Objectives: This study investigated the feasibility and effectiveness of a telehealth-delivered pelvic floor muscle training program for postmenopausal women with urinary incontinence, in comparison with face-to-face pelvic floor muscle training. Stud design: This was a pilot mixed-methods study that included a non-inferiority randomized controlled trial with a nested qualitative study. Community-dwelling postmenopausal women (>40 years) with urinary incontinence were recruited and randomly allocated to 12 weeks of telehealth or face-to-face pelvic floor muscle training. The face-to-face group received supervised training twice weekly, while the telehealth group had eight virtual sessions plus weekly telephone coaching. Main outcome measures: Assessments at baseline, post-intervention, and three-month follow-up included feasibility, anthropometry, body composition, hand grip strength, functional exercise capacity, physical activity levels, the severity of urinary incontinence, and pelvic floor muscle function (assessed through vaginal manometry, transperineal ultrasound, and digital palpation). Results: Among 55 potential participants, 22 enrolled (40 % consent rate). Attendance was 100 %, with 63.3 % adherence to the home program. Satisfaction was high (very satisfied: 71 % face-to-face, 89 % telehealth). Both groups reported increased confidence in pelvic floor muscle training. Urinary symptoms and pelvic floor function improved in both groups, with benefits sustained at three months. Telehealth pelvic floor muscle training also enhanced grip strength. No significant differences were found between groups. Conclusions: Telehealth pelvic floor muscle training appears to be a feasible and potentially effective alternative to face-to-face therapy for postmenopausal women with urinary incontinence. Larger studies are needed to confirm these preliminary findings and guide future interventions. Trial registration: ClinicalTrials.gov (NCT05970796); date of registration: 29/07/2023.