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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT03325543
Other study ID # 1
Secondary ID
Status Not yet recruiting
Phase N/A
First received October 16, 2017
Last updated November 30, 2017
Start date December 1, 2017
Est. completion date October 27, 2018

Study information

Verified date November 2017
Source Federal University of São Paulo
Contact Letícia Ferreira
Phone 55 11 994001829
Email leticia_azfe@hotmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The pelvic floor muscle training (PFMT) is a conservative treatment, currently considered as first line for women with stress urinary incontinence (SUI). However, in practice, about 30 to 50% of women are unable to perform the correct contraction of the pelvic floor muscles (PFMs). When requested to perform the muscle contraction, the contraction of the gluteal muscles, hip adductors, or abdominal muscles is observed initially, rather of contraction of the levator anus muscle. Some factors make it difficult to perform the contraction of the PFM, such as its location on the pelvic floor, and its small size, followed by a lack of knowledge of the pelvic region, as well as its functions. Associated with these factors is the use of the muscles adjacent to the PFM, as previously mentioned. In order for women to benefit from a PFMT program for the treatment of SUI, the awareness phase of PFM can't be omitted, since the literature is unanimous in stating that pelvic exercises improve the recruitment capacity of the musculature, its tone and reflex coordination during the effort activities.


Description:

Research Questions: The objectives of this study is to test the hypothesis that the provision of verbal instructions about the anatomy and function of PFMs associated with the use of body techniques awareness and vaginal palpation helps in learning the correct contraction and improves the function of the PFMs.

Design: A single-centered, double-blind (investigator and outcome assessor) randomised controlled trial with two physiotherapy intervention groups.

Measurements: The primary outcome measure will be the EMG activity of the PFMs, gluteus maximus, hip adductor, and the group formed by the abdominal transverse (TrA) and internal oblique (IO) muscles during rest and maximal voluntary contractions (MVCs). The secondary outcome measure will be the PFM function (vaginal palpation and visual observation), posture assessment (software SAPO), and self-efficacy scale for practising PFM exercises.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 60
Est. completion date October 27, 2018
Est. primary completion date October 27, 2018
Accepts healthy volunteers No
Gender Female
Age group 18 Years to 80 Years
Eligibility Inclusion Criteria:

- Patients with predominance of SUI symptoms and = 2 g leakage measured by pad test and without capability to contract the PFM properly

Exclusion Criteria:

- Not included if they were younger than 18 years old, had chronic degenerative diseases, pelvic organ prolapse greater than stage I by POP-Q, neurologic or psychiatric diseases, ability to contract PFMs, had previous pelvic floor re-education programs and/or pelvic floor surgeries

Study Design


Intervention

Other:
Verbal instruction and Vaginal palpation
The experimental group will receive verbal instructions on the anatomy and function of PFMs associated with the use of body awareness techniques and vaginal palpation to learn the correct PFMs contraction. The control group will receive only verbal instructions on the anatomy and function of PFMs associated with the use of body awareness techniques.

Locations

Country Name City State
Brazil Letícia de Azevedo Ferreira São Paulo

Sponsors (1)

Lead Sponsor Collaborator
Federal University of São Paulo

Country where clinical trial is conducted

Brazil, 

Outcome

Type Measure Description Time frame Safety issue
Primary Electromyography (EMG) EMG activity muscles during rest and maximal voluntary contractions (MVCs) After 4 weeks of supervised treatment
Secondary PFM function Vaginal palpation After 4 weeks of supervised treatment
Secondary Posture assessment Software SAPO After 4 weeks of supervised treatment
Secondary Self-perception of the effectiveness of perineal exercises will be evaluated by the Self-Efficacy Scale for Practice of Pelvic Floor Exercises The scale is composed of 17 questions in the visual analogue scale format with responses ranging from 0 (not confident) to 100 (most confident). Thirteen questions refer to self-efficacy and four questions to expectation of results. The final result is obtained by averaging the items, which ranges from 0 to 100, where higher values are equivalent to more beneficial action of self-efficacy / expected result of the training of the PFM. Questions about the expectation of results will be applied in the first week and after the fourth week of intervention.
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