Group-based pelvic floor muscle training for pregnant women: A randomized controlled feasibility study.

ABSTRACT

AIM: This study aims to test the feasibility and acceptability of a group-based pelvic floor muscle training for pregnant women in China and facilitate women's adherence to the pelvic floor muscle training programme. BACKGROUND: Urinary incontinence is a prevalent health problem in women worldwide, especially in pregnant women. Supervised pelvic floor muscle training is recommended as the first-line conservative treatment for urinary incontinence. However, the implementation and effectiveness of pelvic floor muscle training are limited by insufficient human resources and low adherence. Group-based interventions may improve people's adherence to interventions by facilitating peer support. However, it has been investigated in a limited number of maternity studies. DESIGN: Feasibility testing randomized controlled trial, accompanied by a mixed methods process evaluation. METHODS: This study was guided by the Medical Research Council framework for complex interventions and the Behaviour Change Wheel guide to developing interventions. A three-phase, mixed-methods design was used in this study. This study reported the feasibility of the group-based pelvic floor muscle training programme. Semi-structured reviews were conducted following the intervention to explore the acceptability of the programme. RESULTS: The study included 48 pregnant women with a recruitment rate of 52.17%. The adherence rate to the training programme was 66.67%. The intervention was positively valued, in particular the support promoting participants' adherence, but additional changes need to be made to the programme for a future trial. CONCLUSIONS: Group-based pelvic floor muscle training programme provides a possible way of delivering pelvic floor muscle training with limited health professionals in China. The study showed promising results concerning the acceptability and feasibility of the intervention, which were well perceived by both pregnant women and the midwife. IMPLICATIONS FOR PATIENT CARE Group-based pelvic floor muscle training may have the potential of reducing the prevalence of urinary incontinence in pregnant women with insufficient healthcare professionals. IMPACT This study assessed the feasibility of delivering group-based pelvic floor muscle training in pregnant women in China. The group-based pelvic floor muscle training is acceptable to both pregnant women and the midwife, but integrating online and face-to-face sessions need to be considered. The findings of this study provided evidence for delivering group-based pelvic floor muscle training to pregnant women in China. REPORTING METHOD: The study has adhered to CONSORT guidelines (Table S1) and TIDier checklist (Table S2). PATIENT AND PUBLIC CONTRIBUTION The patient and public have been invited as stakeholders during the development of the intervention. They worked with healthcare professionals to co-design the group-based pelvic floor muscle training programme. REGISTRATION The trial was registered on ClinicalTrials.gov (NCT05242809) under the title 'Development and Feasibility Testing of a Group-based PFMT Programme for Antenatal Women in Nanjing City in China'.