How well do published randomized controlled trials on pelvic floor muscle training interventions for urinary incontinence describe the details of the intervention? A review

Neurourol Urodyn. 2020 Jan;39(1):35-44. doi: 10.1002/nau.24208. Epub 2019 Nov 6.

Abstract

Context: Pelvic floor muscle training (PFMT) is strongly recommended for the management of mild to moderate urinary incontinence (UI) in women, yet the specific elements of PFMT that lead to improvement have not been identified. This gap in knowledge may be related, at least in part, to the lack of detail provided on intervention parameters reported in randomized controlled trials (RCTs) OBJECTIVE: Using three different instruments: the Consensus on Exercise Reporting Template (CERT), the template for intervention description and replication (TIDieR) checklist, and the Consensus on Therapeutic Exercise Training (CONTENT) scale, the purpose of this study was to assess the completeness of exercise reporting among moderate to high quality RCTs on PFMT for women with UI.

Methods: Two raters independently scored all 65 RCTs (n = 65) retrieved by the most up-to-date Cochrane Systematic Review on PFMT for women with UI, and only those of moderate to high quality (>6 on the PEDro scale) were retained. Eighteen articles met the inclusion criteria and were scored by two independent reviewers using the CERT, TIDieR, and CONTENT instruments. The completeness of intervention reporting was evaluated using descriptive statistics.

Results: Over half of the items on each instrument were reported less than 50% of the time. Overall, completeness of exercise reporting was 31% (5.8/16 ± 2.4) on CERT, 47% (5.6/12 ± 1.5) on TIDieR, and 46% (4.1/9 ± 1) on CONTENT. The least frequently reported items were the provider of the intervention, the equipment used, the tailoring of exercises, the rationale behind the intervention, and adherence to the intervention.

Conclusion: PFMT parameters are not adequately reported in the primary RCTs that currently guide clinical practice.

Keywords: CERT; CONTENT; TIDieR; exercise reporting; pelvic floor muscle training; urinary incontinence.

Publication types

  • Review

MeSH terms

  • Exercise Therapy / methods*
  • Female
  • Humans
  • Pelvic Floor Disorders / complications
  • Pelvic Floor Disorders / rehabilitation*
  • Pelvic Floor*
  • Randomized Controlled Trials as Topic*
  • Treatment Outcome
  • Urinary Incontinence / etiology
  • Urinary Incontinence / rehabilitation*