Feasibility and Acceptability of a Protocol-Based Telehealth Treatment for Stress Urinary Incontinence in Postpartum Women: A Pilot Randomized Trial

Background: In-person and telehealth pelvic floor muscle training has been shown to be effective for treating stress urinary incontinence (SUI). However, it is not known if pelvic health physical therapy (PHPT) delivered by telehealth (TH) is a feasible, acceptable, or effective alternative to in-person (IP) treatment for SUI in the postpartum population. This study assessed the feasibility, accessibility, and potential efficacy of a 4-week online program for treating SUI in postpartum women. Methods: In this pilot randomized controlled trial, we compared IP to TH delivery of a 4-week protocol guided PHPT program for the treatment of SUI. We analyzed the subject recruitment, adherence, retention, and acceptability of the intervention. Outcomes included self-reported questionnaires for SUI related symptoms at baseline, 5 weeks, and 1 year. Results: Thirty participants (median: 1.5 yrs IQR [0.7-2.6] years postpartum) were randomly assigned to either group. For both IP and TH interventions, the median of quality of care was 5/5 (IP = 5 IQR[5.0-5.0] TH = 5 IQR[4.5-5.0]). Of the IP group 91% preferred their method while 69% of the TH group preferred theirs. Of the TH participants, 85% to 100% felt they received good care. Both groups improved their QUID SUI scores at 5 weeks (IP: 5 weeks (7 IQR:[5-9] vs 4 IQR: [2-5], P = .005; TH: 5.5 IQR:[3.25-7] vs 3.5 IQR:[1-4.75], P = .006) and at 1-year (IP: 7 IQR:[5-9] vs 5 IQR:[2-6], P = .005; TH: 5.5 IQR:[3.25-7] vs 2 [1-4.75], P = .008); with no significant difference between groups. Discussion/Conclusion: A 4-week telehealth PHPT program for treating SUI in postpartum women is feasible and acceptable. SUI symptoms improved significantly in the telehealth group and were comparable to improvements observed in the in-person group. Video Abstract: Supplemental Digital Content available at: http://links.lww.com/JWHPT/A162