Effects of Home-Based, Telerehabilitation-Assisted High-Intensity Inspiratory Muscle Training on Pelvic Floor Muscle Function and Urinary Symptoms in Women with Stress Urinary Incontinence: A Pilot Randomized Controlled Trial

Abstract

Introduction and Hypothesis Strengthening the diaphragm muscle, the roof of the pelvic floor muscles (PFMs), may be a potential complementary approach in women suffering from stress urinary incontinence (SUI). This pilot randomized controlled study was aimed at investigating the effects of home-based telerehabilitation-assisted high-intensity inspiratory muscle training (IMT) on PFM function and urinary symptoms in women with SUI. Methods Twenty-two women aged 25-50 years with SUI were randomly assigned to either the intervention group (n = 11) or the control group (n = 11). Inspiratory muscle strength (maximal inspiratory pressure [MIP]), PFM function (assessed via pressure biofeedback), and urinary symptoms (evaluated using the Urogenital Distress Inventory Short Form, the International Consultation on Incontinence Questionnaire Short Form, and the Incontinence Severity Index) were evaluated. Participants performed IMT twice daily, 7 days a week, over 8 weeks. The intervention group underwent IMT at 60% of their baseline MIP, whereas the control group performed a sham-IMT. Results Function of the PFMs showed significant improvement in the intervention group compared with the control group, as demonstrated by increases in peak maximum voluntary contraction (p = 0.024, eta 2 effect size = 0.24), average maximum voluntary contraction (p = 0.027, eta 2 effect size = 0.23), and PFM endurance (p = 0.006, eta 2 effect size = 0.36). Additionally, the intervention group showed a significant increase in MIP (p = 0.018, eta 2 effect size = 0.26) compared with the control group. There were no statistically significant differences between the groups in urinary symptom scores (p > 0.05). Conclusions This pilot study demonstrates that home-based high-intensity IMT may enhance inspiratory muscle strength and potentially contribute to improved PFM function in women with SUI.