Woodley, Stephanie J., Moller, Brittany, Clark, Alys R., Bussey, Melanie D., Sangelaji, Bahram, Perry, Meredith, and Kruger, Jennifer (2023) Digital Technologies for Women’s Pelvic Floor Muscle Training to Manage Urinary Incontinence Across Their Life Course: Scoping Review. JMIR mHealth and uHealth, 11. e44929.

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Abstract

Background: Women with urinary incontinence (UI) may consider using digital technologies (DTs) to guide pelvic floor muscle training (PFMT) to help manage their symptoms. DTs that deliver PFMT programs are readily available, yet uncertainty exists regarding whether they are scientifically valid, appropriate, and culturally relevant and meet the needs of women at specific life stages.

Objective: This scoping review aims to provide a narrative synthesis of DTs used for PFMT to manage UI in women across their life course.

Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute methodological framework. A systematic search of 7 electronic databases was conducted, and primary quantitative and qualitative research and gray literature publications were considered. Studies were eligible if they focused on women with or without UI who had engaged with DTs for PFMT, reported on outcomes related to the use of PFMT DTs for managing UI, or explored users’ experiences of DTs for PFMT. The identified studies were screened for eligibility. Data on the evidence base for and features of PFMT DTs using the Consensus on Exercise Reporting Template for PFMT, PFMT DT outcomes (eg, UI symptoms, quality of life, adherence, and satisfaction), life stage and culture, and the experiences of women and health care providers (facilitators and barriers) were extracted and synthesized by ≥2 independent reviewers.

Results: In total, 89 papers were included (n=45, 51% primary and n=44, 49% supplementary) involving studies from 14 countries. A total of 28 types of DTs were used in 41 primary studies, including mobile apps with or without a portable vaginal biofeedback or accelerometer-based device, a smartphone messaging system, internet-based programs, and videoconferencing. Approximately half (22/41, 54%) of the studies provided evidence for or testing of the DTs, and a similar proportion of PFMT programs were drawn from or adapted from a known evidence base. Although PFMT parameters and program compliance varied, most studies that reported on UI symptoms showed improved outcomes, and women were generally satisfied with this treatment approach. With respect to life stage, pregnancy and the postpartum period were the most common focus, with more evidence needed for women of various age ranges (eg, adolescent and older women), including their cultural context, which is a factor that is rarely considered. Women’s perceptions and experiences are often considered in the development of DTs, with qualitative data highlighting factors that are usually both facilitators and barriers.

Conclusions: DTs are a growing mechanism for delivering PFMT, as evidenced by the recent increase in publications. This review highlighted the heterogeneity in types of DTs, PFMT protocols, the lack of cultural adaptations of most of the DTs reviewed, and a paucity in the consideration of the changing needs of women across their life course.

Item ID:	82486
Item Type:	Article (Research - C1)
ISSN:	2291-5222
Keywords:	apps, culture, life course, mobile health, mHealth, pelvic floor muscle training, urinary incontinence, women’s health, mobile phone
Copyright Information:	© Stephanie J Woodley, Brittany Moller, Alys R Clark, Melanie D Bussey, Bahram Sangelaji, Meredith Perry, Jennifer Kruger. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 05.07.2023. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is properly cited. The complete bibliographic information, a link to the original publication on https://mhealth.jmir.org/, as well as this copyright and license information must be included.
Date Deposited:	19 Mar 2024 03:45
FoR Codes:	42 HEALTH SCIENCES > 4203 Health services and systems > 420302 Digital health @ 50% 42 HEALTH SCIENCES > 4201 Allied health and rehabilitation science > 420199 Allied health and rehabilitation science not elsewhere classified @ 50%
SEO Codes:	20 HEALTH > 2002 Evaluation of health and support services > 200299 Evaluation of health and support services not elsewhere classified @ 100%
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