Evidence map›Paper›PMID 31023381›Full record

ArticleTrials2019

Long-term effects of motherfit group therapy in pre-(MOTHERFIT1) and post-partum women (MOTHERFIT2) with stress urinary incontinence compared to care-as-usual: study protocol of two multi-centred, randomised controlled trials.

Heidi F A Moossdorff-Steinhauser, Esther M J Bols, Marc E A Spaanderman, Carmen D Dirksen, Mirjam Weemhoff, Fred H M Nieman, Bary Berghmans

Abstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. AnFrontiers in endocrinology · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Heidi F A Moossdorff-SteinhauserFaculty of Health, Medicine and Life Sciences, Department Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands. heidi.moossdorff@maastrichtuniversity.nl.ORCID http://orcid.org/0000-0002-9651-1731
Esther M J BolsFaculty of Health, Medicine and Life Sciences, Department Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
Marc E A SpaandermanMaastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
Carmen D DirksenMaastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
Mirjam WeemhoffDepartment of Obstetrics and Gynecology, Zuyderland Medisch Centrum, P.O. Box 5500, 6130, MB, Sittard-Geleen, The Netherlands.
Fred H M NiemanMaastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
Bary BerghmansMaastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.

Funding

ZonMw 80-84300-98-72001
6 · The paper itself

Abstract

backgroundStress urinary incontinence (SUI) is highly prevalent during pregnancy and after delivery. It is often associated with a failing pelvic floor, sphincteric and/or supportive system. Pelvic-floor-muscle training (PFMT) peri-partum has been proven effective for up to 1 year post-partum; however, its long-term effects are unknown. Group PFMT, given by a physiotherapist, has been proven to be as equally effective as individual therapy. Motherfit is a group-PFMT therapy with an emphasis on pelvic floor exercises, adherence and general fitness. Care-as-usual (CAU), if guideline driven, should, as first treatment option, consist of PFMT. Cost-effective strategies are of relevance, given the rise of health care costs. Motherfit group therapy has the potential to be cost-effective in women with urinary incontinence. Therefore, the objectives of the two current studies are: (1) to investigate whether intensive, supervised, pre-partum (MOTHERFIT1) or post-partum (MOTHERFIT2) pelvic-floor-muscle group therapy reduces 18-month post-partum severity of SUI compared to CAU and (2) whether MOTHERFIT1 OR MOTHERFIT 2 is more (cost-)effective compared to CAU.

methodsTwo multi-centred, randomised controlled trials (MOTHERFIT1, n = 150, MOTHERFIT2, n = 90) will be performed. Participants will be recruited by their midwife or gynaecologist during their routine check. Participants with SUI will receive either motherfit group therapy or CAU. Motherfit group therapy consists of eight group sessions of 60 min each, instructed and supervised by a registered pelvic physiotherapist. Motherfit group therapy includes instructions on pelvic floor anatomy and how to contract, relax and train the pelvic-floor muscles correctly and is combined with general physical exercises. Adherence during and after motherfit will be stimulated by reinforcement techniques and a mobile app. The primary outcome measure is the absence of self-reported SUI based on the severity sum score of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF) at 18 months post-partum. Secondary outcomes evaluate quality of life, subjective improvement and health care costs. DISCUSSION: The motherfit studies are, to our knowledge, the first studies that evaluate both long-term results and health care costs compared to CAU in pregnant and post-partum women with SUI. If motherfit is shown to be (cost-)effective, implementation in peri-partum care should be considered.

trial registrationNetherlands Trial Register, ID: NL5816 . Registered on 18 July 2016.

Indexed as

Peer GroupExercise TherapyFemaleHumansMulticenter Studies as TopicNetherlandsPelvic FloorPerinatal CarePostpartum PeriodPregnancyPregnancy ComplicationsProtective FactorsPsychotherapy, GroupRandomized Controlled Trials as TopicRisk FactorsTime FactorsCost-effectiveGroup therapyMotherfitPelvic-floor-muscle trainingPeri-partumPost-partumPregnancyPre-partumRandomised controlled trialStress urinary incontinence

Identifiers

PMID31023381
PMCPMC6485130

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.