Efficacy of Pelvic Floor Muscle Training Using Kegel Exercises for Urinary Incontinence: A Systematic Review of Efficacy
Abstract
Background: Urinary incontinence (UI) is a prevalent health issue with significant physical and psychosocial impacts. Pelvic floor muscle training (PFMT), particularly Kegel exercises, is a widely recommended non-invasive treatment. However, the efficacy of Kegel exercises compared to or in combination with adjunct therapies remains debated. This systematic review evaluates the efficacy of Kegel exercises for UI.
Methods: Following PRISMA guidelines, a systematic search was conducted in PubMed and Web of Science. Randomized controlled trials (RCTs), quasi-experimental, and prospective cohort studies assessing Kegel exercises in adults with stress, urge, or mixed UI were included. Risk of bias was assessed using Cochrane RoB 2 and ROBINS-I tools.
Results: Five studies (n=291 participants, all female) were included. Adjunct therapies (EMI, biofeedback, DNS) demonstrated superior outcomes compared to Kegel exercises alone, including greater symptom reduction (e.g., lower ICIQ-UI-SF scores, p<0.001), improved quality of life, and higher treatment satisfaction. Supervised Kegel exercises with biofeedback reduced incontinence severity (p=0.002) but not pelvic floor strength. Risk of bias varied, with two studies rated moderate and one high.
Conclusion: Kegel exercises are effective for UI but yield better outcomes when combined with adjunct therapies. Future research should standardize protocols, include diverse populations, and assess long-term efficacy and cost-effectiveness.
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