Multi-centre Randomised Controlled Trial of Pelvic Floor Muscle Training for Prolapse

NCT ID: NCT00476892

Last Updated: 2011-03-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

448 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-06-30

Study Completion Date

2011-03-31

Brief Summary

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The aim of this study is to determine the effectiveness and cost-effectiveness of pelvic floor muscle training in the management of pelvic organ prolapse in women.

Detailed Description

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Pelvic organ prolapse is a common problem that adversely affects the daily activities and quality of life of many women. Pelvic floor muscle training interventions are commonly used by physiotherapists to manage prolapse. However, a Cochrane review found limited evidence to support the effectiveness of such interventions. Based on the findings of a successful feasibility study, this multi-centre randomised controlled trial will address the paucity of evidence. 556 symptomatic women with diagnosed prolapse will be enrolled in 16 UK centres and 1 New Zealand centre over 16 months and randomised to pelvic floor muscle training plus lifestyle advice, or to receive a lifestyle leaflet only. Principal measures of outcome are: prolapse symptoms, prolapse severity, and subsequent further treatment up to 12 months after trial entry.

Conditions

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Pelvic Organ Prolapse

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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1

It consists of five outpatient appointments (weeks 0, 2, 6, 11 and 16) with a local trial physiotherapist at a trial centre. At the first appointment a standardised history is taken from the woman, anatomy and function of the pelvic floor muscles are taught, and types of prolapse described, using diagrams and a model pelvis. Women are taught how to contract the muscles, and also how to contract and hold prior to an event that increases intra-abdominal pressure ("the Knack"). Pelvic floor muscles are assessed by vaginal examination and recorded on a dedicated form at each appointment thus determining the content of a single set of exercises for each woman. At least three sets of exercises daily is recommended. Women use an exercise diary to record compliance. Tailored advice is given on ways of reducing intra-abdominal pressure, e.g. advice on weight loss, chronic cough, heavy lifting and general exercise.

Group Type OTHER

Pelvic Floor Muscle Training

Intervention Type PROCEDURE

Women in the intervention group attend 5 physiotherapy sessions. At each appointment a clinical history is taken, pelvic floor muscle assessment carried out, exercises taught and prescribed, and appropriate lifestyle advice given. At the first of these appointments a detailed explanation of the pelvic anatomy and different types of prolapse is given.

2

Women allocated to the control group will be sent a lifestyle advice leaflet only, and will have no planned contact with the centre until their consultant review appointment at six months. The leaflet gives instructions on seeking advice where appropriate about weight loss, constipation, and avoidance of heavy lifting, coughing and high impact exercise, with a view to minimising increases in intra-abdominal pressure which may cause prolapse to worsen.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Pelvic Floor Muscle Training

Women in the intervention group attend 5 physiotherapy sessions. At each appointment a clinical history is taken, pelvic floor muscle assessment carried out, exercises taught and prescribed, and appropriate lifestyle advice given. At the first of these appointments a detailed explanation of the pelvic anatomy and different types of prolapse is given.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* New attendee at outpatient gynaecology clinic
* Any type of prolapse

Exclusion Criteria

* Stage 0 or IV prolapse
* Women reporting no symptoms of prolapse
* Previous treatment for prolapse (surgery or formal instruction in Pelvic Floor Muscle Training \[PMFT,\]unless completed more than 5 years ago, pessary, unless pessary removed more than 12 months ago)
* Unable to comply with PFMT
* women who have urogenital atrophy requiring treatment with local oestrogens (after an 8 week course of local oestrogen such women can be included);
* Pregnant or less than 6 months post-natal
* Unable to give informed consent
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Chief Scientist Office of the Scottish Government

OTHER_GOV

Sponsor Role collaborator

South Glasgow University Hospitals NHS Trust

OTHER

Sponsor Role collaborator

University of Aberdeen

OTHER

Sponsor Role collaborator

University of Otago

OTHER

Sponsor Role collaborator

Glasgow Caledonian University

OTHER

Sponsor Role lead

Responsible Party

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NMAHP Research Unit, Glasgow Caledonian University

Principal Investigators

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Suzanne Hagen

Role: PRINCIPAL_INVESTIGATOR

NMAHP Research Unit, Glasgow Caledonian University

Locations

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St George Hospital

Sydney, , Australia

Site Status

Antrim Area Hospital

Antrim, , Ireland

Site Status

Belfast City Hospital

Belfast, , Ireland

Site Status

Dunedin School of Medicine

Dunedin, , New Zealand

Site Status

Crosshouse Hospital / Ayrshire Maternity Hospital

Kilmarnock, Ayrshire, United Kingdom

Site Status

Forth Park Hospital

Kirkcaldy, Fife, United Kingdom

Site Status

Aberdeen Royal Infirmary

Aberdeen, Grampian, United Kingdom

Site Status

North Hampshire Hospitals NHS Trust

Basingstoke, Hampshire, United Kingdom

Site Status

Royal Infirmary of Edinburgh

Edinburgh, Lothian, United Kingdom

Site Status

St John's Hospital

Livingston, West Lothian, United Kingdom

Site Status

Birmingham Women's Hospital

Birmingham, , United Kingdom

Site Status

Bradford Royal Infirmary

Bradford, , United Kingdom

Site Status

Addenbrooke's Hospital

Cambridge, , United Kingdom

Site Status

Chester Hospital

Chester, , United Kingdom

Site Status

St Richard's Hospital

Chichester, , United Kingdom

Site Status

Ninewells Hospital

Dundee, , United Kingdom

Site Status

Falkirk and District Royal Infirmary

Falkirk, , United Kingdom

Site Status

Western Infirmary

Glasgow, , United Kingdom

Site Status

Glasgow Royal Infirmary

Glasgow, , United Kingdom

Site Status

Victoria Infirmary

Glasgow, , United Kingdom

Site Status

Southern General Hospital

Glasgow, , United Kingdom

Site Status

Castle Hill Hospital

Hull, , United Kingdom

Site Status

St James's University Hospital

Leeds, , United Kingdom

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St Mary's Hospital

Manchester, , United Kingdom

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Borders General Hospital

Melrose, , United Kingdom

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James Cook University Hospital

Middlesbrough, , United Kingdom

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Worcestershire Royal Hospital

Worcester, , United Kingdom

Site Status

York Hospital

York, , United Kingdom

Site Status

Countries

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Australia Ireland New Zealand United Kingdom

Other Identifiers

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ISRCTN35911035

Identifier Type: -

Identifier Source: secondary_id

CZH/4/377

Identifier Type: -

Identifier Source: org_study_id

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