Pelvic Floor Muscle Training With a Digital Therapeutic Device to Standard Exercises for Stress Urinary Incontinence

NCT ID: NCT04508153

Last Updated: 2021-12-09

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

369 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-01

Study Completion Date

2021-09-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

A virtual prospective randomized controlled study to evaluate the efficacy of using the leva® Pelvic Digital Health System (PDHS) to perform PFMT compared to a standard home exercise home program for the treatment of SUI/SMUI. The treatment part of the study lasts eight weeks and has two arms. One group will receive routine care consisting of at-home Kegel exercises, and the other will be provided with a leva® device and instructions for use. Subjects in both groups will be assessed at baseline, then at 4 and 8 weeks for change and improvement of their symptoms. They will also be assessed at 6 and12 months after study completion.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This trial is entirely virtual. No office visits, specific locations, or physical examination will be required. Enrollment may occur from any location in the United States

* A virtual prospective randomized controlled study to evaluate the efficacy of using the leva® PDHS to perform PFMT (leva arm) compared to standard care of a PFM exercise home program (Kegel arm) for the treatment of SUI or SMUI.
* Following completion of e-consent and screening, including an initial bladder diary and introductory phone call to review the study requirements, subjects are considered officially enrolled.
* A series of baseline assessments will be administered to all subjects to evaluate symptom severity, frequency and impact.
* Subjects will then be randomized to either the leva® arm or Kegel arm on a 1 to 1 ratio using block randomization. Prior to initiation of the trial, a randomization sequence will be generated by the ObvioHealth system. Participants will be automatically allocated the next available slot in the sequence at the time of their randomization and assigned to the leva® or Kegel group accordingly.
* Prior to beginning the program, subjects in the Kegel arm will receive printed instructions for PFMT with Kegel exercises. Subjects in the leva® arm will be shipped the leva® digital device, along with instructions for use and how to download the corresponding digital app. Day 1 of the study begins the day following receipt of materials.
* Study population: women with SUI or SMUI.
* The study requires no office visits. All participant data will be entered in the subject's smartphone using a custom designed mobile application. Participants will be able to interact with the app throughout the study period and will be presented with surveys and a voiding diary on a specified schedule during an 8-week treatment period. There will also be expected post-intervention follow up surveys at 6- and 12-months
* Using virtual recruiting, a total of up to 350 subjects will be enrolled in the trial.
* Subjects in both arms will have three scheduled phone calls with study staff during the first two weeks of treatment.
* Subjects can speak to the study staff at any time via an in-app chat function, the phone, or videoconference.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Stress Urinary Incontinence

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A virtual prospective randomized controlled study to evaluate the efficacy of using the leva® PDHS to perform PFMT (leva arm) compared to standard care of a PFM exercise home program (Kegel arm) for the treatment of SUI or SMUI.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Subjects will be randomized to either the leva® arm or Kegel arm on a 1 to 1 ratio using block randomization. Prior to initiation of the trial, a randomization sequence will be generated by the ObvioHealth system. Participants will be automatically allocated the next available slot in the sequence at the time of their randomization and assigned to the leva® or Kegel group accordingly

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Leva PDHS arm

Upon randomization, subjects randomized to the leva® arm will receive the leva® PDHS, and instructions for how to download the smartphone app to facilitate use of the device. They will be instructed to use leva® based on the in-app training provided.

Within the app, subjects will be instructed to use the leva® device to perform PFMT according to the training program provided through the smartphone app associated with the device. This entails 2 ½ minute training sessions, three times daily, 7 days per week for a total of 8 weeks.

Group Type OTHER

Leva Pelvic Digital Health System

Intervention Type DEVICE

Pelvic floor muscle training using the pelvic digital health system to treat pelvic floor disorders, specifically stress urinary incontinence.

Kegel arm

Subjects randomized to the Kegel arm will be provided links to view instructions on how to perform PFMT (written instructions per the handout adapted from Voices for PFD, the patient advocacy arm of the American Urogynecologic Society), as well as an audio/visual didactic instructing them to perform Pelvic Floor Muscle Exercises (PFME) three times daily, seven days per week throughout the 8-week study period.

Group Type OTHER

Kegel exercises

Intervention Type OTHER

Pelvic floor muscle training (PFMT), commonly referred to as "Kegel" exercises, is a first line conservative treatment for pelvic floor disorders, specifically stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (SMUI).

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Leva Pelvic Digital Health System

Pelvic floor muscle training using the pelvic digital health system to treat pelvic floor disorders, specifically stress urinary incontinence.

Intervention Type DEVICE

Kegel exercises

Pelvic floor muscle training (PFMT), commonly referred to as "Kegel" exercises, is a first line conservative treatment for pelvic floor disorders, specifically stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (SMUI).

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* ≥18 years of age
* Capable of giving informed consent
* Possess a smartphone capable of interacting with the ObvioHealth and Renovia apps
* Self-reported SUI/SMUI symptoms of ≥ three months duration
* Diagnosis SMUI based on Medical, Epidemiologic and Social Aspects of Aging (MESA) stress symptom score (Percent of total possible stress score) greater than MESA urge symptom score (percent of total possible urge score)
* English speaking
* Postmenopausal, post hysterectomy, or willing to use an acceptable method of birth control for the duration of the study
* Able to complete a bladder diary using the ObvioHealth app
* Able to complete electronic surveys and upload data
* Willing to provide contact information and respond to remote contact: phone calls, text messages, email
* Willing to participate in the 8-week study with follow up at 6-and 12-months, refraining from the pursuit of treatment for Stress UI using other modalities (i.e. will not wear a pessary, participate in pelvic floor Physical Therapy or surgery) during the first 8 weeks

Exclusion Criteria

* Absence of a vagina, per patient report
* Reports seeing or feeling a vaginal bulge or sensation of vaginal bulge
* Diagnosis of any neuromuscular disease that may contribute to UI (i.e., multiple sclerosis, spinal cord injury, Parkinson's Disease, etc.)
* Non-ambulatory, per patient report
* Currently pregnant or \<6 months post-partum per patient report
* Currently (or within the last 1 month) breast feeding
* Prior surgery for stress UI
* Previous PFMT: 2 visits within the last 3 months under a supervised therapeutic plan of care
* Currently taking, or has taken within the last 2 months, medication to treat UI
* Prior augmentation cystoplasty or artificial sphincter
* Implanted nerve stimulator for urinary symptoms, active within the past 60 days
* Participation in another clinical study within 30 days of screening
* Impaired cognitive function per patient report and evaluation of medication list
* Contraindication to the use of a vaginal probe
* Unable to understand instructions on the use of the leva® PDHS
* Unable to operate a smartphone app with use of Bluetooth and Wi-Fi connectivity
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

OBVIO HEALTH USA, Inc.

UNKNOWN

Sponsor Role collaborator

University of Alabama at Birmingham

OTHER

Sponsor Role collaborator

Renovia, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Holly Richter, MD PhD

Role: PRINCIPAL_INVESTIGATOR

University of Alabama at Birmingham

Milena Weinstein, MD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital

Gena Dunnivan, MD

Role: PRINCIPAL_INVESTIGATOR

University of New Mexico

Noelani M Guaderrama, MD

Role: PRINCIPAL_INVESTIGATOR

Southern California Permanentae

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University of Alabama *** Virtual Trial May be enrolled from any US Location

Birmingham, Alabama, United States

Site Status

Southern California Permanente Medical Group*** Virtual Trial May be enrolled from any US Location

Irvine, California, United States

Site Status

University of New Mexico *** Virtual Trial May be enrolled from any US Location

Albuquerque, New Mexico, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Weinstein MM, Dunivan GC, Guaderrama NM, Richter HE. Digital Therapeutic Device for Urinary Incontinence: A Longitudinal Analysis at 6 and 12 Months. Obstet Gynecol. 2023 Jan 1;141(1):199-206. doi: 10.1097/AOG.0000000000005036. Epub 2022 Nov 30.

Reference Type DERIVED
PMID: 36701620 (View on PubMed)

Weinstein MM, Dunivan G, Guaderrama NM, Richter HE. Digital Therapeutic Device for Urinary Incontinence: A Randomized Controlled Trial. Obstet Gynecol. 2022 Apr 1;139(4):606-615. doi: 10.1097/AOG.0000000000004725. Epub 2022 Mar 10.

Reference Type DERIVED
PMID: 35271539 (View on PubMed)

Weinstein MM, Pulliam SJ, Richter HE. Randomized trial comparing efficacy of pelvic floor muscle training with a digital therapeutic motion-based device to standard pelvic floor exercises for treatment of stress urinary incontinence (SUV trial): An all-virtual trial design. Contemp Clin Trials. 2021 Jun;105:106406. doi: 10.1016/j.cct.2021.106406. Epub 2021 Apr 16.

Reference Type DERIVED
PMID: 33866003 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

OBVIO-REN-001

Identifier Type: -

Identifier Source: org_study_id