Effects of Home-based High-intensity Inspiratory Muscle Training for Stress Urinary Incontinence

NCT ID: NCT06842979

Last Updated: 2025-02-24

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

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-29

Study Completion Date

2025-02-10

Brief Summary

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Strengthening the diaphragm muscle, the roof of the pelvic floor muscles (PFM), may be an alternative intervention in patients suffering from stress urinary incontinence (SUI). This study aims to investigate the effects of home-based telerehabilitation-assisted high-intensity inspiratory muscle training (IMT) on PFM function and urinary symptoms in women with SUI.

Detailed Description

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The IMT protocol consisted of home-based high-intensity daily training - two cycles of 30 breaths with a 1-minute rest between sets, twice a day for 8 weeks using an IMT Threshold device (Threshold IMT Philips® Respironics, Inc). The IMT was performed twice a day, 7 days/week, for 8 weeks. The study group performed IMT at 60% of their baseline MIP and was adjusted weekly based on the modified Borg scale from 4 to 6 regarding respiratory effort performed during the session, while the control group performed a sham-IMT without applied resistance. Patients are evaluated before the inspiratory muscle training and after 8 weeks of training.

Conditions

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Stress Urinary Incontinence (SUI)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study was designed as a prospective and Randomized Controlled experimental study. Participants were randomly divided into two groups in a 1:1 ratio; the study group and the control group.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Study Group

Patients who perform inspiratory muscle training (IMT) with %60 loading

Group Type EXPERIMENTAL

Inspiratory Muscle Training (IMT)

Intervention Type DEVICE

The IMT protocol will consist of home-based high-intensity daily training - two cycles of 30 breaths with a 1-min rest between sets, twice a day for 8 weeks using an IMT Threshold device (Threshold IMT Philips® Respironics, Inc). The intensity of the training will be set to 60% of each patient's maximal inspiratory pressure measured and adjusted weekly based on the modified Borg scale from 4 to 6 regarding respiratory effort performed during the session. Patients were also informed to perform knack maneuver in daily activities that may cause sudden intra-abdominal pressure overload.

Sham Group

Patients who perform Sham IMT

Group Type SHAM_COMPARATOR

Sham IMT

Intervention Type DEVICE

The IMT protocol will consist of home-based daily training - two cycles of 30 breaths with a 1-min rest between sets, twice a day for 8 weeks using an IMT Threshold device (Threshold IMT Philips® Respironics, Inc). The intensity of the training will be set to the lowest intensity of the IMT Threshold device. Patients were also informed to perform knack maneuver in daily activities that may cause sudden intra-abdominal pressure overload.

Interventions

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Inspiratory Muscle Training (IMT)

The IMT protocol will consist of home-based high-intensity daily training - two cycles of 30 breaths with a 1-min rest between sets, twice a day for 8 weeks using an IMT Threshold device (Threshold IMT Philips® Respironics, Inc). The intensity of the training will be set to 60% of each patient's maximal inspiratory pressure measured and adjusted weekly based on the modified Borg scale from 4 to 6 regarding respiratory effort performed during the session. Patients were also informed to perform knack maneuver in daily activities that may cause sudden intra-abdominal pressure overload.

Intervention Type DEVICE

Sham IMT

The IMT protocol will consist of home-based daily training - two cycles of 30 breaths with a 1-min rest between sets, twice a day for 8 weeks using an IMT Threshold device (Threshold IMT Philips® Respironics, Inc). The intensity of the training will be set to the lowest intensity of the IMT Threshold device. Patients were also informed to perform knack maneuver in daily activities that may cause sudden intra-abdominal pressure overload.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Diagnosed with stress urinary incontinence by a specialized Urologist
* Being female aged between 25 and 50 years
* To have the ability to access and use technological devices required by the study
* Being able to read and write
* Volunteering to research

Exclusion Criteria

* Inability of the participant to understand or perform the procedures proposed during the evaluations or training program.
* Active urinary tract infection,
* pelvic organ prolapse stage 2 and more according to the pelvic organ prolapse staging system (Pelvic Organ Prolapse Quantification System (POP-Q))
* Fecal incontinence,
* Any neurogenic dysfunction of the lower urinary tract
* Conservative or surgical treatment of urinary incontinence in the last 12 months
* Previous pelvic floor training
* Less than three months after pregnancy or postpartum
* Having undergone any pelvic floor surgery (hysterectomy, etc.)
* Radiotherapy treatment in the last 12 months
* Severe low back pain or pelvic pain
* Lower extremity orthopaedic problems that may affect the pelvic structure (such as lower extremity inequality, total hip arthroplasty)
* Having any chronic respiratory disease
* Having any neurological disease
* Being in menopause
* Latex allergy
Minimum Eligible Age

25 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Izmir University of Economics

OTHER

Sponsor Role lead

Responsible Party

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Ridvan Aktan

Asst. Prof., PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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RIDVAN AKTAN, Asst. Prof.

Role: PRINCIPAL_INVESTIGATOR

Izmir University of Economics

Locations

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Izmir University of Economics

Izmir, Balçova, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010 Jan;21(1):5-26. doi: 10.1007/s00192-009-0976-9. Epub 2009 Nov 25.

Reference Type BACKGROUND
PMID: 19937315 (View on PubMed)

Hodges PW, Gandevia SC. Changes in intra-abdominal pressure during postural and respiratory activation of the human diaphragm. J Appl Physiol (1985). 2000 Sep;89(3):967-76. doi: 10.1152/jappl.2000.89.3.967.

Reference Type BACKGROUND
PMID: 10956340 (View on PubMed)

Talasz H, Kofler M, Kalchschmid E, Pretterklieber M, Lechleitner M. Breathing with the pelvic floor? Correlation of pelvic floor muscle function and expiratory flows in healthy young nulliparous women. Int Urogynecol J. 2010 Apr;21(4):475-81. doi: 10.1007/s00192-009-1060-1. Epub 2009 Dec 8.

Reference Type BACKGROUND
PMID: 19997721 (View on PubMed)

Talasz H, Kremser C, Kofler M, Kalchschmid E, Lechleitner M, Rudisch A. Phase-locked parallel movement of diaphragm and pelvic floor during breathing and coughing-a dynamic MRI investigation in healthy females. Int Urogynecol J. 2011 Jan;22(1):61-8. doi: 10.1007/s00192-010-1240-z. Epub 2010 Aug 31.

Reference Type BACKGROUND
PMID: 20809211 (View on PubMed)

Al-Bilbeisi F, McCOOL FD. Diaphragm recruitment during nonrespiratory activities. Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):456-9. doi: 10.1164/ajrccm.162.2.9908059.

Reference Type BACKGROUND
PMID: 10934070 (View on PubMed)

CAMPBELL EJ, GREEN JH. The variations in intra-abdominal pressure and the activity of the abdominal muscles during breathing; a study in man. J Physiol. 1953 Nov 28;122(2):282-90. doi: 10.1113/jphysiol.1953.sp004999. No abstract available.

Reference Type BACKGROUND
PMID: 13118539 (View on PubMed)

Neumann P, Gill V. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(2):125-32. doi: 10.1007/s001920200027.

Reference Type BACKGROUND
PMID: 12054180 (View on PubMed)

Sapsford RR, Hodges PW, Richardson CA, Cooper DH, Markwell SJ, Jull GA. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001;20(1):31-42. doi: 10.1002/1520-6777(2001)20:13.0.co;2-p.

Reference Type BACKGROUND
PMID: 11135380 (View on PubMed)

Saunders SW, Rath D, Hodges PW. Postural and respiratory activation of the trunk muscles changes with mode and speed of locomotion. Gait Posture. 2004 Dec;20(3):280-90. doi: 10.1016/j.gaitpost.2003.10.003.

Reference Type BACKGROUND
PMID: 15531175 (View on PubMed)

Azevedo IG, Sousa SLO, Viana ESR, Dantas DS, Maciel ACC, Da Camara SMA. Relationship between symptomatic pelvic organ prolapse and respiratory muscle strength in middle-aged and older women in Northeast Brazil: a cross-sectional study. Physiother Theory Pract. 2021 Jun;37(6):755-761. doi: 10.1080/09593985.2019.1642428. Epub 2019 Jul 11.

Reference Type BACKGROUND
PMID: 31294670 (View on PubMed)

Hodges PW, Sapsford R, Pengel LH. Postural and respiratory functions of the pelvic floor muscles. Neurourol Urodyn. 2007;26(3):362-71. doi: 10.1002/nau.20232.

Reference Type BACKGROUND
PMID: 17304528 (View on PubMed)

Deffieux X, Hubeaux K, Porcher R, Ismael SS, Raibaut P, Amarenco G. Pelvic floor muscle activity during coughing: altered pattern in women with stress urinary incontinence. Urology. 2007 Sep;70(3):443-7; discussion 447-8. doi: 10.1016/j.urology.2007.03.084.

Reference Type BACKGROUND
PMID: 17905093 (View on PubMed)

Other Identifiers

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2023/16-03

Identifier Type: -

Identifier Source: org_study_id

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