Three years ago this month I was celebrating my first peer reviewed publication, a telehealth study -“Web Based Treatment for Women with Stress Urinary Incontinence”, in the Oct 2014 issue of the Journal of Urologic Nursing. The study looked at the use of an online course designed for women to independently perform to address their incontinence. The content of the course was focused on helping the women reconnect with the SYSTEM of muscles that is involved in controlling continence (not simply another Kegel based program), and integrating that system into function and basic fitness. The goal of the study was to determine if women could access and independently participate in an online program (feasibility) and benefit from it (efficacy through a low power Lichert scale).
An overwhelming majority of participants, 85%, noted an improvement in incontinence symptoms (61.8%= A little bit better; 23.5%= Much Better) in 3 weeks. My favorite outcome was that the results were not impacted by age, parity (how many babies or no babies delivered), BMI, length of time having incontinence, educational level or socio-economic level to name a few of the demographics we screened for. This is important because age, parity, and BMI are considered three of the top risk factors for developing incontinence. These variables did not impact the results. Older women, younger women, women with high BMI, women with low BMI, women with lots of babies and women with no babies all had similar results to the program. Benefit was measured by self-report, with a low power tool, and of course the study needs to be repeated with other research, so there is only so far that we can extrapolate the findings. However, this was a good first step to look at a program that addressed the multifactorial SYSTEM involved in continence (vs just the pelvic floor), provided new tools, communicated it directly to the women in need and provided a quick result (just 3 weeks!). The coolest part is that women experienced a change in their symptoms while participating independent of professional (rehab or fitness) intervention. Telehealth is the new frontier, many don’t have access to care or don’t seek care for pelvic health issues because of the stigma. So a program like this offers new options to reach more women. My hope is that even a little progress in a short window, would encourage women to continue to build on the success with continued participation and integration of the strategies into their daily life and fitness. It would encourage them that there is hope and help, and to seek out additional care to facilitate further improvements if they have access.
One of my favorite messages over the years and important to re-iterate here, is that the stability system and continence system are one and the same. This helps us to reframe incontinence as a signal that the system is not working in a coordinated, balanced way. This helps to remove the stigma around it both for women and the pros that care for them. Maintaining this system and these strategies during pregnancy and rebuilding it postpartum is critical for all women, regardless if they are demonstrating a symptom like incontinence. Pregnancy alone can have a direct impact on the muscular components of the System, breath mechanics/pressure management and alignment/fitness form. Addressing these changes is critical to system and strategy recovery and preparation for a return to fitness. The reality is this online program is a pregnancy recovery strategy that can be applied as a foundation to address a variety of pregnancy and post partum needs- musculoskeletal aches and pains, prolapse, diastasis, return to fitness and of course incontinence!
To celebrate the 3-year anniversary, check out the online course we studied for 30% off! You can get your own copy of the online program, Pelvic Floor Piston: Foundation for Fitness, here! Use code: ThreeYearsWow until Monday October 30th, 2017 at midnight PST. Here are is a clip.
If you are a mama, this course was designed for you. It is the foundation I hope to re-establish for all the moms out there (no matter how long it has been since your pregnancy).
Rehab and Fit Pros: this program is a first toe in the water for you if you are new to trying to understand how to begin to blend pelvic floor into your current programming. Its not crazy, and ultimately pelvic health symptoms are linked to your attempts at restoring your clients “cores”. You must understand that women are leaking in your rehab programs, not just their fitness. Women are leaving your rehab office with an increase in prolapse symptoms, and they are afraid to tell you. Women have a diastasis and you don’t know it or understand how it would impact their response to your clinical or training program. I hope if you are intrigued, you would consider looking at the online professional courses I have to explore the info in depth, so you can apply it to multiple patient populations. Professional online courses are here (and now eligible for CEUs!!). Join my newsletter to be alerted to new courses (new content is coming soon) and discounts, I love to take care of my subscribers!