Stres üriner inkontinanslı kadınlarda telerehabilitasyonun etkinliği araştırılması

Aim: This research aims to make an evaluation on the effectiveness of telerehabilitation and to compare incontinence severity, PFM strength, social activity level, qualityiof life, sexualifunction activities in women with stressiurinary incontinence. Material and method : According to the inclusion criteria, 57 participants diagnosed with StressiUrinary Incontinence (SUI) were seperated into two main groups: the Online Tele-rehabilitation Group (OTG)(n=28) and the Video Tele-rehabilitation Group (VTG)(n=29), with 36 individuals in each group. The participants' demographic information was recorded. The incontinence severity was evaluated using the Incontinence SeverityiIndex (ISI). Pelvicifloor muscle strength was determined by using the ModifiediOxford Scale (MOS) through digital palpation by an expert doctor. The incontinence impact on qualityiof life and social activity level was evaluated using the IncontinenceiImpact Questionnaire (IIQ-7), UrogenitaliDistress Inventory (UDI-6), and Incontinence Qualityiof Life (I-QOL) questionnaire. Overall qualityiof life was measured using the Euro Qualityiof Life scale (EQ-5D-3L). Sexual dysfunction was evaluated using the Coital Incontinence Questionnaire (CIQ). For a periodiof 6 weeks, bothigroups underwent a tele-rehabilitation (TR) program consisting of pelvicifloor muscle strengthening exercises and bladder training twiceia week. The OTG group followed this program via Zoom, while the VTG group received video instructions and performed the exercises under the guidance of a physiotherapist. After 6 weeks, all participants' evaluations of pelvic floorimuscle strength, qualityiof life, social activity level, and sexual dysfunction were conducted again. Result: The baseline clinical characteristics of the groupsiwere similar (p>.05). In the OTG group, thereiwas a statistically significant change in the pre- and post-treatment scores of ISI (p =.001), IIQ-7 (p =.001), UDİ-6 (p =.001), MOS (p =.001), I-QOL (p=.001), and the VAS (p =.004) value from the anxiety/depression subcategory of EQ-5D-3L. In the VTG group, there was a statistically significant change in the pre- and post-treatment scores of ISI (p =.001), IIQ-7 (p =.001), UDİ-6 (p =.001), MOS (p =.001), and I-QOL (p =.001). The anxiety/depression subcategory of EQ-5D-3L(p =.001) showed a higher score post-treatment compared to pre-treatment in both groups. There was no statisticallyisignificant difference in the CIQ (p =.180) scores between pre- and post-treatment in the OTG group. There was no statistically significantidifference in the CIQ (p =.124) scores between pre- andipost-treatment in the VTG group. In the analysis of pre- to post-treatment changes between groups, no statistically significant difference was found in ISI (p =.397), UDİ-6 (p =.225), MOS (p =.110), I-QOL (p =.436), CIQ (p =.115), and the subcategories of EQ-5D-3L including mobility (p=.326), self-care (p = 1.000), usual activities (p =.971), pain/discomfort (p =.465), and anxiety/depression (p =.165). However, a statisticallyisignificant difference in favoriof the OTG group was observed in the IIQ-7 score (p =.039) in the analysis of pre- to post-treatment changes between groups. Conclusion: In conclusion, our study found statisticallyisignificant differences in both groups after TR. But, there was noistatistically significantidifference between the OTG and VTG groups. We provide strong evidence regarding the short-term effects of TR-based pelvic floor muscleitraining (PFMT). We demonstrate the benefits of TR-based PFMT for women with SUI who cannot participate in rehabilitation outside the home due to weather conditions or health conditions. Key words: Telerehabilitation, pelvic floor, stress urinary incontinence, exercise