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Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women

Overview of attention for article published in Cochrane database of systematic reviews, October 2012
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (95th percentile)

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148 Dimensions

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Title
Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women
Published in
Cochrane database of systematic reviews, October 2012
DOI 10.1002/14651858.cd007471.pub2
Pubmed ID
Authors

Rhianon Boyle, E. Jean C Hay-Smith, June D Cody, Siv Mørkved

Abstract

About a third of women have urinary incontinence and up to a 10th have faecal incontinence after childbirth. Pelvic floor muscle training is commonly recommended during pregnancy and after birth both for prevention and the treatment of incontinence. To determine the effect of pelvic floor muscle training compared to usual antenatal and postnatal care on incontinence. We searched the Cochrane Incontinence Group Specialised Register, which includes searches of CENTRAL, MEDLINE, MEDLINE in Process and handsearching (searched 7 February 2012) and the references of relevant articles. Randomised or quasi-randomised trials in pregnant or postnatal women. One arm of the trial needed to include pelvic floor muscle training (PFMT). Another arm was either no PFMT or usual antenatal or postnatal care. Trials were independently assessed for eligibility and methodological quality. Data were extracted then cross checked. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook for Systematic Reviews of Interventions. Three different populations of women were considered separately, women dry at randomisation (prevention); women wet at randomisation (treatment); and a mixed population of women who might be one or the other (prevention or treatment). Trials were further divided into those which started during pregnancy (antenatal); and those started after delivery (postnatal). Twenty-two trials involving 8485 women (4231 PFMT, 4254 controls) met the inclusion criteria and contributed to the analysis.Pregnant women without prior urinary incontinence (prevention) who were randomised to intensive antenatal PFMT were less likely than women randomised to no PFMT or usual antenatal care to report urinary incontinence up to six months after delivery (about 30% less; risk ratio (RR) 0.71, 95% CI 0.54 to 0.95, combined result of 5 trials).Postnatal women with persistent urinary incontinence (treatment) three months after delivery and who received PFMT were less likely than women who did not receive treatment or received usual postnatal care to report urinary incontinence 12 months after delivery (about 40% less; RR 0.60, 95% CI 0.35 to 1.03, combined result of 3 trials). It seemed that the more intensive the programme the greater the treatment effect.The results of seven studies showed a statistically significant result favouring PFMT in a mixed population (women with and without incontinence symptoms) in late pregnancy (RR 0.74, 95% CI 0.58 to 0.94, random-effects model). Based on the trial data to date, the extent to which mixed prevention and treatment approaches to PFMT in the postnatal period are effective is less clear (that is, offering advice on PFMT to all pregnant or postpartum women whether they have incontinence symptoms or not). It is possible that mixed prevention and treatment approaches might be effective when the intervention is intensive enough.There was little evidence about long-term effects for either urinary or faecal incontinence. There is some evidence that for women having their first baby, PFMT can prevent urinary incontinence up to six months after delivery. There is support for the widespread recommendation that PFMT is an appropriate treatment for women with persistent postpartum urinary incontinence. It is possible that the effects of PFMT might be greater with targeted rather than mixed prevention and treatment approaches and in certain groups of women (for example primiparous women; women who had bladder neck hypermobility in early pregnancy, a large baby, or a forceps delivery). These and other uncertainties, particularly long-term effectiveness, require further testing.

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Mendeley readers

The data shown below were compiled from readership statistics for 237 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 <1%
France 1 <1%
Canada 1 <1%
Unknown 234 99%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 56 24%
Student > Master 43 18%
Student > Ph. D. Student 25 11%
Researcher 24 10%
Student > Postgraduate 23 10%
Other 50 21%
Unknown 16 7%
Readers by discipline Count As %
Medicine and Dentistry 113 48%
Nursing and Health Professions 59 25%
Sports and Recreations 9 4%
Agricultural and Biological Sciences 9 4%
Psychology 7 3%
Other 17 7%
Unknown 23 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 96. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 February 2020.
All research outputs
#204,173
of 15,128,103 outputs
Outputs from Cochrane database of systematic reviews
#437
of 11,111 outputs
Outputs of similar age
#1,458
of 152,816 outputs
Outputs of similar age from Cochrane database of systematic reviews
#4
of 91 outputs
Altmetric has tracked 15,128,103 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,111 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 22.8. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 152,816 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 91 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.