Novel Telerehabilitation Interventions for Stress Urinary Incontinence : A Systematic Review of Randomised Controlled Trials.

چکیده اصلی

OBJECTIVE: To evaluate the effectiveness of telerehabilitation-delivered pelvic floor muscle training (PFMT) for women with stress urinary incontinence (SUI), focusing on clinical outcomes, adherence, satisfaction, and healthcare accessibility. DATA SOURCES: A systematic search was conducted across four electronic databases: Embase, Scopus, CINAHL, and MEDLINE, in June 2024 and updated in May 2026. STUDY SELECTION: Eligible studies were randomised controlled trials (RCTs) examining PFMT delivered via virtual platforms (e.g., mobile applications, video conferencing, or internet-based programs) for women (≥18 years) with SUI. A total of 13 RCTs met all inclusion criteria. DATA EXTRACTION: Two independent reviewers extracted data regarding study characteristics, clinical outcomes, and implementation metrics (adherence and satisfaction). Methodological quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. DATA SYNTHESIS: Due to substantial methodological and clinical heterogeneity, findings were synthesized narratively using the Synthesis Without Meta-analysis (SWiM) reporting guidelines. Digital interventions consistently produced significant subjective reductions in SUI symptoms and improvements in condition-specific quality of life (QoL). Telerehabilitation often demonstrated superior clinical outcomes and higher adherence compared to passive management or no-treatment controls. When compared to active conventional care, such as face-to-face physiotherapy or paper booklets, digital tools generally showed comparable rather than superior efficacy. Adherence was a primary mechanism for success, though technological complexity was a barrier in some protocols. Interventions were safe, with no serious adverse events reported. CONCLUSIONS: Telerehabilitation-delivered PFMT has potential as a safe, feasible, and effective modality for managing SUI. It offers a robust, scalable alternative to traditional care, particularly by improving accessibility for women facing geographical or logistical barriers.

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