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. 2026 Aug 2;32(4):e70177. doi: 10.1111/ijn.70177

The Rehabilitative Effects of Online Pelvic Floor Muscle Exercises on Female Urinary Incontinence Across Various Life Stages: A Systematic Review and Meta‐Analysis

Yu Wang 1,2, Hailian Zhang 1,✉, Jinyang Wang 1, Wanqiu Feng 1, Zihan Sun 1, Yuanyuan Chen 1
PMCID: PMC13429495  PMID: 42543255

ABSTRACT

Aim

This paper aims to evaluate the effects of online pelvic floor muscle training on urinary incontinence frequency, symptom severity, quality of life and adherence across defined female life stages.

Background

Urinary incontinence is a significant public health issue affecting women's physical and mental well‐being.

Design

The paper is designed as a systematic review and meta‐analysis of randomized controlled trials.

Review Methods

Nine databases were searched for RCTs of online PFMT in women with UI. Outcomes included UI incidence, symptom severity, quality of life and compliance. Data extraction, risk‐of‐bias (RoB 2) and GRADE assessment were performed. Random‐effects meta‐analyses used RevMan 5.4.

Results

Sixteen studies were included. Online pelvic floor muscle training significantly reduced postpartum urinary incontinence incidence (RR = 0.56; 95% CI: 0.38 to 0.82) and symptom severity (SMD = −0.25; 95% CI: −0.45 to −0.05), but not in elderly patients (SMD = −0.12; 95% CI: −0.25 to 0.02). Exercise compliance improved in both subgroups. No significant difference was found in quality of life. Moderate‐to‐high heterogeneity was observed.

Conclusions

Online pelvic floor muscle exercise may improve urinary incontinence outcomes across different life stages. In postpartum women, it reduces incontinence incidence, alleviates symptom severity and enhances training compliance, whereas in elderly patients, its benefit is limited to improved compliance.

Keywords: online, pelvic floor muscle exercises, rehabilitative, urinary incontinence, women

Summary

What is already known about this topic?

  • Urinary incontinence has become a burgeoning public health challenge, profoundly impacting the physical and mental well‐being of women experiencing this condition.

  • Pelvic floor muscle exercise is the best conservative treatment for urinary incontinence.

What this paper adds?

  • Online pelvic floor muscle exercises have better rehabilitation effects for women with urinary incontinence in different life cycles.

  • The use of online platform for pelvic floor muscle exercises can significantly reduce the incidence of urinary incontinence, improve the severity of symptoms, and improve exercise compliance.

  • More high‐quality intervention studies are essential to explore the optimal exercise mode for pelvic floor rehabilitation.

The implications of this paper:

  • An online platform can serve as a tool for pelvic floor muscle exercises, aiding women with urinary incontinence across various life stages to improve pelvic floor health.

1. Introduction

Incontinence is defined as the involuntary leakage of urine (Papanikolaou et al. 2023). According to the World Health Organization, urinary incontinence has become a significant public health concern (World Health 2024), affecting the physical and mental well‐being of 25% to 45% of adult women (Abrams et al. 2015). Influenced by factors such as pregnancy, childbirth, and hormonal fluctuations, urinary incontinence predominantly affects women during and after childbirth as well as older individuals (Batmani et al. 2021; S. R. Chang et al. 2022). While urinary incontinence does not pose a threat to life, it significantly disrupts patients' daily lives. Approximately three‐quarters of postpartum patients experience urinary incontinence symptoms persisting for up to 12 years post‐delivery (Sun et al. 2023). This condition leads to diminished self‐esteem, strains spousal relationships, hinders physical recovery and incurs significant societal costs (Gonzalez et al. 2020). Furthermore, urinary incontinence frequently leads to skin breakdown and recurrent urinary tract infections in elderly individuals, reducing their mobility (Batmani et al. 2021). Moreover, urinary incontinence can induce anxiety, loneliness, and other psychological issues (Siahkal et al. 2020). Consequently, the demand for urinary incontinence rehabilitation is steadily rising.

Pelvic floor muscle exercises (PFMEs) are currently the primary conservative treatment for stress urinary incontinence (Dumoulin et al. 2018). Various studies support the effectiveness of pelvic floor muscle training in rehabilitating patients with urinary incontinence, particularly in reducing urinary leakage, promoting healing and improving quality of life. Kalaitzi found that urinary incontinence patients who underwent PFME training had a 10.6% complete cure rate and a 60% improvement in symptoms (Kalaitzi et al. 2024). Research by Dumoulin indicates that women with urinary incontinence who received PFME were approximately twice as likely to experience cure or improvement compared to those in the non‐PFME group (Dumoulin et al. 2018). Pelvic floor muscle damage occurs in both postpartum and elderly patients with urinary incontinence, but the causes differ. Postpartum incontinence is often caused by sustained bladder pressure during pregnancy and muscle trauma from childbirth (S.‐R. Chang et al. 2021), while elderly incontinence is primarily due to ageing and hormonal changes that lead to pelvic floor muscle relaxation (Dan et al. 2024). Additionally, elderly individuals with urinary incontinence often have low health literacy and awareness of their condition (Erkan and Özdemir 2024), making it difficult for them to understand the fundamentals of exercises (Xie et al. 2020), which reduces exercise effectiveness (Åström et al. 2021). Postpartum individuals with urinary incontinence often face challenges in following exercise routines due to factors like forgetfulness, fatigue and childcare responsibilities (Li et al. 2023). This difficulty may also arise from the time‐consuming nature and high cost of PFME (Riemsma et al. 2017), making it challenging for patients to maintain a consistent regimen without professional supervision (Vukovic et al. 2018). Therefore, given the distinct characteristics of postpartum and elderly patients with urinary incontinence, the effectiveness of pelvic floor rehabilitation exercises remains unclear.

Online platforms can serve as key catalysts. To maximize their potential, the Chinese government launched the ‘Internet + Healthcare’ (IPHC) strategy (Yang et al. 2021). Additionally, the introduction of the Internet of Things (IoT) system exemplifies the integration of Internet and medical technologies, enabling devices to connect and communicate via the Internet, thereby advancing the healthcare sector (Gupta et al. 2016). Simultaneously, online platforms have made notable advancements in urinary incontinence management. A 6‐month study of older women revealed that patients undergoing group remote rehabilitation experienced a 73% reduction in the median incidence of urinary incontinence, along with a more than six‐point improvement in quality of life (Le Berre et al. 2025). A prospective study further demonstrated that patients using online pelvic floor functional training reduced daily urinary leakage by 67% (K. Y. Chen et al. 2024). Online training methods have diversified, including mobile applications (Araujo et al. 2020), email push services (Sjostrom et al. 2013), smart pelvic care devices (Kashanian et al. 2011) and video diagnosis and treatment systems (Hui et al. 2006), all of which effectively promote patient self‐management. Thus, online pelvic floor muscle training overcomes the bottleneck of limited nursing resources by enabling large‐scale self‐management, leveraging advantages such as privacy protection, easy access and cost‐effectiveness.

Although some studies have examined the effectiveness of online PFME for urinary incontinence (Papanikolaou et al. 2023), fewer have explored the potential of online tools for PFME among women and older adults across different life stages. This systematic review and meta‐analysis focuses on the two major populations of postpartum urinary incontinence and elderly urinary incontinence and identifies the four indicators of urinary incontinence frequency, symptom severity score, quality of life score and exercise compliance rate as the main outcomes to provide clinical workers with an evidence‐based rehabilitation path based on life cycle, while helping policymakers accurately deploy remote rehabilitation resources and avoid a ‘one size fits all’ service model.

2. Review Methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) (Page et al. 2021). The review has been registered on the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) (CRD42024431735).

2.1. Aim

The inclusion criteria for this meta‐analysis were defined as follows: (1) study type: randomized controlled trial; (2) participants: Incontinence was diagnosed in postpartum and elderly female patients (Rodrigues et al. 2018). The intervention group underwent online combined with PFME, while the control group received standard nursing care. (3) Outcome measures included: incidence of urinary incontinence, symptom severity, quality of life and adherence to exercises. (4) Language: Studies in both Chinese and English were included. The exclusion criteria were defined as follows: (1) Inaccessibility of full text or inability to extract data; (2) repetitive publication; (3) inclusion of systematic reviews, experimental design methodologies and conference abstracts; (4) literature with high risk determined by the Cochrane risk‐of‐bias assessment tool (RoB 2); and (5) studies on indicators of incidence, symptom severity, quality of life and exercise persistence without urinary incontinence.

2.2. Search Methods

This study conducted a search across 9 Chinese and English databases, such as PubMed, Web of Science, CINAHL, the Cochrane Library, Embase, CNKI, Wanfang Database, VIP database and Chinese Biomedical Literature Database. The search employed a combination of subject words and free words in Table S1. Additionally, we manually searched for relevant articles by reviewing the references of eligible articles. The two authors independently performed the search, resolving any disagreements through discussion with the third author.

2.3. Study Selection and Data Extraction

EndNote20 software was utilized for literature management in this study. Two trained researchers independently screened the literature and included it based on the title, abstract and full text, adhering strictly to the inclusion criteria. The researchers extracted information from the literature, such as baseline data, intervention duration, intervention measures and outcome indicators.

2.4. Search Outcomes

A total of 502 pieces of literature were initially retrieved. Duplicate entries were removed, and titles and abstracts were reviewed. Subsequently, 47 pieces were excluded due to inconsistencies with the research focus. Finally, 16 studies were included after full‐text assessment. The literature screening process and results are depicted in Figure 1.

FIGURE 1.

FIGURE 1

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PRISMA flow diagram.

2.5. Quality Appraisal

Two researchers independently employed the Cochrane risk‐of‐bias assessment tool (RoB 2) to assess the quality of the incorporated literature. The assessment covered various aspects like randomization process, deviations from intended interventions, missing outcome data, measurement of the outcome, selection of the reported result and overall bias (Sterne et al. 2019) (Figure 2). In case of discrepancies between the researchers' findings, a third‐party evaluator made the final decision. GRADE was used to ensure the certainty of outcomes.

FIGURE 2.

FIGURE 2

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(a) Risk of bias summary. (b) Risk of bias graph.

2.6. Data Synthesis

Meta‐analyses were conducted with RevMan 5.4. Standardized mean difference (SMD) was calculated for continuous outcomes and risk ratio (RR) for dichotomous outcomes. Statistical heterogeneity was assessed with Cochran's Q and the I 2 statistic. A fixed‐effect model was used when p ≥ 0.10 and I 2 ≤ 50%; otherwise, a random‐effects model was applied. To explore sources of heterogeneity, we performed a priori subgroup analyses stratified by life‐cycle stage, delivery medium and supervision modality. Funnel plots were generated for primary outcomes that included ≥ 10 studies to examine possible publication bias.

3. Results

3.1. Study Characteristics

Of the 16 (Araujo et al. 2020; Asklund et al. 2017; L. Chen et al. 2022; Chu et al. 2023; Dufour et al. 2019; Jin 2019; Loohuis et al. 2021; Mao et al. 2022; Sjöström et al. 2015; Vilela et al. 2024; Wadensten et al. 2021; Wang et al. 2020; Weinstein et al. 2022; Ye et al. 2021; Zhang 2019; Zhou 2017) included studies, seven (Araujo et al. 2020; Asklund et al. 2017; Loohuis et al. 2021; Mao et al. 2022; Wadensten et al. 2021; Weinstein et al. 2022) focused on elderly patients with urinary incontinence, while eight (L. Chen et al. 2022; Chu et al. 2023; Dufour et al. 2019; Jin 2019; Wang et al. 2020; Ye et al. 2021; Zhang 2019; Zhou 2017) were related to postpartum patients with urinary incontinence. The total number of patients involved was 1394, with 702 in the intervention group and 692 in the control group. Table 1 presents the key characteristics of the studies selected.

TABLE 1.

Summary of the characteristics of included articles.

Author Publication year Sample size Mean (age) Follow‐up (months) Implementation measure Outcome index
Intervention group Control group Intervention group Control group Intervention group Control group
Akslund 2017 61 60 44.8 ± 9.7 44.7 ± 9.1 3 Tät application combines PFME Delay treatment ②③
Araujoc 2020 12 9 47.2 ± 10.6 53.3 ± 13.2 3 Vision components combined with PFME Routine care ②③
Dufour 2019 13 10 31.0 ± 2.7 34.0 ± 2.2 3 iBall application combines PFME Routine care ②③
Elisabete 2021 19 17 45.8 ± 6.3 48.8 ± 9.4 3 iPelvisapplication combines PFME Home exercise ②
Jin 2019 30 29 29.5 ± 4.6 31.2 ± 4.4 3 Wechat application combines PFME Routine care ①②④
Lei Chu 2024 21 22 26.0 ± 3.6 25.3 ± 3.8 3 Wechat application combines PFME Routine care ②
Li 2021 51 52 28.4 ± 3.6 29.2 ± 3.0 2 You Ai Wu application combines PFME Routine care ①②③
Loohuis 2021 89 83 54.9 ± 12.2 52.0 ± 9.8 12 URinControl application combines PFME Routine care ②③
Mao 2022 62 62 63.4 ± 6.3 64.1 ± 5.9 3 Application combines PFME Health education ③④
Sjöström 2013 124 126 47.9 ± 10.6 49.4 ± 9.8 4 Internet platform guides PFME Electronic mail ②③
Vilela 2024 52 52 43.8 ± 11.9 45.5 ± 10.4 3 Mobile app guided PFME Booklet guided PFME ②③
Wang 2020 54 54 29.2 ± 2.6 29.1 ± 2.9 6 Intelligent audio guide PFME Routine care ②
Winstein 2022 37 40 51.6 ± 14.7 52.6 ± 13.6 2 Renovia Inc. application combines PFME Routine care ③④
Ye 2022 38 37 31.1 ± 2.7 31.0 ± 2.5 0.93 Wechat application combines PFME Routine care ①④
Zhang 2019 60 60 31.0 ± 3.0 31.0 ± 3.0 1.4 Wechat application combines PFME Routine care ①④
Zhou 2017 31 31 28.23 ± 3.1 28.29 ± 3.4 1.4 Wechat application combines PFME Routine care ②③
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Note: ‘①’, incidence of urinary incontinence; ‘②’, severity of urinary incontinence symptoms; ‘③’, quality of life; ‘④’, exercise compliance.

3.2. Methodology Quality Assessment

For each area, the risk of bias was classified as high, low, or with some concerns. Figure 2 provides a summary of the methodological quality and potential biases for each study. Out of the 16 studies, 14 reported randomization methods, while 12 described allocation concealment techniques. One study demonstrated a low risk of overall bias, while 15 studies raised concerns about the overall evaluation. These concerns were typically caused by variations in randomization processes or unclear risk assessments. This is likely attributable to the challenging nature of pelvic floor muscle training interventions and the difficulties in implementing rigorous blinding methods.

Evidence certainty was evaluated via the GRADE framework (Kirmayr et al. 2021), which classifies evidence quality into four levels (high to very low) through five domains: study limitations, inconsistency, imprecision, indirectness and publication bias. The GRADEpro GDT online platform generated evidence profiles in Table S2.

3.3. Study Outcomes

3.3.1. Incidence of Postpartum Urinary Incontinence

Due to limited reports on the incidence of urinary incontinence in elderly individuals postintervention, this study examined the impact of online PFME exercises on postpartum urinary incontinence. Four studies (K. Y. Chen et al. 2024; Jin 2019; Ye et al. 2021; Zhang 2019) assessed this outcome using RRs for effect size amalgamation. The results indicated no significant heterogeneity (p = 0.17, I 2 = 41%) according to the fixed effects model. The findings demonstrated that online intervention significantly decreased the incidence of postpartum urinary incontinence compared to standard care [RR = 0.55, 95% CI = 0.38–0.82; p < 0.01], as illustrated in Figure 3.

FIGURE 3.

FIGURE 3

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Meta‐analysis results of incidence of postpartum urinary incontinence.

3.3.2. Severity of Urinary Incontinence Symptoms

A total of 11 studies (Asklund et al. 2017; Chu et al. 2023; Dufour et al. 2019; Jin 2019; Loohuis et al. 2021; Sjöström et al. 2015; Vilela et al. 2024; Wadensten et al. 2021; Wang et al. 2020; Weinstein et al. 2022; Zhou 2017) reported the effect of online pelvic floor exercise on the severity of urinary incontinence symptoms. Due to the use of different assessment tools, the SMD combined effect size was used. The results were SMD = −0.16, 95% CI = −0.27 to −0.05, p < 0.001. Heterogeneity was moderate (I 2 = 63%), as shown in Figure 4. After subgroup analysis, five studies (Loohuis et al. 2021; Sjöström et al. 2015; Vilela et al. 2024; Wadensten et al. 2021; Weinstein et al. 2022) reported the severity of symptoms in elderly patients with urinary incontinence, revealing statistically significant differences between the intervention group and the control group [SMD = −0.12, 95% CI = −0.25–0.02, p = 0.09]. Online PFME does not reduce the severity of symptoms in elderly patients with urinary incontinence. Five studies (Chu et al. 2023; Dufour et al. 2019; Sjöström et al. 2015; Wang et al. 2020; Zhou 2017) reported the severity of symptoms in postpartum patients with urinary incontinence, and the difference was statistically significant [SMD = −0.25, 95% CI = −0.45 to −0.05, p = 0.01]. Online PFME can reduce the severity of symptoms in postpartum incontinence patients, as shown in Figure 4. A funnel plot of the association of pelvic floor exercise with severity of symptoms in women with urinary incontinence over different life cycles is shown in Figure S1.

FIGURE 4.

FIGURE 4

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Meta‐analysis results of severity of urinary incontinence symptoms.

3.3.3. Quality of Life of Patients With Urinary Incontinence

Combining the effect sizes from nine studies (Araujo et al. 2020; Asklund et al. 2017; L. Chen et al. 2022; Dufour et al. 2019; Loohuis et al. 2021; Mao et al. 2022; Sjöström et al. 2015; Weinstein et al. 2022) and employing a random effects model. Our analysis showed that in‐home online PFME had no significant impact on the quality of life in urinary incontinence patients (SMD = −0.07, 95% CI = −0.39–0.24, p = 0.64), as demonstrated in Figure 5. Moreover, significant heterogeneity was observed (p < 0.001, I 2 = 84%). Subsequent subgroup analysis indicated that neither the online group nor the conventional care group had improved quality of life for postpartum patients with urinary incontinence (SMD = −0.23, 95% CI = −0.51 to −0.05, p = 0.10) or elderly patients with urinary incontinence (SMD = −0.04, 95% CI = −0.45 to 0.38, p = 0.85). These differences lacked statistical significance, as detailed in Figure 5. Figure S2 presents a funnel plot illustrating the relationship between PFME and quality of life among women experiencing urinary incontinence across various life stages.

FIGURE 5.

FIGURE 5

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Meta‐analysis results of quality of life of patients with urinary incontinence.

3.3.4. Exercise Compliance in Patients With Urinary Incontinence

Five studies (Jin 2019; Mao et al. 2022; Weinstein et al. 2022; Ye et al. 2021; Zhang 2019) investigated the impact of online PFME on patients' adherence to exercise. RRs were used to combine effect sizes, and there was no significant heterogeneity in the results (p = 0.13, I 2 = 44%). A fixed‐effects model was employed. The findings indicated a significant difference between the online group and the conventional treatment group [RR = 1.38, 95% CI = 1.22–1.55, p < 0.01], as presented in Figure 6. Two studies (Mao et al. 2022; Ye et al. 2021) examined the influence of in‐home online platforms on exercise adherence among elderly patients with urinary incontinence, and the difference was statistically significant [RR = 1.51, 95% CI = 1.22 to 1.89; p < 0.01]. Three studies (Jin 2019; Ye et al. 2021; Zhang 2019) investigated exercise adherence among postpartum urinary incontinence patients and revealed a significant difference between the online group and the conventional treatment group [RR = 1.30, 95% CI = 1.14–1.48, p < 0.01].

FIGURE 6.

FIGURE 6

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Meta‐analysis results of exercise compliance in patients with urinary incontinence.

4. Discussion

Urinary incontinence significantly impacts patients' daily lives (Hou et al. 2022). Online PFME patterns allow patients to utilize audiovisual signals for more effective contraction of the pelvic floor muscles (Woodley et al. 2023). This study aimed to analyse how online PFME affect the rehabilitation outcomes of women experiencing urinary incontinence across various life stages. Previous studies had not investigated the suitability of standardized online PFME routines for both demographics. This finding aligns with the majority of prior studies investigating the rehabilitative impact of online pelvic floor exercises on urinary incontinence (Le Berre et al. 2025; Widdison et al. 2022).

The study findings demonstrated that online PFME positively impacted exercise adherence and the incidence of postpartum urinary incontinence, as presented in Table 2. In contrast to traditional exercise methods, the online platform offers diverse intervention forms, making it easier for elderly urinary incontinence patients to comprehend. It also enhances the engagement of postpartum urinary incontinence patients and rectifies their improper exercise techniques (Firet et al. 2021). This addresses the issue of insufficient reminders and supervision in traditional training approaches (Anglès‐Acedo et al. 2021). The online platform can boost enthusiasm and enhance exercise adherence for both elderly and postpartum urinary incontinence patients. Moreover, its animations and audio features can provide pelvic floor function knowledge to patients across various life stages affected by urinary incontinence (Ri et al. 2023). Educational outreach and proactive guidance are essential for modifying unhealthy habits and mastering correct PFME techniques (van Vuuren et al. 2021). Therefore, we believe that online‐guided PFME is significantly more effective than unguided interventions in improving compliance and reducing the incidence of postpartum urinary incontinence in both postpartum and elderly patients.

TABLE 2.

The impact of online PFME on rehabilitating urinary incontinence.

Outcome index Inclusion study Heterogeneity test Effect model Result
p I 2 (%) Effect size 95% CI Z p
Incidence of postpartum urinary incontinence 4 studies 0.17 41% Fixed RR = 0.56 [0.38,0.82] 2.97 < 0.01
Symptom severity 11 studies < 0.01 63% Random SMD = −0.30 [−0.50,−0.10] 2.98 < 0.01
Quality of life 9 studies < 0.01 90% Random SMD = −0.01 [−0.40,0.38] 0.07 0.94
Exercise compliance 5 studies 0.13 44% Fixed RR = 1.38 [1.22,1.55] 5.32 < 0.01
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The analysis found that online‐guided PFME improves symptom severity in patients with postpartum urinary incontinence but is ineffective for elderly patients with urinary incontinence. This aligns with the findings of Zhu et al. (2025). This may be due to the fact that most postpartum urinary incontinence patients experience uterine compression during pregnancy and muscle fibre traction during childbirth, leading to decreased pelvic floor muscle strength and relief from postpartum compression. Furthermore, postpartum pelvic floor muscle injury occurs during the ‘acute phase’, when muscle perception has not yet deteriorated, and compensatory movements are minimal. For elderly patients, the pelvic floor muscles have been in a relaxed state for a prolonged period, leading to degeneration of muscle proprioception, along with degenerative atrophy of the pelvic floor muscles, and potentially complicated by other underlying diseases. Additionally, exercise prescriptions for elderly and postpartum urinary incontinence patients are not fully consistent. It is essential to compare pelvic floor muscle training prescriptions with varying intensities and frequencies and analyse the results.

However, prior studies have reported conflicting findings regarding the effects of online PFME on the quality of life of urinary incontinence patients (Hirakawa et al. 2013; Sherburn et al. 2011). Nonetheless, our meta‐analysis of aggregated data revealed that online PFME did not enhance the quality of life for women with urinary incontinence across various life stages compared to traditional exercises. Nevertheless, our meta‐analysis aggregated data indicating that, compared to traditional exercises, online PFME did not enhance the quality of life for women with urinary incontinence across various life stages, consistent with the findings of Kijmanawat et al. (2023). Nevertheless, research (Hoffman et al. 2017) has demonstrated that patients subjectively perceive an enhancement in their quality of life and lower quality of life scores following treatment compared to pretreatment levels. This indicates that both the intervention group and the control group had improved quality of life. Despite the absence of a significant effect on the quality of life for patients with urinary incontinence across different life stages, healthcare providers may contemplate integrating online platforms into urinary incontinence management strategies, offering resources or platforms for women with urinary incontinence to foster independent problem‐solving with minimal guidance. However, the type, duration and mode of intervention can be tailored according to the online platform and healthcare provider.

The meta‐analysis revealed significant heterogeneity among studies, stratifying women with urinary incontinence into two subgroups across different life stages: postpartum and elderly. This heterogeneity reflects variations in cognition, physiology and recovery urgency between these two groups. Although online PFME are effective for treating urinary incontinence, their applicability varies across elderly and postpartum women due to differing experiences of urinary incontinence during different life stages.

Furthermore, the online platform requires participants to undergo login verification, a notably intricate procedure for elderly patients suffering from urinary incontinence. The time available to postpartum incontinence patients is limited, and requiring multiple login verifications can diminish their motivation. The implementation of simpler technical solutions could decrease the dropout rate within online communities. In summary, while supervised online PFME cannot entirely substitute for face‐to‐face interpersonal interactions, they imply the importance of clinically assessing pelvic floor muscle strength and tension, bolstering motivation and enhancing quality of life for women experiencing urinary incontinence across various life stages.

In summary, this meta‐analysis presents evidence supporting the beneficial effects of the online PFME model on enhancing exercise adherence, reducing symptom severity in patients with urinary incontinence across various life stages, and lowering the incidence of postpartum urinary incontinence. And the integration of online platform aligns with the contemporary demands of both the medical sector and patients alike. Serving as a complementary adjunct to PFME, online seamlessly merges convenience, flexibility and time efficiency, thereby bolstering patients' self‐management capabilities and curbing treatment expenses.

4.1. Limitations

This study possesses certain limitations that warrant attention. Initially, the study overlooked the influence of intervention duration and frequency on rehabilitative outcomes when examining the effects of the online PFMT on the prognosis of urinary incontinence across various life stages. Moreover, an extended follow‐up period to assess the medium and long‐term impacts is lacking. Additionally, the small sample sizes in some of the literature may somewhat compromise the research findings. More high‐quality intervention studies should be conducted in the future to expand follow‐up mechanisms.

5. Conclusions

This meta‐analysis comprehensively evaluates the effects of online PFME on rehabilitation outcomes, aiding individuals with urinary incontinence across different life stages in making informed rehabilitation choices. It also provides practical guidance for medical professionals to develop sustainable, tailored strategies for women with urinary incontinence, supporting evidence‐based decisions by governments and medical institutions to advance online healthcare. In the future, embedding artificial intelligence algorithms into the online PFME platform to deliver personalized prescriptions and real‐time biofeedback could enhance rehabilitation accuracy, improve compliance and accelerate the integration and large‐scale adoption of digital therapy in clinical care.

Author Contributions

Yu Wang: methodology, project administration, writing – original draft. Jinyang Wang: methodology, formal analysis, conceptualization. Wanqiu Feng: resources, conceptualization. Zihan Sun: data curation. Yuanyuan Chen: software. Hailian Zhang: supervision, writing – review and editing.

Funding

The authors have nothing to report.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Figure S1: Funnel plot for Urinary Incontinence Severity Index.

IJN-32-e70177-s001.docx (19.8KB, docx)

Figure S2: Funnel plot for quality of life in patients with urinary incontinence.

IJN-32-e70177-s004.docx (15.9KB, docx)

Table S1: The Search Strategy.

IJN-32-e70177-s002.docx (14.3KB, docx)

Table S2: Certainty of the evidence (GRADE).

IJN-32-e70177-s003.docx (16.3KB, docx)

Acknowledgements

The authors thank A.J.E. for the language editing of the document.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Figure S1: Funnel plot for Urinary Incontinence Severity Index.

IJN-32-e70177-s001.docx (19.8KB, docx)

Figure S2: Funnel plot for quality of life in patients with urinary incontinence.

IJN-32-e70177-s004.docx (15.9KB, docx)

Table S1: The Search Strategy.

IJN-32-e70177-s002.docx (14.3KB, docx)

Table S2: Certainty of the evidence (GRADE).

IJN-32-e70177-s003.docx (16.3KB, docx)

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Articles from International Journal of Nursing Practice are provided here courtesy of Wiley

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