Tibaek 2005

Methods	RCT Setting: outpatient
Participants	26 women adult stroke survivors with mixed stress/urge urinary incontinence. Inclusion: women diagnosed with first ever ischaemic stroke according to WHO definition and verified by CAT scan; stroke symptoms in at least 1 month; normal cognitive function (mini‐mental state examination score <24); UI according to ICS definition; independent walking ability indoors >100m with/without aids; independence in toilet visits; age between 40 and 85 years. Exclusion: urinary tract infection; symptom of vaginal prolapse; chronic respiratory diseases; psychiatric diseases; other neurological diseases; unable to speak Danish. Age: median 60 years
Interventions	A (14): Intervention group: "systematic, controlled, intensive pelvic floor muscle (PFM) training programme". Programme consisted of 1) introduction to theory 2) home exercises, including strength PFM exercise by performing close to maximum contraction (6 sec contraction/6 sec rest) Subjects instructed to repeat exercise programme gradually 6‐10 times in supine, standing and sitting positions, 1‐2 times daily. 3) group treatment once per week, including isolating PFM contraction (6 sec contraction/6 sec rest) and strength exercises (3 sec contraction/3 sec rest, and 6 sec contraction/6 sec rest). All techniques were repeated 4‐8 times while supine, sitting and standing, and also prior to daily activities such as rising, sitting and walking. Vaginal palpation was performed to ensure correct contraction, to evaluate contraction strength and to give feedback to subjects. B (12) Comparison group received normal, general rehabilitation with no specific treatment of urinary incontinence.
Outcomes	Two day mean voiding frequency over 24 hours: A: 7.6, B: 9.2 Two day mean daytime voiding frequency: A: 5.9, B: 7.3 Two day mean nighttime voiding frequency: A: 1.7, B: 1.9 Two day mean number of incontinence episodes/24 hours: A: 0.2, B: 1.1 Two day mean number of used pads/24 hours: A: 1.1, B: 2.0 Three day mean voiding frequency over 24 hours: A: 7.6, B: 10.0 Three day mean daytime voiding frequency: A: 5.8, B: 8.1 Three day mean nighttime voiding frequency: A: 1.7, B: 1.8 Three day mean number of incontinence episodes/24 hours: A: 0.2, B: 1.2 Three day mean number of used pads/24 hours: A: 1.1, B: 1.8 Mean function of pelvic floor muscle: A: 2.3, B: 2.2 Mean strength of pelvic floor muscle: A: 2.6, B: 2.8 Mean static endurance of pelvic floor muscle: A: 23.4, B: 21.3 Mean dynamic endurance of pelvic floor muscle: A:15.7, B: 9.8 Short Form Health Status Questionnaire (SF36) post‐intervention: A: 567, B: 595 Short Form Health Status Questionnaire (SF36) at 6 months: A: 550, B: 596 Incontinence Impact Questionnaire (IIQ) post‐intervention: A: 44, B:47 Incontinence Impact Questionnaire (IIQ) at 6 months: A: 43, B: 47
Notes	No baseline differences in age, number of births or mobility between the groups Proportions for which data reported: 92% at post‐test and 6 months
Risk of bias
Item	Authors' judgement	Description
Allocation concealment?	Yes	A ‐ Adequate