255 - Can exercising with the Function Re-adaptive Exercise Device (FRED) improve stress incontinence in women following childbirth? (BabyFRED)

Purpose: Urinary Stress Incontinence (USI), defined as an unintentional leakage of urine due to weakness of, or lack of control in, the pelvic floor muscles, is very common in women following childbirth, with approximately 36% of postpartum women experiencing USI (Senturk Erenel & Cicek Ozdemir, 2022). In 1948 Dr Arnold Kegal described an exercise regime (Huang & Chang, 2021) of voluntarily contracting the pelvic floor by pulling the pelvic floor inwards and upwards, then relaxing them. These exercises are now commonly known as Kegals, or pelvic floor muscle training exercises. Kegels exercises are difficult to perform for roughly 30% of the symptom-free population (Mateus Vasconcelos et al., 2018) and up to 70% of symptomatic USI patients (Tibaek & Dehlendorff, 2014). Despite the high prevalence of USI, treatment uptake is very low (Yount et al., 2021), which is a common pattern seen across multiple countries and cultural identities (Zhai et al., 2020). Perceived shame (Juszczak et al., 2021), a sense of inevitability following birth (Perera et al., 2014), and attitudes of USI being “normal” by healthcare professionals (Terry et al., 2020), have been blamed for the low-treatment uptake for USI. Even when treatment is sought, traditional Kegal’s exercises may only be effective in a small number of patients (Johannessen et al., 2021).The overall aim of this study is to reduce symptoms of Urinary Stress Incontinence (USI), experienced as a sequelae of childbirth, by using a novel exercise device (the Functional Re-adaptive Exercise Device, FRED) that promotes automatic, non-invasive activation of the pelvic floor muscles. The objectives of this study are to determine (1) the effectiveness of 12 sessions over four weeks of FRED intervention on exercise-induced stress incontinence, (2) the experiences of postpartum women and people who have given birth who have in performing the exercise, and (3) their tolerance and acceptability to the exercise intervention.

Methods: N=20 women and people who had given birth in the last 12 years. The study consisted of 12 exercise intervention sessions, either twice a week over 6 weeks or 3 times a week for 4 weeks, of Functional Re-adaptive Exercise Device. Pre- and Post intervention data collection included 1-hour exercise stress test pad weight, FRED movement variability and patient reported outcome measures. These questionnaires included The Questionnaire for female Urinary Incontinence Diagnosis (QUID), International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSqol), Treatment Self-Regulation Questionnaire (TSRQ),Perceived Competence (Exercising Regularly) PCS ER Questionnaire, Health care Communication Questionnaire and bespoke BabyFRED specific questions. the final data collection was a 12-week email questionnaire follow-up

Results: Data collection is June to finish in June 2024. The pilot study preliminary results will be discussed

Conclusion(s): Data collection is June to finish in June 2024. The pilot study preliminary results will be discussed

Impact: BabyFRED is a proof-of-concept pilot study which potentially provides the first exercise intervention which automatically recruits the pelvic floor muscles offering annon-invasive treatment for USI.

Funding acknowledgements: This project was kindly supported by a grant from the Private Physiotherapy Education Foundation number 382