Pelvic Floor Muscle Training for Urinary Incontinence in Bedridden Patients with Multimorbidity: A Cross-Sectional Survey at Sir Ganga Ram Hospital, Lahore
DOI:
https://doi.org/10.61919/jhrr.v5i12.1942Keywords:
urinary incontinence; pelvic floor muscle training; bedridden; multimorbidity; adherence; rehabilitation.Abstract
Background: Urinary incontinence in bedridden patients with multimorbidity is common and clinically burdensome, yet evidence guiding conservative management in highly dependent populations remains limited. Objective: To evaluate continence-related outcomes associated with pelvic floor muscle training (PFMT) in bedridden patients with multimorbidity and to identify factors associated with clinically meaningful response. Methods: A cross-sectional survey was conducted at Sir Ganga Ram Hospital, Lahore (n=120). Participants reported supervised or unsupervised PFMT, adherence, and pre–post continence-related outcomes. Outcomes included weekly incontinence episodes, ICIQ-UI SF, 24-hour pad test leakage, pelvic floor strength, and continence-related quality of life impact. Paired comparisons used Wilcoxon tests with bootstrap confidence intervals and false discovery rate adjustment. Multivariable logistic regression examined predictors of responder status (≥50% reduction in weekly episodes). Results: Weekly episodes decreased from 16.0 (IQR 13.0–19.0) to 6.0 (IQR 4.0–7.2) with median change −9.0 (95% CI −10.0 to −9.0; q<0.001). All secondary outcomes improved with large effect sizes (r≈0.867; all q<0.001). Responders comprised 103/120 (85.8%). Adherence independently predicted response (aOR 2.74 per 0.1 increase; 95% CI 1.65–4.55; p<0.001). Conclusion: In this bedridden multimorbid sample, PFMT was associated with large improvements across continence outcomes, and adherence was the key independent correlate of clinically meaningful response.
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