***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Introduction and hypothesisOur goal was to compare the long-term efficacy of bladder training ( BT ) , pelvic floor muscle training ( PFMT ) , combined pelvic floor rehabilitation ( CPFR ) , and drug therapy ( DT ) in patients with urgency urinary incontinence ( UUI ) . Methods This multicenter single-blind r and omized controlled trial compared the efficacy of BT , PFMT , DT , and CPFR at baseline and 3- and 12-month follow-ups . Outcome measures included number of voids/24 h , number of UUI episodes , Quality of Life related to UUI ( QOL-rUI ) , urogynecologic visual analog scale , and self-reported function and disability . Results A significant improvement was found for all treatment groups at 3 and 12 months in urinary frequency , UUI episodes , QOL-rUI , and number of daily pads . Only CPFR showed a significant decrease of 4 voids/24 h and a significant increase in self-reported function . Conclusions The study demonstrated long-term benefits of DT , BT , PFMT , and CPFR in the treatment of UUI with a slight advantage for CPFR Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials The purpose of this study is to compare the effectiveness of oxybutynin , functional electrostimulation ( FES ) , and pelvic floor training ( PFT ) for treatment of women with detrusor overactivity . Sixty-four subjects were r and omized to oxybutynin ( n = 22 ) , FES ( n = 21 ) , or PFT ( n = 21 ) . Women were evaluated before and after completion of 12 weeks of treatment by subjective response , voiding diary , and urodynamic test . There was subjective symptomatic improvement in 77 % of the women treated with oxybutynin , 52 % with FES , and 76 % with PFT .  Urgency resolved in 64 % of women treated with oxybutynin , 52 % with FES , and in 57 % with PFT .  Urodynamic evaluation was normal in 36 % treated with oxybutynin , 57 % with FES , and 52 % with PFT .  Maximum detrusor involuntary contraction pressure decreased in all groups ( p < 0.05 ) . All treatments were equally effective . Subjective reduction of urge-incontinence episodes was associated with symptomatic improvement OBJECTIVES To investigate whether the combination of tolterodine plus ( Tp ) a simple pelvic floor muscle exercise ( PFME ) program would provide improved treatment benefits compared with tolterodine alone ( Ta ) in patients with symptoms of overactive bladder ( OAB ) . METHODS After a 1 - 2 week run-in period , 480 patients with symptoms of urinary frequency ( > or = 8 micturitions/24 hr ) , urgency , and urge incontinence ( > or = 1 episode/24 hr ) , were r and omized to receive tolterodine 2 mg bid with or without a simple PFME program for 24 weeks in this multinational study . Treatment efficacy was assessed by comparing the change from baseline in 3-day micturition diary recordings . RESULTS After 24 weeks ' treatment , in the Ta group the urgency episodes reduced from mean of 4.1 to 1.5 ( 83 % reduction ) while in the Tp group the urgency episodes reduced from 4.2 to 2.1 ( 78.7 % reduction ) . Mean incontinence episodes per day decreased from 3.21 ( st and ard deviation ( SD ) 3.4 ) to 0.95 ( SD 1.9 ) in Ta group and from 3.44 ( SD 3.4 ) to 1.25 ( SD 2.7 ) in the Tp group . Similarly , the number of micturition/24 hr were significantly reduced , from 12.78 to 9.20 ( 27.3 % reduction ) in the Ta group and from 11.87 to 9.29 ( 23 % reduction ) in the Tp group . There was an improvement in the patients ' perception of urinary symptoms in 85.9 % of patients on Ta and 81.7 % patients on Tp PFME . There were no statistically significant differences between the groups with regard to any of the outcome parameters . CONCLUSIONS Tolterodine therapy for 24 weeks results in significant improvement in urgency , frequency , and incontinence , however , no additional benefit was demonstrated for a simple PFME program The objective of this study was to compare the short-term effectiveness of rehabilitation treatment with a st and ard drug treatment for urge urinary incontinence ( UUI ) . The study design includes parallel clinical trial in an outpatient urogynecologic clinic setting . The subjects were 44 women who suffered from UUI and who were systematic ally assigned to a rehabilitation group ( REH )  ( N=24 ) or a medication group  ( MED ) ( N=20 ) . The intervention for REH was consisted of five visits during a 3-month period of pelvic floor muscle training and behavioral training , whereas for MED was extended release oxybutynin at 5 mg/day , for 3 months . The urinary symptoms considered were frequency of voiding per day and night ( freq/day and freq/night ) , number of incontinent episodes per week based on a bladder diary , and data based on the Incontinence Quality of Life Instrument ( I-QoL ) . In the within-group comparison , both groups had improved significantly over time with respect to urinary symptoms and I-QoL ( p<0.01 ) . In addition , there was a significant group – time interaction effect on freq/day . While REH improved during the 3-month follow-up period , the MED group deteriorated to mean baseline value ( p<0.01 ) . A significant negative association was found between the urinary symptoms and the I-QoL at the end of follow-up ( rp=−0.35 to −0.62 , p<0.05 ) . Three months after the intervention , both groups maintained the achievements of the intervention period . In addition , the REH group demonstrated additional improvement in mean freq/day while the condition of MED patients deteriorated to baseline values CONTEXT Previous research on urge urinary incontinence has demonstrated that multicomponent behavioral training with biofeedback is safe and effective , yet it has not been established whether biofeedback is an essential component that heightens therapeutic efficacy . OBJECTIVE To examine the role of biofeedback in a multicomponent behavioral training program for urge incontinence in community-dwelling older women . DESIGN Prospect i ve , r and omized controlled trial conducted from April 1 , 1995 , to March 30 , 2001 . SETTING University-based outpatient continence clinic in the United States . PATIENTS A volunteer sample of 222 ambulatory , nondemented , community-dwelling women aged 55 to 92 years with urge incontinence or mixed incontinence with urge as the predominant pattern . Patients were stratified by race , type of incontinence ( urge only vs mixed ) , and severity ( frequency of accidents ) . INTERVENTIONS Patients were r and omly assigned to receive 8 weeks ( 4 visits ) of biofeedback-assisted behavioral training ( n = 73 ) , 8 weeks ( 4 visits ) of behavioral training without biofeedback ( verbal feedback based on vaginal palpation ; n = 74 ) , or 8 weeks of self-administered behavioral treatment using a self-help booklet ( control condition ; n = 75 ) . MAIN OUTCOME MEASURES Reduction in the number of incontinence episodes as documented in bladder diaries , patients ' perceptions and satisfaction , and changes in quality of life . RESULTS Intention-to-treat analysis showed that behavioral training with biofeedback yielded a mean 63.1 % reduction ( SD , 42.7 % ) in incontinence , verbal feedback a mean 69.4 % reduction ( SD , 32.7 % ) , and the self-help booklet a mean 58.6 % reduction ( SD , 38.8 % ) . The 3 groups were not significantly different from each other ( P = .23 ) . The groups differed significantly regarding patient satisfaction : 75.0 % of the biofeedback group , 85.5 % of the verbal feedback group , and 55.7 % of the self-help booklet group reported being completely satisfied with treatment ( P = .001 ) . Significant improvements were seen across all 3 groups on 3 quality -of-life instruments , with no significant between-group differences . CONCLUSIONS Biofeedback to teach pelvic floor muscle control , verbal feedback based on vaginal palpation , and a self-help booklet in a first-line behavioral training program all achieved comparable improvements in urge incontinence in community-dwelling older women . Patients ' perceptions of treatment were significantly better for the 2 behavioral training interventions OBJECTIVE To compare the efficacy of pelvic floor muscle exercises ( PFME ) using weighted vaginal cones ( WVC ) on the symptoms , clinical findings , urodynamic findings and quality of life ( QoL ) in overactive bladder ( OAB ) patients with tolterodine . STUDY DESIGN Thirty-nine patients with urinary frequency ( ≥ 8/day ) , nocturia ( ≥ 2/night ) , urgency and a total score of ≥ 8 to the overactive bladder-awareness tool ( OAB-V8 ) were diagnosed as OAB and were r and omized into two treatment groups ; WVC and extended release tolterodine ( tolterodine ER ) 4 mg/day for 8 weeks . Results of the clinical findings , 3-day urinary diary , vali date d question naires for symptom bother and QoL ( Urinary distress inventory ( UDI-6 ) , incontinence impact question naire ( IIQ-7 ) , OAB-V8 , Wagner question naire ) and urodynamic examination before and after treatment were compared . RESULTS A reduction of frequency , nocturia and urinary incontinence was observed in WVC group ( p=0.006 , p=0.034 and p=0.008 , respectively ) and in tolterodine group ( p<0.001 , p=0.002 and p=0.035 , respectively ) . 24-h dry pad test results were improved significantly in both groups ( p=0.003 and p=0.001 , respectively ) . Pelvic muscle strength was significantly improved in WVC group but not in tolterodine group ( p=0.010 and p=0.180 , respectively ) . UDI-6 , IIQ-7 , OAB-V8 scores were improved significantly in both groups . Improvements in Wagner question naire were observed in WVC group but not in tolterodine group ( p=0.002 and p=0.591 , respectively ) . First sensation of bladder filling was significantly improved after WVC treatment but not in tolterodine group ( p=0.035 and p=0.550 , respectively ) . After treatment , detrusor overactivity ( DO ) resolved in 8 patients in the WVC group ( p=0.003 ) and in 2 patients in the tolterodine group ( p=0.426 ) . CONCLUSIONS WVC treatment seems to be an efficacious therapeutic option for the improvement of overactive bladder syndrome ( OABS ) Study Type – Symptom prevalence ( prospect i ve cohort A recent study by the senior author demonstrated that striated urethral sphincter contraction effected the inhibition of vesical contraction and suppression of the desire to micturate , an action suggested to be mediated through the " voluntary urinary inhibition reflex " . We hypothesized that the effect of pelvic floor muscle ( PFM ) exercises on the overactive bladder was mediated through this reflex action . The current communication investigates this hypothesis . A total of 28 patients ( mean age 44.8±10.2 years , 18 men , 10 women ) with overactive bladder and 17 healthy volunteers ( mean age 42.6±9.8 years , 12 men , 5 women ) were enrolled in the study . The vesical and posterior urethral pressures were determined before and after vesical filling reached the volume at which urge in control subjects , and involuntary voiding in the patients , occurred . Intra-abdominal pressure was recorded to obtain detrusor pressure readings . The bladder was refilled to the above volume and the subject asked to hold PFM contractions for 10 s during which the vesical and posterior urethral pressures were recorded . In healthy volunteers , the mean detrusor and posterior urethral pressures at urge to void were 30.6±4.8 SD and 18.7±3.3 cm H2O , respectively . On PFM 
    Output:
    
PFMT , with the objective of controlling urgent micturition , demonstrated improvements in quality of life in women with OAB .