***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 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Urinary incontinence ( UI ) is a major problem in older women . Management is usually restricted to dealing with the consequences instead of treating underlying causes such as bladder dysfunction or reduced mobility . The aim of this multicenter r and omized controlled trial was to compare a group-based behavioral exercise program to prevent or reduce UI , with usual care . The exercise program aim ed to improve functional performance of pelvic floor muscle ( PFM ) , bladder and physical performance of women living in homes for the elderly . Methods Twenty participating Dutch homes were matched and r and omized into intervention or control homes using a r and om number generator . Homes recruited 6–10 older women , with or without UI , with sufficient cognitive and physical function to participate in the program comprising behavioral aspects of continence and physical exercises to improve PFM , bladder and physical performance . The program consisted of a weekly group training session and homework exercises and ran for 6 months during which time the control group participants received care as usual . Primary outcome measures after 6 months were presence or absence of UI , frequency of episodes ( measured by participants and caregivers ( not blinded ) using a 3-day bladder diary ) and the Physical Performance Test ( blinded ) . Linear and logistic regression analysis based on the Intention to Treat ( ITT ) principle using an imputed data set and per protocol analysis including all participants who completed the study and intervention ( minimal attendance of 14 sessions ) . Results 102 participants were allocated to the program and 90 to care as usual . ITT analysis ( n = 85 intervention , n = 70 control ) showed improvement of physical performance ( intervention + 8 % ; control −7 % ) and no differences on other primary and secondary outcome measures . Per protocol analysis ( n = 51 intervention , n = 60 control ) showed a reduction of participants with UI ( intervention −40 % ; control −28 % ) and in frequency of episodes ( intervention −51 % ; control −42 % ) in both groups ; improvement of physical performance ( intervention + 13 % ; control −4 % ) was related to participation in the exercise program . Conclusions This study shows that improving physical performance is feasible in institutionalized older women by exercise . Observed reductions in UI were not related to the intervention . [ Current Controlled Trials IS RCT N63368283 OBJECTIVE To evaluate the effects of Kinesiotherapy on function and level of pressure of pelvic floor muscle and quality of life ( QOL ) of a group of women with urinary incontinence ( UI ) . MATERIAL S AND METHODS This is a r and omized controlled pilot trial . Thirty women ( age 60.87±9.05 years ) were evaluated , before and after 12 weeks of treatment , for urinary loss , pelvic floor muscle function and pressure ; and quality of life ( QOL ) . Volunteers were r and omly allocated into two groups : Kinesiotherapy Group and Control Group . The Kinesiotherapy Group protocol consisted of 12 1-hour sessions with exercises to strengthen pelvic floor muscle and information for UI . The Control Group did not receive any treatment during the corresponding time . The data were analyzed by non-parametric Wilcoxon and Mann-Whitney test . The significance level was 5 % . RESULTS The Kinesiotherapy Group presented a significant improvement in urinary loss ( p=0.053 ) , pelvic floor muscle function ( p<0.006 ) and pressure ( p=0.0014 ) and in some domains of Kinǵs Health Question naire for QOL assessment : incontinence impact ( p=0.034 ) , limitations of daily activities ( p=0.025 ) , sleep and disposition ( p=0.018 ) and also gravity domains ( p=0.004 ) . No differences were found in the control group for any variables . CONCLUSION The protocol to strengthen the pelvic floor muscle used by the Kinesiotherapy Group was effective to improve the UI , QOL , function and pressure of pelvic floor muscle contraction 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 The aim of this study was to determine the efficacy of the Paula method of circular muscle training in the management of  stress incontinence ( SI ) . The theory behind this method states that activity of distant sphincters affects other muscles . In a pilot study , 59 women , mainly hospital employees , were r and omly assigned to participate in exercises according to the Paula method or pelvic floor training .  Efficacy was measured by reports of incontinence , quality of life ( I-QOL ) , pad test , and pelvic floor muscle strength ( assessed by perineometer and digital examination ) . Both the Paula exercises and pelvic floor training produced significant changes in urinary leakage compared to baseline as measured by the pad test [ mean decrease of 5.4 g ( p=0.002 ) and 9.5 g ( p=0.003 ) , respectively ] . Women r and omized to the Paula method reported improvement in I-QOL scores . The Paula method was found to be efficacious for SI in a population of Israeli women . Larger community-based studies will be required to confirm these results and enable evaluation of between-group differences Introduction and hypothesisVaginal weight cone ( VWC ) versus assisted pelvic floor muscle training ( APFMT ) in the treatment of urinary incontinence ( UI ) in women . Methods One hundred three incontinent women were r and omly distributed into two groups : group G1 ( n = 51 ) treated with VWC and G2 ( n = 52 ) , APFMT . The following parameters were performed initially and after treatment : ( 1 ) clinical question naire , ( 2 ) visual analogue scale ( VAS ) , ( 3 ) 60-min pad test , and ( 4 ) subjective and objective assessment of pelvic floor muscle ( PFM ) . Results There was a significant decrease in nocturia and urine loss after treatment in both groups ( p < 0.05 ) . In VAS , there was a significant improvement of all parameters in both groups ( p < 0.05 ) . The pad test showed significant decrease in both groups ( p < 0.05 ) . There was a significant increase of PFM strength in both groups ( p < 0.05 ) . Conclusion There was no difference between groups treated with VWC and APFMT PURPOSE To compare the effectiveness of pelvic floor exercises , electrical stimulation , vaginal cones , and no active treatment in women with urodynamic stress urinary incontinence . PATIENTS AND METHODS One hundred eighteen subjects were r and omly selected to recieve pelvic floor exercises ( n=31 ) , ES ( n=30 ) , vaginal cones ( n=27 ) , or no treatment ( untreated control ) ( n=30 ) . Women were evaluated before and after completion of six months of treatment by the pad test , quality of life question naire ( I-QOL ) , urodynamic test , voiding diary , and subjective response . RESULTS In the objective evaluation , we observed a statistically significant reduction in the pad test ( p=0.003 ) , in the number of stress urinary episodes ( p<0.001 ) , and a significant improvement in the quality of life ( p<0.001 ) in subjects who used pelvic floor exercises , electrical stimulation , and vaginal cones compared to the control group . No significant difference was found between groups in the urodynamic parameters . In the subjective evaluation , 58 % , 55 % , and 54 % of women who had used pelvic floor exercises , electrical stimulation , and vaginal cones , respectively , reported being satisfied after treatment . In the control group , only 21 % patients were satisfied with the treatment . CONCLUSION Based on this study , pelvic floor exercises , electrical stimulation , and vaginal cones are equally effective treatments and are far superior to no treatment in women with urodynamic stress urinary incontinence Introduction and hypothesisPelvic floor muscle training ( PFMT ) is a treatment for stress urinary incontinence ( SUI ) that can be done individually or in a group . The aim of this study was to compare these two types of treatment . Methods Sixty women 30 to 75 years old with SUI were r and omly assigned to participate in the two groups . They were evaluated before and after the treatment with the Oxford grading system , pad test , voiding diary , and the King ’s Health Question naire . Results Both groups experienced significant reductions in urinary leakage as measured by the pad test and bladder diary . A negative pad test was observed in about 50 % of patients in both groups . There were statistically significant improvements in both muscle strength and quality of life . When the groups were compared , there were no differences in the results between them . Conclusions Individual treatment and group PFMT appear to be equally effective for improving SUI This study was a r and omized controlled trial to investigate the effect of treating women with stress or mixed urinary incontinence ( SUI or MUI ) by diaphragmatic , deep abdominal and pelvic floor muscle ( PFM ) retraining .  Seventy women were r and omly allocated to the training ( n = 35 ) or control group ( n = 35 ) . Women in the training group received 8 individual clinical visits and followed a specific exercise program . Women in the control group performed self-monitored PFM exercises at home . The primary outcome measure was self-reported improvement . Secondary outcome measures were 20-min pad test , 3-day voiding diary , maximal vaginal squeeze pressure , holding time and quality of life . After a 4-month intervention period , more participants in the training group reported that they were cured or improved ( p < 0.01 ) . The cure/improved rate was above 90 % . Both amount of leakage and number of leaks were significantly lower in the training group ( p < 0.05 ) but not in the control group . More aspects of quality of life improved significantly in the training group than in the control group . Maximal vaginal squeeze pressure , however , decreased slightly in both groups . Coordinated retraining diaphragmatic , deep abdominal and PFM function could improve symptoms and quality of life . It may be an alternative management for women with SUI or MUI Introduction and hypothesisTo compare the effects of pelvic floor muscle training ( PFMT ) , with or without biofeedback ( BF ) , for stress urinary incontinence ( SUI ) , focusing on condition-specific quality of life ( QOL ) outcomes . Methods Women with SUI were r and omized to PFMT with BF ( BF group , n = 23 ) or without BF ( PFMT group , n = 23 ) for 12 weeks . As primary outcome measures , subjective symptoms and QOL were assessed by the King ’s Health Question naire ( KHQ ) and International Consultation on Incontinence Question naire-Short Form ( ICIQ-SF ) . A voiding diary , 1-h pad test , and measurement of PFM strength were secondary outcome measures . Changes in the primary and secondary outcomes were assessed before and after 12 weeks ’ exercise training . Results Of the 9 domains of the KHQ , the scores of 5 significantly decreased in the PFMT group , and the scores of 7 significantly decreased in the BF group . All ICIQ-SF items and the total score significantly decreased in both groups after therapy . The number of incontinence episodes significantly decreased in the PFMT group , and tended to decrease in the BF group , but this was not significant ( P = 0.054 ) . The leakage volume in the 1-h pad test tended to decrease in both groups , but was not significant . Maximum vaginal squeeze pressure significantly increased in both groups . There were no significant inter-group differences in the changes in any of the parameters assessed . Conclusions The results indicate that PFMT is effective for treating SUI . There is no apparent add-on effect of BF training in short-term follow-up OBJECTIVE : The aim of this study was to compare the effectiveness of multimodal supervised physiotherapy programs with the absence of treatment among women with persistent postnatal stress urinary incontinence . METHODS : This was a single-blind r and omized controlled trial . Sixty-four women with stress urinary incontinence were r and omly assigned to 8 weeks of either multimodal pelvic floor rehabilitation ( n = 21 ) , multimodal pelvic floor rehabilitation with abdominal muscle training ( n = 23 ) , or control non – pelvic floor rehabilitation ( n = 20 ) . The primary outcome measure consisted of a modified 20-minute pad test . The secondary outcome measures included a Visual Analog Scale describing the perceived burden of incontinence , the Urogenital Distress Inventory , the Incontinence Impact Question naire , and pelvic floor muscle function measurements . RESULTS : Two patients dropped out , leaving 62 for analysis . At follow-up , more than 70 % of the women in the treatment groups ( 14/20 in the pelvic floor and 17/23 in the pelvic floor plus abdominal group ) were continent on pad testing compared with 0 % of women in the control group . Scores on the pad test , Visual Analog Scale , Urogenital Distress Inventory , and Incontinence 
    Output:
    
After analysing the results , we conclude that the treatment of stress or mixed urinary incontinence through training exercises for the musculature of the pelvic floor contributes positively to improving symptoms and strengthening the muscles of the pelvic floor and to the quality of life of affected patients