Adherence to Pelvic Floor Muscle Exercises and the Role of Smart Phone Apps

  • Catroina Stephen
  • Kate Stephen

Student thesis: Doctoral ThesisDoctor of Philosophy (awarded by OU/Aberdeen)


Urinary incontinence (UI) is a condition commonly experienced by women worldwide. Many women suffer in silence as they refrain from or delay seeking help. Pelvic Floor Muscle Exercises (PFME) have proven to be effective and are recommended as the first line of treatment. Regular exercise of the pelvic floor muscles can prevent symptoms developing. However, there is evidence of lack of motivation and poor adherence to exercises. The use of mobile phone applications have been suggested as an effective resource for health behaviour interventions, especially for sensitive or embarrassing conditions.
A mixed methodology was used to gather evidence about the experience of community dwelling women in the North of Scotland over a three month period. Of the twenty three participants who completed a three month explanatory randomised controlled trial, fifteen participants exercised at least daily on average by the end of the trial. Of the fifteen who exercised at least daily, five continued average exercise of at least daily at the twelve month follow-up. Taking part in the study helped women to focus on the exercises and this had a positive impact on their adherence. Eleven out of the fifteen participants with incontinence experienced an improvement in their symptoms after twelve weeks. This had a positive impact on their quality of life. Of those who experienced UI, the women who had the biggest increase in level of exercise also had the biggest improvement in symptoms.
Participants in the intervention group of the trial were provided with apps for PFME. Six out of the ten of intervention group participants who completed the trial reported that the apps were not useful and of the four who found them useful, their level of use was varied. The data from this study suggests that simply being provided with apps or equipment to use the apps cannot be linked to improved levels of participation in the study. This suggests that the provision of technology is insufficient in itself to engage with individuals in health behaviour change and has important implications for future service provision in continence promotion and mHealth.
Date of Award22 Jul 2015
Original languageEnglish
Awarding Institution
  • University of Edinburgh
SponsorsUHI Studentship, Highlands and Islands Enterprise & NHS Highland
SupervisorSarah-Anne Munoz (Supervisor), Grant Cumming (Supervisor), Abdel-Fattah Mohammed (Supervisor) & Melanie Smith (Supervisor)

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