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CompletedNCT03296462HER-PhysioUpdated May 26, 2022

Hip External Rotation Physical Therapy Trial

An interventional study of Hip external rotation exercise and Pelvic floor muscle exercise in Urinary Incontinence, Stress, sponsored by University of Alberta. Completed at 1 site in Canada. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-05-26.

Sponsored by University of Alberta · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
31
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

This RCT is a feasibility study to evaluate the Lois Hole Hospital for Women's Urogynecology Clinic's ability to recruit and randomize SUI patients to the proposed RCT, and to test the study procedures and follow-up schedule for participants.

The study interventions used in the feasibility study will be training of (1) Hip Extension Rotation (HER) exercises alone, (2) HER exercises in combination with Pelvic Floor Muscle (PFM) exercises, or (3) PFM exercises alone (control/usual care) in the treatment of SUI.

Read the detailed description

Background: Hip External Rotation (HER) exercises are being adopted into physiotherapy practice for the treatment of stress urinary incontinence (SUI) despite little evidence compared to the proven effective standard of care treatment, pelvic floor muscle (PFM) exercises. A randomised clinical trial (RCT) is needed to determine whether HER exercise alone or in combination with PFM is more or less effective than PFM exercises alone.

Objective: Before designing an RCT, a feasibility study is needed to evaluate the Lois Hole Hospital for Women's Urogynecology Clinic's ability to recruit and randomize SUI patients to the proposed RCT, and to test the study procedures and follow-up schedule for participants.

Interventions: The interventions used in the feasibility study will be training of (1) HER exercises alone, (2) HER exercises in combination with PFM exercises, or (3) PFM exercises alone (control/usual care) in the treatment of SUI.

Study design: RCT in which participants are randomly allocated 1:1:1 to each intervention.

Outcome Measures: Feasibility outcomes will pertain to recruitment, adherence to training, appropriateness of outcome measures and completion rates. The design of the proposed RCT will be based on these feasibility outcomes.

Outcome measures for the proposed RCT will include pelvic floor muscle strength, external hip rotator muscle strength, diary-reported urinary incontinence, incontinence related quality of life, and (to test patient mobility) six minute walk test and timed up and go test.

Sample size: The proposed sample size is 30 participants. Duration of study: After recruitment, each woman will undergo 12 weeks of training, with the first outcome measure at the end of that period, and a further follow up at 24 weeks from recruitment.

02

Conditions studied

03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Stress urinary incontinence
  • Attending Lois Hole Hospital for Women Urogynecology Clinic
  • Referred for physiotherapy for stress urinary incontinence
  • Able to toilet independently
  • Able to undertake hip rotation exercises
  • Able to speak and read English

Exclusion criteria

Exclusion Criteria:

  • Urge urinary incontinence
  • Using a pessary
  • Neurological or cognitive impairment
  • Using other treatment for incontinence
  • Unable to complete study forms
  • Unable to understand educational instruction
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
31 participants (actual)

Study arms

  • Experimental
    Hip external rotation exercise (alone)

    Standardised hip external rotation exercise training - over 12 week period

    Other: Hip external rotation exercise

  • Experimental
    Hip external rotation + PFM exercises

    Standardised hip external rotation plus pelvic floor muscle exercises - over 12 week period

    Other: Hip external rotation exercise · Other: Pelvic floor muscle exercise

  • Active comparator
    pelvic floor muscle exercises (alone)

    Standardised pelvic floor muscle exercises - over 12 week period (usual care)

    Other: Pelvic floor muscle exercise

Interventions

  • OtherHip external rotation exercise

    Standardised HER exercise training by physiotherapist (plus video recording of exercises)

  • OtherPelvic floor muscle exercise

    Standardised PFM exercise training by physiotherapist (plus video recording of exercises)

05

What researchers measure

Primary outcomes

  1. Feasibility: achieve recruitment of 30 women over 12 months

    Is recruitment feasible? "Feasibility" is defined as achieving recruitment target of 30 recruits within 12 months

    Time frame: 12 months

  2. Feasibility: achieve follow-up for 60% of recruits over 12 months

    Is follow-up complete for 60% of recruits?

    Time frame: 12 months

Secondary outcomes

  1. Pelvic floor muscle strength

    Strength will be measured using Peritron perineometer

    Time frame: 12 & 24 weeks

  2. External hip rotator muscle strength

    Strength will be measured using Microfit ET3

    Time frame: 12 & 24 weeks

  3. Diary-reported urinary incontinence

    3-day bladder diary to record amount and reason for leakage

    Time frame: 12 & 24 weeks

  4. Incontinence-related quality of life (distress)

    UDI-6 questionnaire (measure of distress caused by incontinence, 0 minimum to 100 maximum)

    Time frame: 12 & 24 weeks

  5. Incontinence-related quality of life (impact)

    IIQ-7 questionnaire (measure of impact of incontinence, 0 minimum to 100 maximum)

    Time frame: 12 & 24 weeks

  6. Patient mobility (walking)

    Six minute walk test - distance walked (metres)

    Time frame: 12 & 24 weeks

  7. Patient mobility

    "timed up and go" test - time in sconds

    Time frame: 12 & 24 weeks

06

Study locations

1 site
  • Lois Hole Hospital for Women, Royal Alexandra Hospital
    Edmonton, Alberta T5H 3V9, Canada
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03296462
Lead sponsor
University of Alberta
Collaborators
Physiotherapy Alberta - College + Association
Responsible party
Sponsor
First posted
Sep 28, 2017
Start date
Nov 3, 2016
Primary completion
Jul 10, 2019
Completion
Jul 10, 2019
Last update
May 26, 2022

Study contacts

Sue Ross, PhD
study director · University of Alberta

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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