Use of mobile fitness app to improve pelvic floor muscle training in puerperal women with gestational diabetes mellitus: A randomized controlled trial.

Abstract

Background: Gestational diabetes mellitus (GDM) is one of the risk factors for postpartum urinary incontinence. Pelvic floor muscle training (PFMT) improves pelvic floor dysfunction in puerperal women, but patient compliance is low. Mobile Health (mHealth) is a promising solution. Objective: To investigate PFMT compliance and effects on pelvic floor muscles in GDM puerperal women guided by the mobile fitness app Keep. Methods: This randomized controlled trial included puerperal women with GDM (n = 72) who were delivered at a tertiary general hospital, selected from November 2021 to April 2022 using convenience sampling, and randomly divided into control (n = 36) and experimental (n = 36) groups. The control group performed PFMT based on routine postpartum PFMT training instruction. The experimental group performed PFMT based on Keep. Both groups had a 4-week intervention period. The PFMT compliance, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Pelvic Muscle Self-efficacy Scale, and the Knowledge, Attitude, Belief, and Practice (KAP) scores of PFMT in puerperal women in the groups were compared pre- and post-intervention. Pelvic floor surface electromyographic biofeedback was used to compare the post-intervention pelvic floor muscle strength between the two groups. Results: Compared with the control group, the test group had higher post-intervention maternal PFMT compliance, pelvic floor muscle strength, pelvic floor muscle self-efficacy, and KAP scores (p < 0.05); incontinence scores were lower (p < 0.05). Pelvic floor muscles in both groups recovered better post-intervention (p < 0.05). Conclusion: The Keep app can improve PFMT adherence, urinary incontinence, KAP scores, self-efficacy, and pelvic floor muscle strength in GDM puerperal women and promote pelvic floor rehabilitation after delivery.